Reactive gastropathy

Reactive gastropathy
Micrograph of a reactive gastropathy. H&E stain.
Classification and external resources
eMedicine	article/1962893

In gastroenterology, reactive gastropathy, also chemical gastropathy, is an abnormality in the stomach caused by chemicals, e.g. bile, alcohol, and characteristically has minimal inflammation.

Diagnosis

The diagnosis is by examination of tissue, e.g. a stomach biopsy.

It is characterized, histologically, by:^[1]

foveolar hyperplasia with gland tortuosity and dilation,
smooth muscle hyperplasia in the lamina propria, and
scant or minimal inflammation, i.e. lack of large numbers of neutrophils and plasma cells.

Etiology

Reactive gastropathy has a large number of causes, including:

Alcohol abuse.
Bile reflux, such as may be seen post-Billroth II.
NSAIDs.

Relation to gastritis

Reactive gastropathy is morphologically distinct entity^[2]^[3] that can be separated from gastritis, which by definition has a significant inflammatory component.

As a reactive gastropathy may mimic a (true) gastritis symptomatically and visually in an endoscopic examination, it may incorrectly be referred to as a gastritis. Even aware of the underlying etiology of the pathologic process, e.g. NSAID use, the label "chemical gastritis" is applied to a chemical gastropathy.

Additional images

Low mag.
High mag.

References

↑ Genta, RM. (Nov 2005). "Differential diagnosis of reactive gastropathy.". Semin Diagn Pathol 22 (4): 273–83. doi:10.1053/j.semdp.2006.04.001. PMID 16939055.
↑ Pashankar, DS.; Bishop, WP.; Mitros, FA. (Nov 2002). "Chemical gastropathy: a distinct histopathologic entity in children.". J Pediatr Gastroenterol Nutr 35 (5): 653–7. doi:10.1097/00005176-200211000-00012. PMID 12454581.
↑ Dixon, MF.; O'Connor, HJ.; Axon, AT.; King, RF.; Johnston, D. (May 1986). "Reflux gastritis: distinct histopathological entity?". J Clin Pathol 39 (5): 524–30. doi:10.1136/jcp.39.5.524. PMC 499914. PMID 3722405.

External links

Reactive gastropathy - surgical pathology criteria (standford.edu).

Diseases of the digestive system (primarily K20–K93, 530–579)

Upper GI tract

Esophagus	Esophagitis Candidal Eosinophilic Herpetiform Rupture Boerhaave syndrome Mallory-Weiss syndrome UES Zenker's diverticulum LES Barrett's esophagus Esophageal motility disorder Nutcracker esophagus Achalasia Diffuse esophageal spasm Gastroesophageal reflux disease (GERD) Laryngopharyngeal reflux (LPR) Esophageal stricture Megaesophagus

Stomach	Gastritis Atrophic Ménétrier's disease Gastroenteritis Peptic (gastric) ulcer Cushing ulcer Dieulafoy's lesion Dyspepsia Pyloric stenosis Achlorhydria Gastroparesis Gastroptosis Portal hypertensive gastropathy Gastric antral vascular ectasia Gastric dumping syndrome Gastric volvulus

Lower GI tract:
Intestinal/
Enteropathy

Small intestine (Duodenum/Jejunum/Ileum)	Enteritis Duodenitis Jejunitis Ileitis Peptic (duodenal) ulcer Curling's ulcer Malabsorption: Coeliac Tropical sprue Blind loop syndrome Small bowel bacterial overgrowth syndrome Whipple's Short bowel syndrome Steatorrhea Milroy disease bile acid malabsorption

Large intestine (Appendix/Colon)	Appendicitis Colitis Pseudomembranous Ulcerative Ischemic Microscopic Collagenous Lymphocytic Functional colonic disease IBS Intestinal pseudoobstruction / Ogilvie syndrome Megacolon / Toxic megacolon Diverticulitis/Diverticulosis

Large and/or small	Enterocolitis Necrotizing Gastroenterocolitis IBD Crohn's disease Vascular: Abdominal angina Mesenteric ischemia Angiodysplasia Bowel obstruction: Ileus Intussusception Volvulus Fecal impaction Constipation Diarrhea Infectious Intestinal adhesions

Rectum	Proctitis Radiation proctitis Proctalgia fugax Rectal prolapse Anismus

Anal canal	Anal fissure/Anal fistula Anal abscess Anal dysplasia Pruritus ani

GI bleeding/BIS

Accessory

Liver	Hepatitis Viral hepatitis Autoimmune hepatitis Alcoholic hepatitis Cirrhosis PBC Fatty liver NASH Vascular Budd-Chiari syndrome Hepatic veno-occlusive disease Portal hypertension Nutmeg liver Alcoholic liver disease Liver failure Hepatic encephalopathy Acute liver failure Liver abscess Pyogenic Amoebic Hepatorenal syndrome Peliosis hepatis Metabolic disorders Wilson's Disease Hemochromatosis

Gallbladder	Cholecystitis Gallstones/Cholecystolithiasis Cholesterolosis Rokitansky-Aschoff sinuses Postcholecystectomy syndrome Porcelain gallbladder

Bile duct/ Other biliary tree	Cholangitis Primary sclerosing cholangitis Secondary sclerosing cholangitis Ascending Cholestasis/Mirizzi's syndrome Biliary fistula Haemobilia Gallstones/Cholelithiasis Common bile duct Choledocholithiasis Biliary dyskinesia Sphincter of Oddi dysfunction

Pancreatic	Pancreatitis Acute Chronic Hereditary Pancreatic abscess Pancreatic pseudocyst Exocrine pancreatic insufficiency Pancreatic fistula

Abdominopelvic

Hernia	Diaphragmatic Congenital Hiatus Inguinal Indirect Direct Umbilical Femoral Obturator Spigelian Lumbar Petit's Grynfeltt-Lesshaft Undefined location Incisional Internal hernia

Peritoneal	Peritonitis Spontaneous bacterial peritonitis Hemoperitoneum Pneumoperitoneum

Inflammation

Acute

Plasma derived mediators

Cell derived mediators

preformed:	Lysosome granules biogenic amines Histamine Serotonin

synthesized on demand:	cytokines IFN-γ IL-8 TNF-α IL-1 eicosanoids Leukotriene B4 Prostaglandins Nitric oxide Kinins

Chronic

Processes

Traditional:	Rubor Calor Tumor Dolor (pain) Functio laesa

Modern:	Acute-phase reaction/Fever Vasodilation Increased vascular permeability Exudate Leukocyte extravasation Chemotaxis

Specific locations

mouth	Stomatitis Gingivitis Gingivostomatitis Glossitis Tonsillitis Sialadenitis/Parotitis Cheilitis Pulpitis Gnathitis

tract	Esophagitis Gastritis Gastroenteritis Enteritis Colitis Enterocolitis Duodenitis Ileitis Caecitis Appendicitis Proctitis

accessory	Hepatitis Ascending cholangitis Cholecystitis Pancreatitis Peritonitis

Integumentary

Musculoskeletal

Arthritis
Dermatomyositis
soft tissue
Osteochondritis: Osteitis/Osteomyelitis
- Spondylitis
- Periostitis
Chondritis

Urinary

Reproductive

female:	Oophoritis Salpingitis Endometritis Parametritis Cervicitis Vaginitis Vulvitis Mastitis

male:	Orchitis Epididymitis Prostatitis Seminal vesiculitis Balanitis Posthitis Balanoposthitis

pregnancy/newborn:	Chorioamnionitis Funisitis Omphalitis

Endocrine

Lymphatic

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