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Pathology of Reactive Gastropathy

Overview

Reactive gastropathy refers to the constellation of endoscopic and histologic findings caused by chemical injury to the gastric mucosa.
The histologic picture is characterized by foveolar hyperplasia with edema, smooth muscle hyperplasia, and congestion of superficial capillaries in the lamina propria in the absence of significant inflammation (see an example in the image below).

Mild reactive gastropathy involving gastric antral

Mild reactive gastropathy involving gastric antral mucosa (original magnification 200×).

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These features were originally described in biopsy specimens obtained from patients who had undergone gastric surgery and were felt to be specific for bile reflux.
It has since become apparent, however, that the constellation of histologic features seen in reactive gastropathy is a nonspecific response to chemical injury of the gastric mucosa.

Reactive gastropathy has also been referred to as chemical gastropathy, reflux gastritis, and type C gastritis.
The term “chemical gastropathy” was recommended by the Updated Sydney System,
because it indicates an underlying chemical injury that is not associated with infection.

Go to Peptic Ulcer Disease for complete information on this topic.

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