by Jason Wasserman MD PhD FRCPC
March 7, 2023
Chemical gastropathy is a condition that develops when substances such as non-steroidal anti-inflammatory drugs (NSAIDs), alcohol, or bile damage the cells that cover the inside of the stomach. Another name for this condition is reactive gastropathy.
The damage causes abdominal pain which is often worse after a meal.
If left untreated, chemical gastropathy can lead to ulcers or bleeding in the stomach.
The inside of the stomach is covered by specialized foveolar cells which produce a substance called mucus. Mucus protects the cells from the strong acids normally found in the stomach. In chemical gastropathy, the foveolar cells have become damaged by substances not normally found in the stomach. This damage prevents the foveolar cells from producing mucus.
The substances that cause chemical gastropathy can come from inside the body or they can be from a source outside of the body. The most common cause of chemical gastropathy is the movement of bile or pancreatic secretions into the stomach from the small bowel. This is called reflux. Other causes include alcohol and non-steroidal anti-inflammatory drugs (NSAIDs). Smoking has also been shown to cause chemical gastropathy.
The diagnosis of chemical gastropathy is made after a pathologist examines a tissue sample from the inside of the stomach under the microscope. The tissue sample is removed in a procedure called a biopsy. The biopsy is usually performed after the patient is sedated and a camera called an endoscope is inserted into the stomach.
The following microscopic features are typically seen in chemical gastropathy: