Erosive gastritis

What is erosive gastritis?

Erosive gastritis is a type of injury inside the stomach. It results in a loss of specialized epithelial cells that normally form a barrier on the inside surface of the stomach. Erosive gastritis can be caused by prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs) such as Aspirin and Advil, alcohol, iron pills, stress, physical injury, chemotherapy, or radiation therapy to the stomach.

Erosive gastritis is a serious medical condition that needs to be treated quickly to prevent further injury to the stomach. After reviewing your pathology report, your doctors will attempt to determine the cause of erosive gastritis. Make sure to tell your doctors about any medications you are taking or have recently stopped.

Continue reading to learn more about your pathology report for erosive gastritis.

The stomach

The stomach is part of the gastrointestinal tract. When we eat, food enters the mouth and travels down the esophagus into the stomach. Once in the stomach, the food is mixed with a strong acid which breaks the food down into very small particles. This process is called digestion. The digested food particles are then either absorbed into the bloodstream or removed from the body as waste.

The tissue on the inner surface of the stomach is made up of specialized epithelial cells that form a barrier called the epithelium. In the stomach, the epithelium forms long downward finger-like projections called glands. The cells at the top of the glands are called foveolar cells and they protect the stomach from the strong acid used to break down food. The types of cells found lower down in the glands varies based on the location in the stomach. Underneath the surface epithelium is a thin layer of connective tissue called the lamina propria which supports the surface cells. Together, the glands and lamina propria are called the mucosa.

How do pathologists make this diagnosis?

The diagnosis is usually made after a small sample of tissue is removed in a procedure called a biopsy. When examined under the microscope, the epithelium on the inner surface of the stomach is damaged or completely lost. Pathologists describe this as an erosion. The loss of epithelium leaves the tissue below exposed to the acids inside the stomach. This can lead to pain and bleeding. A combination of acute and chronic inflammatory cells may also be seen. Your pathologist may order additional tests such as immunohistochemistry or special stains to look for bacteria that may be causing gastritis.

by Jason Wasserman MD PhD FRCPC (updated December 2, 2021)
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