by Jason Wasserman MD PhD FRCPC
November 9, 2022
Reactive 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 chemical gastropathy.
The inside of the stomach is covered by specialized foveolar cells which produce a substance called mucus. The mucus protects the cells from the strong acids normally found in the stomach. In reactive 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 reactive gastropathy can come from inside the body or they can be from a source outside of the body. The most common cause of reactive 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 reactive gastropathy.
The damage causes abdominal pain which is often worse after a meal.
If left untreated, reactive gastropathy can lead to ulcers or bleeding in the stomach.
The diagnosis of reactive gastritis 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 reactive gastropathy: