Injury to the gastric mucosa leads to epithelial cell damage and regeneration. The term gastritis is used to denote inflammation associated with gastric mucosal injury. Epithelial cell damage and regeneration without associated inflammation is properly referred to as "gastropathy" [1,2]. (See "Classification and diagnosis of gastritis and gastropathy".)
The causes, natural history, and therapeutic implications of gastropathy differ from gastritis:
●Gastropathy is usually caused by gastric irritants medications (such as nonsteroidal anti-inflammatory drugs [NSAIDs]), ethanol ingestion, bile reflux, or by mucosal ischemia or vascular congestion. Gastritis is usually due to an infectious agent (such as Helicobacter pylori), an autoimmune disorder, or rarely a hypersensitivity reaction.
Most classification systems distinguish acute, short-term gastropathy from chronic, long-term disease. The terms acute and chronic are also used in patients with gastritis to describe the type of inflammatory cell infiltrate. Acute gastritis is associated with neutrophilic infiltration, while chronic gastritis is characterized by mononuclear cells, chiefly lymphocytes, plasma cells, and macrophages. A practical clinicopathologic framework for the classification of gastritis and gastropathy based upon these factors can be proposed (table 1) .
This topic review will discuss acute hemorrhagic and erosive gastropathy and chronic chemical gastropathy. The classification and diagnosis of gastritis and gastropathy, and the causes of acute and chronic gastritis are presented separately. (See "Classification and diagnosis of gastritis and gastropathy" and "Acute and chronic gastritis due to Helicobacter pylori".)