Acute hemorrhagic erosive gastropathy and chronic chemical gastropathy
- Pamela J Jensen, MD
Pamela J Jensen, MD
- Attending Pathologist
- Texas Health Presbyterian Hospital Dallas
- Mark Feldman, MD, MACP, AGAF, FACG
Mark Feldman, MD, MACP, AGAF, FACG
- Section Editor — Acid Peptic Disease
- Texas Health Presbyterian Hospital Dallas
- Clinical Professor of Internal Medicine
- University of Texas Southwestern Medical School at Dallas
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".)
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- ACUTE HEMORRHAGIC AND EROSIVE GASTROPATHY
- Clinical features
- - Ulceration
- - Common causative agents
- Treatment and prevention
- CHRONIC CHEMICAL GASTROPATHY
- Clinical features
- Chronic NSAID-associated chronic chemical gastropathy
- Bile reflux chronic chemical gastropathy
- - Diagnosis
- - Treatment
- Alcohol and other possible causes of chronic chemical gastropathy
- SUMMARY AND RECOMMENDATIONS
- Acute hemorrhagic and erosive gastropathy
- Chronic chemical gastropathy