Gastric inflammatory disease can be broadly categorized into gastritides and gastropathies. Gastritis is predominantly an inflammatory process while gastropathy demonstrates minimal to no inflammation. The term gastritis is used to denote inflammation associated mucosal injury. However, epithelial cell injury and regeneration are not always accompanied by mucosal inflammation. This distinction has caused considerable confusion since the term "gastritis" is often used to describe endoscopic or radiologic characteristics of the gastric mucosa rather than specific histologic findings. Epithelial cell damage and regeneration with minimal or no associated inflammation is properly referred to as "gastropathy."
The causes, natural history, and therapeutic implications of gastropathy differ from gastritis:
- Gastritis is commonly secondary to infectious or autoimmune etiologies, although it can also result from drugs, hypersensitivity reactions, or extreme stress reactions.
- Gastropathy is commonly secondary to endogenous or exogenous irritants, such as bile reflux, alcohol, or aspirin and nonsteroidal antiinflammatory drugs. However, gastropathy can also be secondary to ischemia, stress, or chronic congestion.
"Gastritis" is a term often used by endoscopists to describe the gastric mucosa rather than representing a particular endoscopic entity. A gastric mucosal biopsy is necessary to establish a definitive diagnosis of gastritis versus gastropathy.
This topic review will discuss the classification and diagnosis of gastritis and gastropathy. The causes of acute and chronic gastritis are presented separately.