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Acute hemorrhagic erosive gastropathy and reactive gastropathy

Pamela J Jensen, MD
Mark Feldman, MD, MACP, AGAF, FACG
Section Editor
J Thomas Lamont, MD
Deputy Editor
Shilpa Grover, MD, MPH, AGAF


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 reactive 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:

Reactive gastropathy is usually caused by gastric irritants (medications, ethanol, bile reflux), or by mucosal ischemia or vascular congestion. Gastritis is usually due to an infectious agent (such as Helicobacter pylori) or an autoimmune disorder. A practical etiology-based framework for the classification of gastropathy and gastritis is presented (table 1) [1].

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 (or "active") gastritis is associated with neutrophilic infiltration, while chronic gastritis is characterized by mononuclear cells, chiefly lymphocytes, plasma cells, and macrophages. An etiology-based classification of gastropathy and gastritis is outlined in the table (table 1).

This topic review will discuss acute hemorrhagic and erosive gastropathy and reactive gastropathy. The classification and diagnosis of gastropathy and gastritis, 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" and "Metaplastic (chronic) atrophic gastritis".)

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Literature review current through: Dec 2017. | This topic last updated: Jan 09, 2018.
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