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Classification and diagnosis of gastritis and gastropathy

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


Gastritis is predominantly an inflammatory process, while the term gastropathy denotes a gastric mucosal disorder with minimal to no inflammation. The term gastritis is occasionally 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." An etiology-based classification of gastropathy and gastritis is presented (table 1).

The causes, natural history, and therapeutic implications of gastropathy differ from gastritis:

Gastritis is commonly secondary to infectious or autoimmune etiologies.

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, physical stress, or chronic congestion.

"Gastritis" is a term often used by endoscopists to describe an abnormal-appearing gastric mucosa rather than representing a particular endoscopic entity. A gastric mucosal biopsy is necessary to establish a definitive diagnosis of gastritis versus gastropathy.

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Literature review current through: Dec 2017. | This topic last updated: Nov 07, 2017.
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