Differential diagnosis of reactive gastropathy

Robert M. Genta

Research output: Contribution to journalArticlepeer-review

61 Scopus citations


Reactive or chemical gastropathy is the constellation of endoscopic and histological changes caused by chemical injury to the gastric mucosa. Its diagnosis rests on the histopathological demonstration of nonspecific elementary lesions that may occur simultaneously or separately in different degrees and various proportions. These lesions include foveolar hyperplasia, interfoveolar smooth muscle fibers, erosions, edema, and hyperemia, in the absence of significant inflammation. Their respective occurrence in a set of gastric biopsies can be placed on a spectrum of diagnostic certainty that is never absolute because each of such changes can and does occur in other conditions. Although a correlation between histological evidence of chemical gastropathy and clinical manifestations, particularly risk of bleeding, is yet to be documented, reporting the suspicion of drug-induced gastric damage may help clinicians to identify patients that might benefit from change, reduction, or discontinuation of certain medications.

Original languageEnglish (US)
Pages (from-to)273-283
Number of pages11
JournalSeminars in Diagnostic Pathology
Issue number4
StatePublished - Nov 2005


  • Bile reflux
  • Chemical gastropathy
  • Drug-induced damage
  • Erosions
  • Foveolar hyperplasia
  • Gastritis
  • Gastropathy
  • Nonsteroidal antiinflammatory agents
  • Reactive gastropathy

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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