HomeAnswersInternal Medicinereactive gastropathyHow to manage reactive gastropathy?

I am diagnosed with reactive gastropathy. What are your suggestions for treatment?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Preetha. J

Published At October 16, 2020
Reviewed AtAugust 18, 2023

Patient's Query

Hi doctor,

I began to get a dull pain and burning sensation in my right upper abdomen. It spread to the middle and left side of the upper part of my stomach over some time. I also get some sharp pains for a second or two on the lower right side of my abdomen directly to my belly button's right. Here are my endoscopy results. What is reactive gastropathy, and what are your suggestions for treatment? Right upper quadrant pain, epigastric pain diagnosis, A. Stomach, antrum, biopsy: Reactive gastropathy no helicobacter organisms identified, and no evidence of intestinal metaplasia, dysplasia, or malignancy. B. Stomach body biopsy: Gastric mucosa with no significant histopathologic findings. Images reactive gastropathy gross description, A. Stomach antrum biopsy received in formalin are three tan tissue fragments, 0.2 - 0.3 cm, all as A.

B. Gastric body biopsy obtained in formalin are three tan tissue fragments, 0.1 - 0.2 cm, all as B.

Microscopic findings A: Stomach antrum biopsy- Fragments of antral type gastric mucosa with foveolar hyperplasia, vascular congestion, and smooth muscle proliferation. There is also an increase in lymphoplasmacytic infiltrate in the lamina propria. No active inflammation is identified, and no intestinal metaplasia is seen on H and E and PAS/Alcian Blue stains. No Helicobacter organisms were identified on Diff-Quik stain. No evidence of dysplasia or malignancy. B: Gastric body biopsy- The biopsy shows oxyntic type gastric mucosa with no significant inflammation identified. No intestinal metaplasia is seen on H and E and PAS/Alcian Blue stains. No Helicobacter organisms are identified on Diff-Quik stain. No evidence of dysplasia or malignancy.

Laboratory tests like ultrasound, HIDA scan, and MRCP all came back normal.

Answered by Dr. Prathish Kumar

Hi,

Welcome to icliniq.com.

I went through your clinical and endoscopy details. Regarding your query, reactive gastropathy is a type of gastritis to say type C, chemical induced gastropathy. It will show some pathological changes in the biospy, but there will not be any signifiant inflammation. It is most commonly caused by exposure of gastric mucosa to chemicals. Substances under chemicals include alcohol, even your own bile reflux and exposure to medicines most commonly NSAIDS (nonsteroidal anti-inflammatory drug) or painkillers. Not all people develop this condition. There are individual tendencies that expose certain people to such risks. If you can provide me some more detail, it will be helpful.

  • Are you on any medicines particularly painkillers?
  • Do you consume alcohol and how much?
  • Or do you do binge drinking?
  • Are you a drug abuser?
  • Do you experience frequent burpings or eructations after having food?
  • Follow my advice as given below and review after two weeks?

Investigations to be done

CBC (complete blood count) and absolute eosinophil count.

Probable diagnosis

Reactive type C gastropathy.

Treatment plan

Tablet Rabeprazole 20 mg twice daily half an hour before food for two weeks. Syrup Sucralfate 10 ml thrice daily one hour before food for two weeks.

Preventive measures

Avoid alcohol, painkiller and other medicine abuse. Avoid heavy meals at a single time.

Regarding follow up

Follow-up after two weeks.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Prathish Kumar
Dr. Prathish Kumar

General Medicine

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