What is the pathophysiology of acute erosive gastritis?

Updated: Jul 12, 2020
  • Author: Sarah El-Nakeep, MD; Chief Editor: BS Anand, MD  more...
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Answer

Acute erosive gastritis can result from exposure to a variety of agents or factors. This is referred to as reactive gastritis. These agents/factors include nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, cocaine, stress, radiation, bile reflux, and ischemia. The gastric mucosa exhibits hemorrhages, erosions, and ulcers. NSAIDs, such as aspirin, ibuprofen, and naproxen, are the most common agents associated with acute erosive gastritis. This results from both oral and systemic administration of these agents, either in therapeutic or supratherapeutic doses.

Because of gravity, the inciting agents lie on the greater curvature of the stomach. This partly explains the development of acute gastritis distally over or near the greater curvature of the stomach in the case of orally administered NSAIDs. However, the major mechanism of injury is the reduction in prostaglandin synthesis. Prostaglandins are chemicals responsible for maintaining the mechanisms that result in the protection of the mucosa from the injurious effects of gastric acid. Long-term effects of such ingestions can include fibrosis and stricture formation.


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