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Pathology of Reflux/Reactive/

Chemical Gastritis (Type C)

Dr  Sampurna Roy  MD


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August  2015

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


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An outline of the anatomy and normal histology of the  stomach for pathologists.

Reporting of gastric biopsies (non-neoplastic gastric lesions).

Pathology and pathogenesis of peptic ulcer.

Acute Gastritis 

Chronic Gastritis

Helicobacter pylori  associated (TypeB)  Gastritis 

Lymphocytic Gastritis

Collagenous Gastritis

Granulomatous Gastritis

Eosinophilic Gastritis


- Consumption of aspirin and other nonsteroidal anti-inflammatory drugs.

- Chronic alcohol ingestion

- Alkaline or bile reflux (abnormal pyloric sphincter function, previous surgical intervention).

- Uraemia

Microscopic features:

- Glandular elongation and tortuosity

- Mucin depletion

- Edema

- Hypercellularity of the gastric pits

- Foveolar hyperplasia

- Increased number of smooth muscle fibres in lamina propria.

- Villiform transformation of the mucosa.

- Regenerative (basophilic) glands with increased mitotic activity.

- Capillary congestion and vasodilation in superficial lamina propria.

- A few chronic inflammatory cells and occasional neutrophils.

- Usually there is no evidence of atrophy.

- Bile in the glands.

- Long standing bile reflux cases may be accompanied by erosions or intestinal metaplasia (including all its subtypes).

Note :  Reactive gastritis with erosions is the commonest cause of false positive diagnosis of dysplasia or carcinoma in the stomach.



Further reading:

Cell proliferation in type C gastritis affecting the intact stomach.

Bile reflux gastritis and intestinal metaplasia at the cardia. 

Reflux gastritis in gastroesophageal reflux disease: A histopathological study.

Bile reflux and intestinal metaplasia in gastric mucosa.

Gastritis in patients on non-steroidal anti-inflammatory drugs. 

Reflux gastritis in the intact stomach.  

Reflux gastritis: distinct histopathological entity?


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