Etiological Analysis of Reactive Gastropathy in an Urban Population

Reactive gastropathy (RG) is an adaptive response to assaults of the gastric mucosa. Demographic information regarding RG as well as the coincidence of RG and gastrointestinal cancer are poorly characterized entities.

Herein, we aim to investigate relationships of RG to both modifiable and nonmodifiable risk factors, as well as conduct a stratified analysis by race in an ethnically diverse, urban population.

In this retrospective study, we queried an urban hospital inpatient pathology database searching for patients with surgical gastric biopsies positive for RG between March 25, 2015, and March 25, 2016. Of the 728 patients with a final diagnosis of RG, 292 were selected based on strict inclusion and exclusion criteria. We explored risk factors and conducted a stratified analysis for associations based on patient demographics.

In this urban minority population, nonsteroidal anti-inflammatory drugs (NSAIDs) were the most common medication associated with RG (Fig. 1), as well as the most common cause of RG, followed by chronic bile reflux. In addition, significant differences in demographics and gastropathic characteristics associated with RG, stratified by ethnicity, were found (Fig. 2). Notably, Hispanics, African Americans, and Caucasians had the highest rate of concomitant RG and diabetes, hypertension, and tobacco/alcohol use, respectively.

Our study indicated that NSAID usage is the most common cause of RG, followed by bile reflux-mediated mucosal injury, in an ethnically diverse urban US-based population. Of note, few patients had intestinal metaplasia, suggesting it to be a slow or negligent sequela of RG.