title: Reactive gastropathy is associated with inflammatory conditions throughout the gastrointestinal tract.
abstract: BACKGROUND
  The epidemiology of reactive gastropathy and its relationship with other conditions of the gastrointestinal tract associated with NSAID use have not been evaluated.
  
  
  OBJECTIVE
  To test the hypothesis that if reactive gastropathy shares common aetiological factors with these conditions, the analysis of a large cohort would unveil associations.
  
  
  METHODS
  We queried a national pathology database for subjects with a diagnosis of reactive gastropathy; controls were patients with normal gastric biopsies. We also extracted diagnoses of H. pylori infection, intestinal metaplasia, duodenal lymphocytosis, duodenitis, ileitis, microscopic colitis and focal colitis.
  
  
  RESULTS
  Of 504 011 patients with gastric biopsies, 69 101 had oesophageal, 166 134 duodenal, 13 010 ileal and 83 334 colonic biopsies. Reactive gastropathy was diagnosed in 15.6% of patients, H. pylori infection in 10.3% and normal gastric mucosa in 16.3%. Reactive gastropathy was evenly distributed across the US and increased from 2.0% in the first decade of life to >20% in octogenarians. Compared with controls, reactive gastropathy was significantly associated with Barrett's mucosa (OR 1.21 95% CI 1.16-129); duodenitis (OR 1.36; 95% CI 1.28-1.44); duodenal intraepithelial lymphocytosis (OR 1.25; 95% CI 1.13-1.39); active ileitis (OR 1.88; 95% CI 1.47-2.40); focal active colitis (OR 1.57; 95% CI 1.33-1.86); and collagenous colitis (OR 1.50; 95% CI 1.12-2.03).
  
  
  CONCLUSIONS
  Reactive gastropathy, a common histopathological feature of the stomach, shows an age-dependent rise and is associated with changes of the digestive tract believed to be caused by NSAID use or duodenogastric reflux. However, a large fraction of reactive gastropathy remains unexplained; its frequent occurrence merits further efforts at elucidating its aetiology.
authors.affiliation: Universidade do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: I
authors.initials: I
authors.lastname: Maguilnik
authors.forename: W L
authors.initials: WL
authors.lastname: Neumann
authors.forename: A
authors.initials: A
authors.lastname: Sonnenberg
authors.forename: R M
authors.initials: RM
authors.lastname: Genta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004751:Enteritis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications; D006801:Humans; D007223:Infant; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013272:Stomach Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal