A Guide to Gastropathy

Medically Reviewed By Youssef (Joe) Soliman, MD
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Gastropathy refers to a condition in which the stomach lining becomes damaged. Many factors may contribute to gastropathy, including nonsteroidal anti-inflammatory drug (NSAID) use, alcohol consumption, or certain underlying conditions. While gastropathy may be asymptomatic, some people may experience indigestion or ulcers. Treatment depends on the underlying cause and may consist of proton pump inhibitors (PPIs), H2 blockers, or avoiding triggers.

Read on to learn about the types, symptoms, and treatments for gastropathy.

What are the types of gastropathy?

A woman drinking alcohol
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There are several types of gastropathy that experts classify by their causes. We explain three general gastropathy types below.

Reactive gastropathy

Reactive gastropathy occurs as a result of long-term stomach exposure to irritating substances. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), these substances commonly include NSAIDs, alcohol, and bile.

Reactive gastropathy can be chronic and erosive, which means it may cause lesions or ulcers in the stomach or small intestine.

Acute erosive gastropathy

Acute erosive gastropathy is similar to reactive gastropathy in that irritating substances may also contribute to its development. However, acute erosive gastropathy may also develop due to serious underlying health conditions. These conditions can include sepsis, critical illnesses, or severe injuries or burns.

Portal hypertensive gastropathy

Portal hypertensive gastropathy develops when elevated blood pressure in the portal vein, the major vein leading to the liver, causes damage to the stomach lining. While researchers do not yet fully understand the processes behind this condition’s development, increased blood and pulse pressure and liver disease may be contributing factors.

What are the symptoms of gastropathy?

Many people with gastropathy may not experience any symptoms. However, when symptoms do occur, they can include:

Because gastropathy can lead to ulcers and intestinal bleeding, some people may also experience:

  • black or tarry stool
  • stool containing maroon blood
  • abdominal cramps
  • fatigue
  • shortness of breath
  • lightheadedness
  • vomit containing blood
  • vomit resembling coffee grounds

How do doctors diagnose gastropathy?

To diagnose gastropathy, your doctor may perform a physical examination and ask about your symptoms and medical history. To confirm a diagnosis, they typically perform an upper gastrointestinal (GI) endoscopy.

An upper GI endoscopy involves passing a flexible tube containing a camera into your upper GI tract. This tract includes your esophagus, stomach, and the upper part of your small intestine.

Learn more about upper GI endoscopy.

During the endoscopy, your doctor may take a biopsy of your stomach lining, allowing a pathologist to look for clinical signs of gastropathy under a microscope.

Other tests that doctors may order to confirm a gastropathy diagnosis include:

  • blood tests
  • stool tests
  • upper GI series, which involves swallowing a chalky liquid to make it easier to see problems in your GI tract with an X-ray

What are the treatments for gastropathy?

Treatments for gastropathy depend on the underlying cause. If NSAID or alcohol use is causing your gastropathy, you may need to reduce or stop your consumption of those substances. For reactive gastropathy, doctors may recommend PPIs to allow the stomach to heal.

Other acid-reducing medications, like H2 blockers or sucralfate, can help treat gastropathy.

The NIDDK notes that doctors may also prescribe a medication called ursodiol to help heal the lining of the stomach if bile reflux is occurring. Bile reflux is a backup of bile from the small intestine to the stomach.

If acute bleeding occurs in people with portal hypertensive gastropathy, peptide drugs and PPIs or vasoactive drugs can be beneficial.

In severe cases, treatment through endoscopy or surgery may be necessary to relieve symptoms. 

What is the outlook for people with gastropathy?

People with gastropathy may have either acute or chronic symptoms. Prompt treatment of the underlying cause is essential to providing relief and may be sufficient unless doctors suspect internal bleeding.

What are some potential complications of gastropathy?

One of the main complications of gastropathy is the development of peptic ulcers, particularly in people who use NSAIDs for long periods.

Also, portal hypertensive gastropathy may lead to acute or chronic bleeding in the GI tract.

What are the risk factors for gastropathy?

Certain factors may increase the risk of developing gastropathy, including:

  • long-term consumption of NSAIDs or alcohol
  • conditions that cause bile reflux
  • conditions that impair blood flow to the stomach, including sepsis or severe injuries

In addition, portal hypertensive gastropathy may be more likely in people with liver cirrhosis.

Can you prevent gastropathy?

You may be able to prevent gastropathy by avoiding the long-term use of NSAIDs, alcohol, or other irritating substances. Prompt treatment for underlying conditions that cause bile reflux or reduce blood flow to the stomach may also help prevent the condition.

Other frequently asked questions

Here are a few other common questions about gastropathy. Dr. Joe Soliman has reviewed the answers.

Is gastropathy serious?

Without treatment, gastropathy can cause serious complications. For example, people with gastropathy are more likely to develop peptic ulcers, which can cause severe bleeding in the stomach and small intestine.

Contact your doctor right away if you are experiencing symptoms of internal bleeding.

What does gastropathy feel like?

Gastropathy can cause pain, discomfort, and cramps in the abdominal area. Some people may also experience nausea, vomiting, or fatigue.


Gastropathy refers to damage to the stomach lining. This damage may result from long-term exposure to irritating substances, severe conditions like sepsis, or portal hypertension.

While some people may not have any symptoms, others may experience abdominal pain, weight loss, or symptoms consistent with bleeding in the GI tract.

Treatment depends on the underlying cause. Doctors may prescribe acid-reducing medications, peptide drugs, or vasoactive medications. In severe cases, surgery may be necessary.

Contact your doctor if you experience symptoms consistent with gastropathy.

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Medical Reviewer: Youssef (Joe) Soliman, MD
Last Review Date: 2022 Sep 28
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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