Bowel movements: How often should you poop? Sobala GM, King RF, Axon AT, Dixon MF. Chronic Gastritis: Background, Pathophysiology, Etiology - Medscape Digestive fluids can harm and inflame your stomach lining if the mucus-lined barrier that covers your stomach wall is damaged. Association between self-rated depressive symptoms and mucosal 1985 Aug. 103(2):178-83. Mucosal Diseases of the Stomach: Differentiating Benign from Malignant 1986 May. J Clin Pathol. can it come back with stress? It seems that indomethacin and stress (restraint) ulcer formation were followed by a predominant fundic (oxyntic cell area) mucosal DNA increase, while in the antral mucosa this phenomenon was connected to a significant RNA increase. By working to inform readers of the options available to them, he hopes to improve their health and quality of life. [QxMD MEDLINE Link]. Billroth II. Endoscopy pathology report. N Engl J Med. Hepatologist & Transplant Hepatologist, Sign up for our free Health Library Daily Newsletter, What Is Antral Gastritis? Gastritis can also be exacerbated by the use of certain pain medications and excessive alcohol consumption. what are my odds of getting colon or gastric cancer. Hum Pathol. and why cells are "reactive . With the advent of highly effective medical treatment for H pylori infection, there has been a decline in such surgical procedures, paralleled by a reduction in the incidence of stump carcinoma. Treatment is supportive, with removal of the inciting cause and initiation of acid-suppressant therapy. Re-seal . Reactive gastropathy definition, causes, symptoms, diagnosis & treatment This low-acid fruit can benefit those who suffer from acid reflux by soothing an inflamed esophagus lining and therefore alleviating discomfort. [QxMD MEDLINE Link]. Maguilnik I, Neumann WL, Sonnenberg A, Genta RM. An antral ulcer is also known as an antral gastric ulcer. Helicobacter pylori as an Initiating Factor of Complications in Upper gi, antral mucosa w/ regenerative epithelial changes and vascular congestion. (See Pathophysiology and Etiology. The features are those of a chronic gastritis. [8]. what does this really mean? Here are a few easy tips to help prevent gastritis: Gastritis is a common medical condition that can be managed and treated without major complications. "Clinical perspectives on the rationale for potassium supplementation.". The duodenogastric reflux results in disruption of the protective mucus barrier and direct injury to the gastric mucosa, causing backflow of hydrogen ions and epithelial damage. The following are other causes of gastritis pain: The primary mode of symptom formation is the development of inflammation in the antrumthe lower portion of the stomach. This can cause gastritis. Although decreasing in overall incidence with the routine use of histamine-2 (H 2 ) blockers, the overall death rate from peptic ulcer disease has remained stable. PDF Understanding Your Pathology Report: Esophagus With Reactive or Reflux }); Aspirin / nonsteroidal anti-inflammatory drugs (NSAIDs). Most people have a problem with their stomach at one time or another. [QxMD MEDLINE Link]. Another name for this condition is chemical gastropathy. This can be done by changing your diet around or changing your lifestyle habits. The most common benign cause of mucosal ulcerations is peptic ulcer disease. The management of this condition may include discontinuance of NSAID use along with administration of proton pump inhibitors (PPIs) and prostaglandin analogues. The antrum refers to the lower portion of the stomach. What Is Antral Gastritis? - Treatments and Symptoms - Apollo Hospitals Blog Am J Surg Pathol. [QxMD MEDLINE Link]. Gastritis can develop quickly (acute gastritis) or gradually over time (chronic gastritis). 1985 Aug. 103(2):178-83. Iacobuzio-Donahue, Christine A.; Montgomery, Elizabeth A. Gastric changes due to injury to the mucosa by abnormal luminal contents Alternate/Historical Names Chemical gastropathy Environmental gastritis / gastropathy Reactive gastritis Type C gastritis Some names based on specific causes Bile reflux gastritis NSAID gastritis Diagnostic Criteria Foveolar hyperplasia and expansion The mucosa may be normal or may exhibit erythema, congestion, edema, or erosions 8. 1983 Nov 12. Gastritis - Symptoms and causes - Mayo Clinic Foveolar hyperplasia Symptoms, Causes, Treatment: [QxMD MEDLINE Link]. [2]. (Dec 2014). 46(4):269-74. negative h.pylori/malignancy/metaplasia/dysplasia. This lining shields the stomach from the corrosive stomach acid that aids digestion by breaking down food. After a meal, avoid lying down for up to 2 to 3 hours. Lanza FL, Royer GL Jr, Nelson RS. Drugs that cause erosions and/or ulcers - adapted from Genta:[1], Not well-developed with minimal inflammation. Press J to jump to the feed. The reported prevalence of reactive gastropathy among patients taking daily NSAIDs for at least 1 month ranges from 30% to 40% 9. 1999 Jun 17. [18, 19, 20], At present, reactive gastropathy is usually encountered in the clinical setting of chronic nonsteroidal anti-inflammatory drug (NSAID) use. [Full Text]. a weakened immune system. AskApollo online Health Information Library is an initiative by Apollo Hospitals for general people, patients, their families and friends who seek useful health information, tips and advice on disease, procedure and certain medications to help you take care of yourself and your loved ones. Antral Ulcer Symptoms Due to the location of an antral ulcer, the symptoms can be more severe and take longer to heal than another form of peptic ulcer known as a duodenal ulcer. newsletter along with exclusive offers from, Bel Marra Health This finding, along with its distinctive endoscopic appearance ("watermelon stomach"), aids in the differentiation of GAVE from other similar-appearing entities. a stomach biopsy. [Full Text]. [4], The most common complaint associated with NSAID-induced reactive gastropathy is mild dyspepsia. Thus, inhibition of COX by NSAIDs reduces prostaglandin synthesis, thereby diminishing mucosal blood flow and decreasing mucus and bicarbonate secretion. There are two different forms of antral gastritis: Antral superficial gastritis. . The primary symptom of antral gastritis is inflammation or feeling a burning sensation inside your stomach. Book An Appointment.no-styles{background-color:transparent !important;}. Some forms are erosive, meaning that they wear away the stomach lining and cause shallow breaks, called erosions, and ulcers. Antral Ulcer: Causes, Symptoms, Complications, Diet, and Treatment Tips Superficial erosions may be observed. What are reactive changes? 16(4):325-41. Taha AS, Nakshabendi I, Lee FD, Sturrock RD, Russell RI. The gastric antral mucosa shows expansion of the lamina propria by chronic inflammatory cells, consisting of plasma cells and small lymphocytes, predominantly located toward the luminal aspect of the mucosa, a pattern that is suggestive of H pylori infection. lack of large numbers of neutrophils and plasma cells. Avoid foods that are greasy, fried, spicy, or acidic. This is very common, especially in less developed countries. Gastroenterol Clin North Am. 23(2):281-94. Semin Diagn Pathol 2005; 22: 27383. 23(2):281-94. Genta RM. PDF | Sleeve gastrectomy (SG) often induces gastroesophageal reflux, with few and discordant long-term data on the risk of Barrett's esophagus (BE) in. Gastric antral vascular ectasia (GAVE) should be considered in the differential diagnosis. Mar 16, 2018 #6 All DOI: 10.1111/j.1365-2362.2004.01358.x Corpus ID: 25298464; Role of apoptosis and CD95receptor/ligand system in aspirin and Helicobacter pyloriinduced cell death @article{Domhan2004RoleOA, title={Role of apoptosis and CD95receptor/ligand system in aspirin and Helicobacter pyloriinduced cell death}, author={Sophie Domhan and Wolfgang Stremmel and Jochen Rudi}, journal={European . Copyrights - 2020. Reactive gastropathy has also been referred to as chemical gastropathy, reflux gastritis, and type C gastritis6. Histology of the postoperative stomach before and after diversion of bile. Mod Pathol. Mamoun Younes, MD Professor of Pathology, Director of Gastrointestinal and Liver Pathology Service, University of Texas Health Science Center at Houston, McGovern Medical School All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. 2013:393015. Peel back the label of the Pylo-Plus thus exposing the reactive yellow pad. 352(25):2576-8. Is COVID-19 Reinfection Possible? 1993 Oct. 23(4):341-8. Carrasco G, Corvalan AH. lack of large numbers of neutrophils and plasma . The following microscopic features are typically seen in reactive gastropathy: With the right information, patients can make the best decisions about their care. Acute gastritis can persist anywhere from 2 to 10 days. The stomach has three tasks. The products released by Bel Marra Health. Nodular GAVE and gastric hyperplastic polyps have similar appearance on upper GI endoscopy (EGD) as well as histology, which could delay specific targeted therapy. 2014 Dec. 210(12):847-54. Chronic gastritis: Causes, symptoms, and treatments - Medical News Today [QxMD MEDLINE Link]. Mucin expression is reported to be altered in reactive gastropathy in comparison with normal gastric mucosa as well as H pylori gastritis. Press question mark to learn the rest of the keyboard shortcuts. May be seen in the context of a previous resection/surgical reconstruction, e.g. My doc said I dont have gastritis and nothing is wrong. Definition: The antral mucosa (Synonym: pyloric mucosa) is the mucosa found in the gastric antrum. 2008 Oct. 132(10):1586-93. This increase in intraluminal bacteria leads to subsequent generation of relatively increased concentrations of deconjugated and secondary bile acids within the refluxate. BIOPSY: GASTRIC ANTRAL MUCOSA WITH MILD REACTIVE CHANGES; NEGATIVE FOR HELICOBACTER PYLORI TYPE ORGANISMS. The presentation of gastritisinflammation of the stomach liningcan be due to various causes. [14, 17], This condition was originally described in patients who had undergone partial gastrectomymost frequently, Billroth II gastric reconstruction. 2012 Oct. 36(8):736-43. Surgery. 3. These gastric mucosal protection and ulcer healing effects are associated with antioxidant effects and the augmentation of prostaglandin E2 and suggest that P. cuspidatum might be a promising . Definition & Facts for Gastritis & Gastropathy - NIDDK Aliment Pharmacol Ther. November 9, 2022. The endoscopic findings of reactive gastropathy are mostly nonspecific. what is the treatment for this? Disclaimer: MyPathologyReport.ca is a registered not-for-profit charity (769563271RR0001). Histological features do not define NSAID-induced gastritis. Antioxidative Properties of Iberis amara Extracts in Biochemical Model Please confirm that you would like to log out of Medscape. Another name for this condition is chemical gastropathy. 137(4):527-31. [QxMD MEDLINE Link]. Gastric mucosa - Wikipedia What is the antrum in the body? Having chronic inflammation with extensive intestinal metaplasia is the precursor for developing gastric cancer. Despite the occasional development of stump carcinomas in postgastrectomy stomachs, reactive gastropathy is not a major risk factor for the development of gastric carcinoma. - Scant or minimal inflammatory cells (white arrow), i.e. Aliment Pharmacol Ther. Bile reflux usually occurs in patients who have undergone a Billroth II partial gastrectomy; it is also recognized to occur in intact stomachs in individuals with alcohol abuse, cigarette smoking, chronic respiratory disease, or duodenal ulcer, and even in healthy subjects. Histological features do not define NSAID-induced gastritis. What is the Difference Between Piles, Fissures and Fistula? These are lined by mucus cells that are interspersed with endocrine cells (chiefly G and D types), and a few parietal cells. Poor digestion, stretching, and increment of the stomach takes place during Foveolar Hyperplasia. thoughts? Gastrointestinal Tract Part 1 2 - DR. VERGARA November 15, 2022 A Moderate reactive gastropathy. H. pylori bacteria are the most common cause of persistent gastritis and peptic ulcer disease (stomach ulcers). N Engl J Med. "Reactive gastropathy is associated with inflammatory conditions throughout the gastrointestinal tract.". Mucosal changes in reactive gastropathy are readily appreciated by comparison with normal gastric mucosa (see the image below). It was shown that Iberis amara extract (STW 6) has the potential for scavenging ROS, dependent on the individual test system, and a major activity of IAE proved to represent inhibition of lipid peroxidation processes, shown as delay of the lag phase of the Cu(II)-induced LDL oxidation as well as protection of -linolenic acid fromperoxidation by singlet oxygen. Gastric antral type mucosa | HealthTap Online Doctor The updated Sydney System. [13]. Moderate reactive gastropathy involving gastric oxyntic mucosa (original magnification 100). . 2.75. Buxbaum KL. Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. google_ad_client: "ca-pub-9759235379140764", Antral mucosa exhibiting the features of reactive gastropathy (adsbygoogle = window.adsbygoogle || []).push({}); (adsbygoogle = window.adsbygoogle || []).push({ Footnote: Antral mucosa exhibiting the features of reactive gastropathy, including corkscrewlike foveolar hyperplasia, a mucin depleted epithelium and bundles of hyperplastic smooth muscle arranged perpendicular to the surface. Gastritis in patients on non-steroidal anti-inflammatory drugs. It is typically acute, manifesting with bleeding, but may be subacute or chronic with few or no symptoms. A feeling of fullness in your upper abdomen after eating. [16] but the more proximal oxyntic mucosa may also be affected. International Workshop on the Histopathology of Gastritis, Houston 1994. The inner lining of the esophagus is known as the mucosa. Devon has written extensively for Bel Marra Health. In reactive gastropathy (chemical gastropathy), the distribution of CK8, CK18, and CK19 was normally distributed but increased in intensity. MyPathologyReport is independently owned and operated and is not affiliated with any hospital or patient portal. Symptoms of Intestinal Metaplasia. 303(3):136-8. Cardiac mucosa: the heart of the problem | Gut The results probably reflect regeneration process from an. It mixes the food with stomach acids. ; Sonnenberg, A.; Genta, RM. A stomach, or gastric, polyp is an unusual growth of tissue within the inner lining of the stomach. Cleveland Clinic is a non-profit academic medical center. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTk2Mjg5My1vdmVydmlldw==. Devon Andre has been involved in the health and dietary supplement industry for a number of years. Genta RM. Focal intestinal metaplasia usually is caused and occurs in conjunction with chronic gastritis. 1999 Jun 17. [26]. Gastroenterol Clin North Am. Sobala GM, King RF, Axon AT, Dixon MF. Malagelada JR, Phillips SF, Shorter RG, et al. The deficiency of red blood cells within the human body is an indication of Foveolar Hyperplasia. It consists of simple columnar epithelium, lamina propria, and the . Reactive gastropathy - Libre Pathology [11, 12] Prostaglandins are derived from arachidonic acid via the cyclooxygenase (COX) pathway. Autoimmune illnesses occur when the immune system assaults healthy cells in the stomach lining and can result in gastritis. For EGD, an Olympus GIF-Q200 (Olympus Optical Co. Ltd., Tokyo, Japan) was used. Furthermore, NSAIDs, being weak organic acids, can freely diffuse into the gastric epithelium. Yes. This can include everything from ulcers to gastritis. Types of stomach polyps and their causes and treatments are discussed. This question is best answered by your gastroenterologist who had a good look at your tissue and pathology report. Arrow points to smooth muscle fibers in superficial lamina propria (original magnification 200). (2005). Owen DA. 1999 Jun. Reactive gastropathy is characterized, histologically, by 21: If long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) leads to reactive gastropathy, your doctor may recommend that you stop taking NSAIDs, take a lower dose, or take a different medicine for pain. Gastritis, PUD, esophagitis, UGI cancers 2022.docx.pdf The predominant mechanism of NSAID-induced gastric injury involves decreased synthesis of mucosal prostaglandins13. Wolf EM, Plieschnegger W, Schmack B, et al. This increase in intraluminal bacteria leads to subsequent generation of relatively increased concentrations of deconjugated and secondary bile acids within the refluxate. Summary Gastro-intestinal . [1] because it indicates an underlying chemical injury that is not associated with infection. Warshaw AL. The microscopic features of reactive gastropathy were well characterized by Dixon et al in their original description of reflux gastritis as a distinct histopathologic entity. Quinn CM, Bjarnason I, Price AB. Reactive gastropathy is a condition that develops when substances such as non-steroidal anti-inflammatory drugs (NSAIDs), alcohol, or bile damage the cells that cover the inside of the stomach. N Engl J Med. Partly due to excess gas accumulation, but also because of the inflammatory processes that may cause pain felt while eating. Other causes that may result in gastric mucosal erosions include Crohn's disease and viral gastritis, such as cytomegalovirus or herpesvirus. Share cases and questions with Physicians on Medscape consult. Stomach cancer: Gastritis produced by H. pylori and autoimmune diseases can create growths in the stomach lining, which can ultimately lead to stomach cancer. Chronic gastritis is organized into three types based on related causes: Type A is caused by . here is what was written: antral-type and body type gastric mucosa with focal intestinal metaplasia. N Engl J Med. 1996. Histologic and Endoscopic Similarity between Nodular Gastric Antral Evolving patterns in the diagnosis of reactive gastropathy: data from a prospective Central European multicenter study with proposal of a new histologic scoring system. 2003 Apr. Mild reactive gastropathy involving gastric antral mucosa (original magnification 200). Bile reflux is thought to play a key role in the development of dysplasia and carcinoma in the gastric remnant. (Nov 2005). Am J Surg Pathol. Copyright 2023 Bel Marra Health. Occasionally, focal intestinal metaplasia may be present. Medscape Education. Make certain that the tissue is positioned to have maximum contact with the reactive pad. By partnering with patients, healthcare providers, and hospitals, we hope to provide all patients with the tools and knowledge to understand their pathology report. [QxMD MEDLINE Link]. 20021610541-overviewDiseases & Conditions, encoded search term (Pathology of Reactive Gastropathy) and Pathology of Reactive Gastropathy, Helicobacter Pylori-Associated Active Gastritis, Fast Five Quiz: Helicobacter pyloriAssociated Gastritis, A Guide to Managing Gastric Intestinal Metaplasia, Prevalence and Prognostic Significance of Vitamin C Deficiency in Patients With Acute Upper Gastrointestinal Bleeding, AGA Offers Key Guidance on Managing Subepithelial GI Lesions, Early Satiety, Nausea, and Vomiting After Meals: Case Presentation. Infection is more common in rural areas and in the developing parts of the world. Antral Mucosa with mild reactive changes? Galangin protects gastric mucosa from indomethacin induced injury via Genta RM, Sonnenberg A. Characteristics of the gastric mucosa in patients with intestinal metaplasia. The signs and symptoms of gastritis include: Gnawing or burning ache or pain (indigestion) in your upper abdomen that may become either worse or better with eating. Read More "Chemical gastritis" is misnomer. 1991 Feb. 71(1):33-44. What is gastric antral mucosa with reactive Gastropathy? The vast majority of cases of gastric ulcers (70% to 90% . Genta, RM. [QxMD MEDLINE Link]. This was the only thing on my colonoscopy/endoscopy report that I don't understand. All Rights Reserved. Chronic Gastritis: Causes, Symptoms & Diagnosis - Healthline 1992 Feb. 45(2):135-9. What Is Intermittent Fasting? In one study the risk of metaplasia > gastric cancer was 1 IN 39 PATIENTS OVER A 20 YEAR PERIOD. Im 36 years old,had a sessile serrated adenoma without dysplasia and also antral mucosa with reactive foveolar hyperlplasia. Triad rarely present; mild inflammation common. Antonia R Sepulveda, MD, PhD Professor of Pathology and Cell Biology, Vice Chair for Translational Research, Director, Division of Gastrointestinal Pathology, Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons * Lives in the mucus layer of stomach lumen and can bind to gastric . This is the American ICD-10-CM version of K29.60 - other international versions of ICD-10 K29.60 may differ. Reactive gastropathy is associated with inflammatory conditions throughout the gastrointestinal tract. Then it sends the mixture on to the small intestine. Am J Gastroenterol. To date, no specific genetic predisposing factors for the development of reactive gastropathy have been identified. Abstract Objectives: The gastric mucosal change accompanying gastric antral intestinal metaplasia (IM) in the pediatric population and its clinical implications remain unclear. Reactive gastropathy is associated with inflammatory conditions throughout the gastrointestinal tract. Other causes include alcohol and non-steroidal anti-inflammatory drugs (NSAIDS). Eur J Gastroenterol Hepatol. none? Most people do not experience noticeable effects of intestinal metaplasia. Messages 32 Location Green Valley, AZ Best answers 0. Had endoscopy done extremely mild im found. Foveolar hyperplasia Symptoms, Causes, Treatment: This is called reflux. a stomach biopsy. Finally . Wilson P, Jamieson JR, Hinder RA, et al. Call 1860-500-1066 to book an appointment. Wolf, EM. The end-of-study data was captured in the last week of the 1 year after therapy follow up period. Chronic gastritis can also be seen in people who have previously been treated for Helicobacter pylori. A number of things, including chronic reflux (regurgitation) of stomach contents up into the esophagus, trauma from taking medicines, and infections can injure the squamous lining of the esophagus. If long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) leads to reactive gastropathy, your doctor may recommend that you stop taking NSAIDs, take a lower dose, or take a different medicine for pain. Of all the antral gastritis symptoms, one of the most common symptoms is indigestion. For more information about this site, contact us at info@mypathologyreport.ca. Loss of appetite, indigestion, weight loss, belching, and stomach bloating are all possible symptoms. | Find, read and cite all the research . Introduction . The articles on MyPathologyReport are intended for general informational purposes only and they do not address individual circumstances. "Evolving patterns in the diagnosis of reactive gastropathy: data from a prospective Central European multicenter study with proposal of a new histologic scoring system.". Characterized by scars and lesions, this form is considered difficult to treat. When they occur, symptoms can include stomach distress, such as acid reflux, ulcers, gastritis, or gastroesophageal reflux disease (GERD). The prostaglandin E1 analog drug, Cytotec (misoprostol) has proven to be an effective preventative medication for gastric lesions associated with high-dose . The finding of reactive gastropathy indicates the presence of an offending agent, usually nonsteroidal anti-inflammatory drugs (NSAIDs) or reflux of bile acid-containing duodenal contents into the stomach. what does it mean? Common types of gastritis and gastropathy include . The localization of CK7 and CK20 staining was modified, with extension toward the deep foveolar region. The substances that cause reactive gastropathy can come from inside the body or they can be from a source outside of the body. Diagram of the alkaline mucous layer in the stomach with mucosal defense mechanisms. [14] However, most of these COX-2 inhibitors have been withdrawn from the market or have had their indications drastically limited in view of their potential serious cardiovascular side effects. Antral Gastritis: Gastritis refers to inflammation of the inner stomach lining. It can lead to ulcers and may also increase the risk of developing stomach cancer. Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. Other symptoms associated with antral gastritis are: Almost everyone has experienced indigestion and stomach discomfort at some point in their lives. 1996 Oct. 20(10):1161-81. Symptoms. I was diagnosed with functional dyspepsia and told to try brain-gut meds (antidepressants). As a result of the neutral pH within the surface epithelial cells, the NSAID compound dissociates into its ionized form, contributing to direct cell injury. Stomach Antrum Vascular Ectasia - an overview | ScienceDirect Topics J Clin Pathol. If bile reflux is causing reactive gastropathy, doctors may prescribe ursodiol, a medicine that contains bile acids and can help heal the stomach lining, or surgery to stop flow of bile into the stomach. [4] The secondary (deoxycholic and lithocholic) and deconjugated bile acids are more injurious to the gastric mucosa than the primary (colic and chenodeoxycholic) and conjugated bile acids. May be seen post-Bilroth II (distal gastrectomy). Ann Intern Med. Iijima K, Iwabuchi T, Ara N, et al. [QxMD MEDLINE Link]. The most common complaint associated with NSAID-induced reactive gastropathy is mild dyspepsia. 27:1348-54. Tortuosity of glands in the "neck" region of the gastric glands. This can lead to a burning sensation that happens with indigestion to occur in the upper abdomen. Gastropathy indicates there is something wrong there, typically inf. [QxMD MEDLINE Link]. Devon is keenly aware of trends and new developments in the area of health and wellness. 43(4):303-6. Nausea, bilious vomiting, and other dyspeptic symptoms may also be present. Dig Dis Sci. This damage prevents the foveolar cells from producing mucus. What causes antral gastritis and how to treat it? - Bel Marra Health [QxMD MEDLINE Link]. [13], Although it is known that NSAIDs that selectively inhibit COX-2 cause significantly fewer GI complications than nonselective COX inhibitors do, it is still unclear whether administration of selective inhibitors results in less severe reactive gastropathy (chemical gastropathy).