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Most patients with portal hypertensive gastropathy have either a stable or improving course in the appearance of the gastropathy on endoscopy.However, according to retrospective data, roughly one in seven patients with portal hypertensive gastropathy will develop bleeding (either acute or chronic) attributable to the gastropathy. [1]
Gastric erosion occurs when the mucous membrane lining the stomach becomes inflamed. Specifically, the term "erosion," in this context means damage that is limited to the mucosa (which consists of three distinct layers: The epithelium (in the case of a healthy stomach, this is non-ciliated simple columnar epithelium), basement membrane, and lamina propria).
There is erosive gastritis, for which the common causes are stress, alcohol, some drugs, such as aspirin and other nonsteroidal anti-inflammatory drugs , and Crohn's disease. And, there is non-erosive gastritis, for which the most common cause is a Helicobacter pylori infection. [15] [1]
In case of severe hemorrhagic or erosive gastritis and stress ulcers, a combination of antacids and H2-blockers may stop active bleeding and prevent bleeding from happening again. In selected patients, either endoscopic therapy or selective infusion of vasopressin into the left gastric artery may help control the hemorrhage.
Endoscopy is essential in ruling out other causes of upper gastrointestinal bleeding and in rare cases; active bleeding can be seen from the duodenal ampulla. Even though endoscopy may be normal, it helps to rule out other causes of upper digestive bleeding (erosive gastritis, peptic ulcers, and oesophageal and gastric fundus varices, etc.).
Reactive gastropathy is morphologically distinct entity [3] [4] that can be separated from gastritis, which by definition has a significant inflammatory component. As a reactive gastropathy may mimic a (true) gastritis symptomatically and visually in an endoscopic examination , it may incorrectly be referred to as a gastritis.
Thickening of the gastric folds may be observed by endoscopy or radiography and may aid in the differential diagnosis of many disease processes including: [3] Gastritis The folds become very thick due to inflammation. [7] Peptic ulcer disease Ulcers cause breaks in the mucosa and cause erosion of the sub-mucosa. Zollinger-Ellison syndrome
Sometimes the lesions are found when endoscopy is done for other hernia symptoms than anemia such as heartburn, regurgitation, swallowing difficulty, pain or distention. [9] When a person with iron deficiency anemia is found to have a large hernia and Cameron lesions on endoscopy, this usually explains the blood loss.