reactive gastropathy reactive gastropathy reactive gastropathy, chemical gastropathy also called gastritis of « c type » or "chemical gastritis" is an abnormality in the stomach caused by chemicals, e.g. bile, alcohol, and characteristically has minimal inflammation. reactive gastropathymicrograph of a reactive gastropathy. h&e stain.specialtypathology, gastroenterology cause reactive gastropathy has a large number of causes, including: alcohol use disorder. bile reflux, such as may be seen post-billroth ii. nsaids. diagnosis reactive gastropathy, is characterized histologically by: - foveolar hyperplasia (black arrow), as a tortuosity in the "neck" region of the gastric glands.- scant or minimal inflammatory cells (white arrow), i.e. lack of large numbers of neutrophils and plasma cells..- smooth muscle hyperplasia in the lamina propria (in black oval). the diagnosis is by examination of tissue, e.g. a stomach biopsy. low mag. high mag. relation to gastritis reactive gastropathy is morphologically distinct entity 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. even aware of the underlying etiology of the pathologic process, e.g. nsaid use, the label "chemical gastritis" is applied to a chemical gastropathy.