Chemical Reactive Gastropathy Without NSAID/Alcohol Use

Initial Management Approach

• The American College of Gastroenterology recommends proton pump inhibitor (PPI) therapy as the primary treatment for chemical reactive gastropathy without typical risk factors, combined with investigation for other causative factors, particularly bile reflux and H. pylori infection 1, 2

Treatment Protocol

• The American College of Gastroenterology recommends PPI at standard doses, such as omeprazole 20-40 mg daily or equivalent, for at least 8-12 weeks based on symptom response 2
• Eradication of H. pylori infection is recommended as it is a modifiable risk factor that increases gastropathy risk 2-4 fold, even without NSAID use, according to the American College of Gastroenterology 1

Long-Term Management

• Long-term PPI use is considered safe with very low side effect rates, although monitoring for potential risks like pneumonia and hip fracture in prolonged use is suggested by the American College of Gastroenterology 2