Gastroscopic demonstration of extensive mucosal erythema is a clinical manifestation of portal hypertensive gastric disease. Gastric mucosal congestion and edema, erythematous exudative gastritis with bile reflux, is commonly seen in gastritis. Such atypical changes are seen in all types of gastritis. What are the causes of gastroscopic manifestation of extensive mucosal erythema? 1, mucosal circulation disorders Normal gastric mucosa can concentrate H 1 million times, so that the gastric lumen and the gastric wall between the maintenance of a very high H concentration gradient, the gastric mucosa relies on abundant blood flow to clear the H entering the gastric wall, hemodynamic changes after elevated portal pressure, submucosal vasodilation, arteriovenous traffic, venous and capillary varices, venous stasis, increased submucosal blood flow, but reduced mucosal blood supply caused by ischemia and hypoxia. 2, liver function status Acute gastric mucosal lesions and bleeding occur in 18.6% of those with normal or mildly impaired liver function, and 55.5% of those with severe liver insufficiency. 3, bile reflux In portal hypertension, gastrointestinal stasis and hypergastrinemia inhibit the regulation of pyloric sphincter and Oddi sphincter by cholecystokinin and glucagon, making them relax, and bile and duodenal contents reflux into the stomach, causing bile reflux gastritis. 4, endotoxemia Patients with portal hypertension are often complicated by endotoxemia, more common in those with hepatic decompensation, such as 66% to 100% of acute liver failure with endotoxemia; the complication rate of those with hepatic encephalopathy is about 93%; the complication rate of those with gastrointestinal bleeding is 53.8%. 5, infection The presence of hepatitis B virus in the epithelial cells of the gastric mucosa, due to the formation of antigen-antibody complexes and deposited in the microvascular endothelial cells, causing inflammatory reactions and destruction of the gastric mucosal barrier. 6, stress reaction Critical patients, including those with severe liver disease, often experience a stress reaction, causing reduced blood flow to the gastrointestinal mucosa, ischemia and hypoxia and their secondary series of pathophysiological changes.