PROTON PUMP INHIBITOR-ASSOCIATED GASTRIC POLYPS - A RETROSPECTIVE ANALYSIS OF THEIR FREQUENCY, AND ENDOSCOPIC, HISTOLOGIC, AND ULTRASTRUCTURAL CHARACTERISTICS

Since 1992 there have been reports of proton pump inhibitors being ass ociated with fundic gland-type gastric polyps. Endoscopic and histolog ic characteristics and natural history of these polyps have not been c learly defined We performed a retrospective study of patients on long- term treatment with proton pump inhibitors who developed gastric polyp s. Gastric polyps developed in 17 (10 males and 7 females, 7.3%) of th e 231 patients who underwent 2 or more upper endoscopies for complicat ed gastroesophageal reflux disease and who were receiving long-term tr eatment with proton pump inhibitors. The mean interval of proton pump inhibitor use after which an endoscopy revealed gastric polyps was 32. 5 months. In I patient discontinuation of treatment resulted in disapp earance of the polyps within 3 months. The polyps recurred 4 months af ter the treatment was restarted Endoscopy established that typical pol yps were generally small (<1 cm), sessile, multiple and whitish pink w ith a mottled, partially translucent surface. The polyps were most oft en present in the proximal/midgastric body. Of the 15 polyps removed e ndoscopically, 9 were of the fundic gland type, 4 were of the hyperpla stic type and 2 were of the inflammatory type. Eight of 9 polyps with typical endoscopic appearance were of the fundic gland type. None of t he polyps contained dysplasia or carcinoma. Long-term use of proton pu mp inhibitors may be associated with the presence of small gastric fun dic gland polyps and hyperplastic polyps. A prospective study is requi red to establish their incidence, natural history and clinical signifi cance.