scholarly journals Disappearance of Gastric Hyperplastic Polyps after the Discontinuation of Proton Pump Inhibitor in a Patient with Liver Cirrhosis

2021 ◽  
pp. 202-209
Author(s):  
Kengo Yasugi ◽  
Ken Haruma ◽  
Miwa Kawanaka ◽  
Mitsuhiko Suehiro ◽  
Jun Nakamura ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Upper Gastrointestinal Endoscopy ◽  
Complete Disappearance ◽  
Hyperplastic Polyps ◽  
Cell Hyperplasia ◽  
Greater Curvature ◽  
One Year ◽  
Epithelium Cells

Here, we report on a rare case of gastric hyperplastic polyps which disappeared after the discontinuation of proton pump inhibitor (PPI). The patient was an 83-year-old woman with liver cirrhosis and portal hypertension, along with gastroesophageal reflux disease treated by PPI. An initial upper gastrointestinal endoscopy showed unique polypoid lesions in the greater curvature of the stomach. Biopsy specimens of the lesions were diagnosed as hyperplastic polyps and she was followed. One year later, a second endoscopy showed that the lesions had increased in number and size, and an endoscopic mucosal resection (EMR) was performed for the main polyps. The resected specimens indicated a proliferation of foveolar epithelium cells with an increase of capillary ectasia and parietal cell hyperplasia, which was thought to be induced by hypergastrinemia from the PPI. Three months after the EMR, she was admitted because of bleeding from the remaining polyps along with an increase in new polyps. After conservative treatment, PPI was stopped and rebamipide was used. One year and 6 months later, an endoscopy showed the complete disappearance of all gastric polyps.

scholarly journals ENDOSCOPIC AND HISTOPATHOLOGIC GASTRIC CHANGES IN CHRONIC USERS OF PROTON-PUMP INHIBITORS

2015 ◽  
Vol 52 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Sílvia Maria Perrone CAMILO ◽  
Élia Cláudia de Souza ALMEIDA ◽  
Benito André Silveira MIRANZI ◽  
Juliano Carvalho SILVA ◽  
Rosemary Simões NOMELINI ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Serum Levels ◽  
Control Group ◽  
Upper Gastrointestinal Endoscopy ◽  
Positive Serology ◽  
Cell Hyperplasia ◽  
Sydney System ◽  
A Prospective Study ◽  
Histopathologic Findings

Background Proton-pump inhibitors have been used for at least two decades. They are among the most commonly sold drugs in the world. However, some controversy remains about the indications for their use and the consequences of their prolonged use. Objectives To evaluate and compare the endoscopic and histopathologic gastric changes in chronic users of proton-pump inhibitors to changes in non-users. Methods A prospective study performed at a tertiary Public Hospital involving 105 patients undergoing upper-gastrointestinal endoscopy. Subjects included 81 proton-pump inhibitor users and 24 non-users (control group). Biopsies of the antral-type mucosa, the antral-fundic transition, and the fundus were evaluated by the Sydney System. The presence of erosion or ulceration, lymphatic follicles, reactive gastropathy, and polypoid or epithelial hyperplasia was also determined. Serum levels of gastrin were measured. Results We found two polyps, one in each group, both of which were negative for Helicobacter pylori. There were two cases of parietal cell hyperplasia in users of proton-pump inhibitors. Gastrin was elevated in 28 users of proton-pump inhibitors and in four members of the control group. We did not find statistically significant differences in the endoscopic or histopathologic findings between the two groups. Conclusions Chronic use of proton-pump inhibitors for the duration examined was not associated with significant gastric changes. An interesting finding was that the 4 chronic users of proton-pump inhibitors who had serum gastrin levels above 500 pg/mL also had positive serology for Chagas disease.

scholarly journals The Rate of Prescribing Gastrointestinal Prophylaxis with Either a Proton Pump Inhibitor Or an H2-Receptor Antagonist in Nova Scotia Seniors Starting Nonsteroidal Anti-Inflammatory Drug Therapy

2010 ◽  
Vol 24 (8) ◽  
pp. 481-488 ◽  
Author(s):  
Bogdan Superceanu ◽  
Sander Veldhuyzen van Zanten ◽  
Chris Skedgel ◽  
Michael Shepherd ◽  
Ingrid Sketris
Keyword(s):  
Nova Scotia ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Nonselective Nsaid ◽  
H2 Receptor Antagonist ◽  
Number Of Patients ◽  
Increased Risk ◽  
Gastroprotective Agent ◽  
Anti Inflammatory ◽  
One Year

BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used agents that can cause serious gastrointestinal (GI) side effects. For patients at increased risk of NSAID-related GI complications, prophylaxis with either a nonselective NSAID plus gastroprotective agent (GPA) or, alternatively, therapy with a cyclooxygenase-2 selective inhibitor with or without a GPA such as a proton pump inhibitor (PPI), is recommended.AIM: To describe the rate, timing and duration of GI prophylaxis in Nova Scotia seniors receiving nonselective NSAIDs.METHODS: The Nova Scotia Seniors’ Pharmacare Program beneficiaries for the years 1998 to 2002 were studied. A cohort of incident NSAID and GPA users was selected from all nonselective NSAID users (no prescribed NSAID dispensed 12 months before the index month and no GPA dispensed two months before the index prescription). Monthly coprescribing rates were calculated by dividing the number of patients in the cohort using GPAs by the number of NSAID users. GI prophylactic coprescribing was defined as the coprescribing rate present at the first month (index month) of prescribing an NSAID.RESULTS: The cohort consisted of 12,906 patients. Seventy-five per cent of the nonselective NSAID prescriptions dispensed were for up to two months duration, with only 2.3% longer than one year. GI prophylaxis was given to only 3.8% of patients starting NSAIDs who were not on a GPA in the two months before starting NSAIDs. Of this 3.8%, 92.7% of the patients received H2-receptor antagonists (H2RAs), and 7% received PPIs. The rate of H2RA coprescribing increased with the number of consecutive months on an NSAID from 3.5% in the first month to 24.1% at 48 months. For PPIs, the coprescribing rate increased from 0.3% to 1.9% of all NSAID users in the cohort. The rate of gastroprophylaxis coprescribing for patients receiving NSAIDs did not rise with increasing age.CONCLUSION: In Nova Scotian seniors using nonselective NSAIDs, the rate of GI prophylaxis was low. Most patients received H2RAs as GPAs despite evidence that they offer insufficient protection.

scholarly journals Prevalence of gastric polypoid lesions in a single endoscopic centre

2013 ◽  
Vol 154 (20) ◽  
pp. 770-774
Author(s):  
Ágnes Anna Csontos ◽  
Bálint Fekete ◽  
Katalin Lőrinczy ◽  
Orsolya Terjék ◽  
Lajos Berczi ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Chronic Gastritis ◽  
Malignant Lesion ◽  
Fundic Gland ◽  
Hyperplastic Polyps ◽  
Gastric Polyps ◽  
Fundic Gland Polyps ◽  
Upper Gastrointestinal

Background: The prevalence of gastric polyps is unknown in Hungary. Aim: The aim of the authors was to assess the prevalence of polypoid lesions of the stomach in the endoscopic centre of the 2nd Department of Medicine, Semmelweis University. Methods: Results of upper gastrointestinal endoscopies carried out between March 2010 and June 2011 were analysed. Results: 193 cases with polyps were diagnosed in 4174 endoscopies (4.62%). Hyperplastic polyps, fundic gland polyps and malignant lesion were detected in 33.67%, 31.09% and 2.07% of the cases, respectively. Proton pump inhibitor use was more frequent among patients diagnosed with fundus gland polyps (p = 0.007), while hyperplastic polyps were diagnosed more frequently in patients with chronic gastritis (p = 0.032). Conclusions: The frequency of gastric polyps was higher than expected from data published in the literature. Long-term proton pump-inhibitor use and chronic gastritis were associated with fundus gland and hyperplastic polyps, respectively. Orv. Hetil., 2013, 154, 770–774.

scholarly journals Outcome of Post Esophageal Variceal Band Ligation with Sucralfate and Proton Pump Inhibitor vs. Proton Pump Inhibitor Alone in Cirrhotic Patients

2019 ◽  
Vol 2 (2) ◽  
pp. 209-214
Author(s):  
Binod Karki ◽  
Ramila Shrestha ◽  
Bidhan Nidhi Paudel ◽  
Sudhamshu KC ◽  
Dibas Khadka ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Primary Prophylaxis ◽  
Upper Gastrointestinal Endoscopy ◽  
Ulcer Formation ◽  
Open Label ◽  
Esophageal Variceal ◽  
Band Ligation ◽  
Mean Size ◽  
Group B

Introduction: Endoscopic band ligation is the mainstay of treatment in bleeding varices in cirrhosis.  Subsequent bleeding from the band ulcers is a possible complication. Proton pump inhibitors and Sucralfate are commonly used post band ligation and often in combination. The aim of the study was to identify the advantage of combining Sucralfate to proton pump inhibitor in reducing the number and size of band ulcers.Materials and Methods: This was an open-label comparative study conducted in a tertiary level hospital of Nepal. Patients with cirrhosis after band ligation were included. Eligible patients were randomized into a proton pump inhibitor alone (Group A) or proton pump inhibitor and sucralfate group (Group B) and they underwent upper gastrointestinal endoscopy after two weeks. Baseline parameters, number and mean size of band ulcers were compared.Results: A total of 58 patients, 29 in each group, were evaluated. The baseline characteristics were comparable. EBL was done for bleeding varices in 51.7% and as primary prophylaxis in the rest of them. All the patients had band ulcers after two weeks. The mean size of the largest ulcer was 1.62±0.72 and 1.10±0.60 (p=0.78) respectively in groups A and B. Low albumin was significantly associated with OR of 8.7 (95% CI:1.68-44.99) for the formation of multiple (more than two) ulcers (p=0.01).Conclusions: The ulcer formation was universal after band application. The addition of sucralfate did not offer more benefits in terms of the number and mean size of the ulcer. Low albumin was the independent predictor for multiple ulcer formation.

scholarly journals Disease severity and proton pump inhibitor use impact strongest on faecal microbiome composition in liver cirrhosis

2020 ◽  
Vol 40 (4) ◽  
pp. 866-877 ◽  
Author(s):  
Vanessa Stadlbauer ◽  
Irina Komarova ◽  
Ingeborg Klymiuk ◽  
Marija Durdevic ◽  
Alexander Reisinger ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Proton Pump Inhibitor ◽  
Disease Severity ◽  
Proton Pump ◽  
Microbiome Composition ◽  
Faecal Microbiome

scholarly journals Proton Pump Inhibitor-Associated Large Hyperplastic Polyp in Non-Helicobacter pylori-Infected Stomach

2021 ◽  
pp. 539-544
Author(s):  
Kimitoshi Kubo ◽  
Noriko Kimura ◽  
Norishige Maiya ◽  
Soichiro Matsuda ◽  
Momoko Tsuda ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Hyperplastic Polyp ◽  
Gastric Body ◽  
Tarry Stool ◽  
Transnasal Endoscopy ◽  
Pedunculated Polyp ◽  
Greater Curvature ◽  
H Pylori

A proton pump inhibitor (PPI)-associated hyperplastic polyp (HP) in the non-<i>Helicobacter pylori</i>-infected stomach is rare, and its endoscopic features remain poorly described. A 42-year-old man with tarry stool was referred to our hospital for examination and treatment. He had taken PPI for 14 years and was confirmed to be <i>H. pylori</i>-negative. Transnasal endoscopy revealed bleeding from a 20-mm, reddish pedunculated polyp with a nodular surface, located in the greater curvature of the upper gastric body. Endoscopic mucosal resection was performed, and the lesion was diagnosed as an HP. To our knowledge, this report represents a valuable addition to the HP literature describing a rare case of PPI-associated large HP in the non-<i>H. pylori</i>-infected stomach.

Complete disappearance of an esophagogastric polyp with concurrent early-stage adenocarcinoma after administration of a proton pump inhibitor

Endoscopy ◽  
2010 ◽  
Vol 42 (S 02) ◽  
pp. E176-E177 ◽  
Author(s):  
T. Yoshida ◽  
Y. Shimizu ◽  
J. Hirota ◽  
Y. Ono ◽  
M. Nakagawa ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Early Stage ◽  
Complete Disappearance
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