It is controversial whether proton pump inhibitor use leads to fundic gland polyp development.
Dr Kleibeuker and colleagues from the Netherlands determined whether fundic gland polyp development is due to proton pump inhibitor (PPI) use.
The research team also investigated mechanisms involved.
Proton pump inhibitor use and the presence of fundic gland polyps were assessed in consecutive patients undergoing esophagogastroduodenoscopy.
| Long-term PPI use had a higher frequency of parietal cell hyperplasia|
|Alimentary Pharmacology & Therapeutics|
The researchers took biopsies from fundic gland polyps and gastric mucosa.
Dysplasia was graded as negative, low or high grade.
In addition, the team assessed prevalence of parietal cell hyperplasia and parietal cell protrusions and the proportional cystic area.
The team reported that 599 patients participated, of which 322 used proton pump inhibitors, and 107 had fundic gland polyps.
The researchers found that long-term PPI use was associated with an increased risk of fundic gland polyps.
Short-term therapy with PPIs was not associated with an increased risk of fundic gland polyps.
The team found identified low-grade dysplasia in 1 fundic gland polyp.
Fundic gland polyps associated with long-term PPI use had a larger proportional cystic area.
The team observed that long-term PPI use also had a higher frequency of parietal cell hyperplasia and parietal cell protrusion.
Dr Kleibeuker's team concludes, “Long-term PPI use is associated with an up to 4-fold increase in the risk of fundic gland polyps.”
“Risk of dysplasia is negligible.”
“Etiologically, these polyps seem to arise because of parietal cell hyperplasia and parietal cell protrusions resulting from acid suppression.”