Related Experiment Video
Updated: Aug 19, 2026
Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia
Published on: February 16, 2024
Effect of Helicobacter pylori eradication on gastric hyperplastic polyposis in Cowden's disease
Hajime Isomoto1, Hisashi Furusu, Ken Ohnita
1Second Department of Internal Medicine, Nagasaki University School of Medicine 1-7-1 Sakamoto, Nagasaki, Japan. hajimei2002@yahoo.co.jp
Insights
Cowden's disease patients with gastric polyps and Helicobacter pylori infection may benefit from eradication therapy. Successful treatment led to significant regression of polyposis lesions, reducing potential cancer risk.
Area of Science:
- Gastroenterology
- Genetics
- Oncology
Background:
- Cowden's disease (CD) is an autosomal dominant disorder associated with multiple hamartomas.
- Patients with CD have an increased risk of developing various cancers.
- Gastric hyperplastic polyps and Helicobacter pylori infection are potential complications.
Observation:
- A 21-year-old woman with Cowden's disease presented with hematochezia.
- Endoscopy revealed rectal and colonic hyperplastic polyps, esophageal glycogenic acanthosis, and gastric hyperplastic polyposis with H. pylori gastritis.
- Initial H. pylori eradication therapy failed.
Findings:
- Salvage therapy for H. pylori infection resulted in near-complete regression of gastric polyposis.
- Follow-up gastroscopy confirmed sustained regression and absence of H. pylori infection for 2-3 years.
- This suggests a link between H. pylori eradication and polyposis resolution in CD.
Implications:
- Eradication therapy for H. pylori in CD patients with gastric hyperplastic polyps is recommended.
- Prompt treatment may mitigate the risk of gastric carcinoma associated with these polyps.
- Further research into the pathogenesis and management of gastrointestinal manifestations in Cowden's disease is warranted.
Abstract:
A 21-year-old woman with complaints of hematochezia was diagnosed as having Cowden's disease (CD), an autosomal dominant condition characterized by multiple hamartomas, since facial papules and gingival papillomas were identified. On endoscopy, multiple hyperplastic polyps were seen in the rectum and left-side colon. There were also esophageal glycogenic acanthosis and hyperplastic polyposis in the antrum accompanied by Helicobacter pylori-related gastritis. Although gastric hyperplastic polyposis had by no means regressed with unsuccessful first-line eradication therapy for H pylori, following cure of the infection with salvage therapy consisting of rabeprazole, amoxicillin and metronidazole, the polyposis lesions almost disappeared. Follow-up gastroscopy 2 and 3 years after cessation of the second-line eradication therapy revealed almost complete regression of the polyposis lesions with no evidence of H pylori infection. We recommend eradication treatment for CD patients with gastric hyperplastic polyps and the infection, as the occurrence of gastric carcinoma among hyperplastic polyps has been described.
Related Concept Videos
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
01:26Gastritis II: Pathophysiology
01:30Peptic Ulcer Disease I: Introduction
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
01:24Pathophysiology of Peptic Ulcer Disease: Mucosal Defense Factors
01:24Peptic Ulcer Disease II: Pathophysiology
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.