Gastric Polyps in Long-Term Proton Pump Inhibitor Use: Identification of Risks and Characteristics

Area of Science:

• Gastroenterology
• Pharmacology
• Epidemiology

Background:

• Proton pump inhibitors (PPIs) are widely used for acid-related gastrointestinal disorders.
• Long-term PPI use has been anecdotally linked to gastric polyp formation.
• Understanding the prevalence and risk factors of PPI-associated gastric polyps is crucial.

Purpose of the Study:

• To estimate the prevalence of gastric polyps in patients with long-term PPI use.
• To identify risk factors associated with PPI-induced gastric polyps.
• To characterize the features of these gastric polyps.

Main Methods:

• Prospective cross-sectional study of ~1000 patients undergoing upper GI endoscopy.
• Data collected via questionnaire on PPI use, demographics, and clinical history.
• Exclusion of patients with H. pylori, hypergastrinemia, or history of gastric polyps.

Main Results:

• A 30% prevalence of gastric polyps was observed in long-term PPI users.
• Minimum PPI duration for polyp formation was approximately 24 months; dosage was not significant.
• Polyps were more common in females (OR 2.9), increased with age, and were predominantly fundic gland polyps (FGPs).

Conclusions:

• PPI-induced FGPs showed no dysplasia in this study; no direct link to gastric cancer is proven.
• The incidence of FGPs has risen with widespread PPI use, warranting attention to potential dysplasia risks.
• Limiting PPI prescriptions to defined indications and identifying associated risk factors are important.