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Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
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Pharmacological management
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Potassium-Competitive Acid Blocker-Associated Gastric Hyperplastic Polyps With Severe Bleeding: A Case Series.

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Switching from vonoprazan (VPZ) to H2-receptor antagonists (H2RAs) effectively treated severe gastric hyperplastic polyp bleeding and regression in three patients. This suggests VPZ may contribute to polyp growth, and H2RAs offer a viable alternative.

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Area of Science:

  • Gastroenterology
  • Pharmacology

Background:

  • Gastric hyperplastic polyps can cause significant gastrointestinal bleeding.
  • Long-term acid-suppressive therapy is linked to polyp enlargement.
  • Vonoprazan (VPZ), a potassium-competitive acid blocker, may induce hypergastrinemia, potentially promoting polyp growth, but clinical data is limited.

Purpose of the Study:

  • To report clinical information on gastric hyperplastic polyps associated with vonoprazan (VPZ) use.
  • To investigate the effect of switching from VPZ to H2-receptor antagonists (H2RAs) in patients with VPZ-associated gastric hyperplastic polyps and bleeding.

Main Methods:

  • Case series reporting three patients with severe bleeding from gastric hyperplastic polyps while on VPZ.
  • Clinical data including endoscopy, serum gastrin levels, and treatment outcomes were analyzed.
  • Patients were switched from VPZ to H2RAs, and polyp regression and bleeding status were monitored.

Main Results:

  • All three patients experienced severe bleeding from gastric hyperplastic polyps attributed to VPZ.
  • Switching from VPZ to H2RAs led to polyp regression and improvement in anemia in all cases.
  • Elevated serum gastrin levels were noted in one patient; hemodialysis in two patients may have exacerbated hypergastrinemia.

Conclusions:

  • Vonoprazan (VPZ) may contribute to the growth and bleeding of gastric hyperplastic polyps.
  • Discontinuation of VPZ or switching to an H2-receptor antagonist (H2RA) can be an effective strategy for managing VPZ-associated gastric hyperplastic polyps and bleeding.
  • Further investigation into the relationship between VPZ, hypergastrinemia, and gastric polyp development is warranted.