Proton-pump inhibitor-induced fundic gland polyps with hematemesis

Clin J Gastroenterol. 2019 Apr;12(2):193-195. doi: 10.1007/s12328-018-0908-7. Epub 2018 Sep 24.

Abstract

Fundic gland polyps (FGPs) are generally considered benign. Proton-pump inhibitors (PPIs) are used worldwide as first-line therapy for gastroesophageal reflux disease and nonsteroidal anti-inflammatory drug-induced ulcer treatment. Long-term use of PPIs increases the risk of FGP development. We report an extremely rare case of PPI-induced FGPs with hematemesis. A 37-year-old woman taking daily rabeprazole presented to the hospital with a complaint of hematemesis and tarry stools. Esophagogastroduodenoscopy (EGD) revealed > 20 pedunculated polyps in the gastric body and fundus. Histological examination showed multiple fragments of fundic gland mucosa with dilated glands. Based on these findings and the clinical history, FGPs were diagnosed. Rabeprazole use was discontinued. Repeat EGD performed 9 months later showed a significant decrease in the number and size of the polyps. FGPs are small polyps typically located in the gastric corpus and fundus. They are commonly reported in patients in their 60s and predominantly in females. We conclude that PPI use is a risk factor for the development of FGPs and hematemesis.

Keywords: Esophagogastroduodenoscopy (EGD); Fundic gland polyps (FGPs); Gastroesophageal reflux disease (GERD); Proton-pump inhibitors (PPIs).

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Endoscopy, Digestive System
  • Female
  • Gastric Fundus / pathology
  • Gastroesophageal Reflux / drug therapy*
  • Hematemesis / chemically induced*
  • Humans
  • Polyps / chemically induced*
  • Polyps / diagnosis
  • Polyps / pathology
  • Proton Pump Inhibitors / adverse effects*
  • Stomach Neoplasms / chemically induced*
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / pathology

Substances

  • Proton Pump Inhibitors