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Prevalence of gastric proliferative changes in patients with chronic use of proton pump inhibitor agents

BACKGROUND: The medications most often prescribed and used chronically by patients with dyspeptic symptoms belong to the group of inhibitors of proton pump whose main representative is omeprazole, used clinically about 20 years. Recent studies have postulated the relationship between chronic use of this medication and macroscopic and microscopic proliferative changes in mucosal of gastric body, especially the fundic gland polyps. AIM: To analyze the frequency and type of gastric proliferative changes in chronic users of proton pump inhibitors proton and its association with age, dose, time of use, symptoms and Helicobacter pylori infection. METHODS: A survey of prevalence was conducted in Digestive Endoscopy Service, Hospital de Clínicas, Federal University of Paraná, using questionnaire referring the use of these drugs and performed in subjects using this class of drugs during at least 12 months prior to the endoscopy. Gastric biopsies of fundus, body and antrum were performed in all patients. Polyps were removed when present for histopathological analysis. Research on Helicobacter pylori was done by urease test and histopathology. RESULTS: Twenty-two individuals were included of which six (27.3%) had proliferative changes of the mucosa. Of these, two (9.1%) had sporadic fundic polyps and four only microscopic proliferative change as cystic glandular formation. Statistic significant (p <0.05) association between age > 60 years and these changes was found. There was no association between dose of use, time of use, symptoms and Helicobacter pylori infection. CONCLUSIONS: It was observed the existence of proliferative mucosa changes in individuals with chronic use of inhibitors of proton pump. In this group, the association between age and proliferative changes was significant.

Proton pump inhibitors; Gastric mucosa; Polyps


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