Acid suppressive therapy improved symptoms due to circumferential cervical inlet patch with proton pumps (H⁺/K⁺-ATPase)

Abstract

Cervical inlet patch (CIP), also referred to as esophageal heterotopic gastric mucosa, is regarded as the residue of columnar epithelium of the embryonic esophagus. Narrow band imaging increases the detection rate of CIP. Herein, we present a 55-year-old man with symptomatic circumferential inlet patch. He exhibited globus and dysphagia, and esophagogastroduodenoscopy found cir-cumferential CIP, where im-munohistochemistry revealed the existence of pro-ton pumps (H+, K+-ATPase). His throat symptoms were relieved by acid suppressive therapy with pump inhibitors. This case indicated that CIP should be considered as a differential diagnosis for the cause of globus symptoms in rare cases.

Esophageal Polyp Lesion in a Patient with Globus Pharyngeus Compliant

“…[3][4][5][6][7] Proton pomp (H + , K + , -ATPase) influence at the inlet patch has been shown by immunohistochemistry. 8 PPI influence in some studies supports the theory that acid released from proton pomp in patients with inlet patch may cause the emergence of globuspharyngeus signs. In one study, the inlet patch has been known as one of the main causes of globus pharyngeus.…”

Issues and controversies in esophageal inlet patch

“…Detection of IP-like lesions and subsequent confirmation by histology would help to avoid confusing incipient cancers with heterotopic mucosa. IPs present with a reddish or salmon-rose colored focal area on standard endoscopy and as a homogeneous dark brown lesion that is distinctly separated from the light green squamous epithelium in the NBI mode[54]. NBI systems can be very helpful to identify brownish areas with brown dots and branching vessels in the cervical esophagus as potential superficial esophageal cancers.…”

Heterotopic Gastric Mucosa in Middle Esophagus Complicated with Esophageal Ulcers

“…A standard treatment for esophageal HGM has yet to be established, although some case reports have described successful use of proton pump inhibitors (PPIs) for symptomatic esophageal-HGM patients ( 19 - 21 ). In the present case, both clinical symptom and endoscopic findings were improved following oral intake of vonoprazan, a potassium-competitive acid blocker (PCAB).…”