Fundic gland polyp prevalence according toHelicobacter pyloriinfection status

Abstract

Background and AimThe prevalence of fundic gland polyp (FGP) occurrence has not been clarified in individuals with Helicobacter pylori infection post‐eradicated status. This study was performed to examine the relationship between FGP prevalence and H. pylori infection status.MethodsWe enrolled 3400 subjects (2185 male subjects and 1215 female subjects; mean age 54.7 ± 9.5 years) with known H. pylori infection status and who underwent an upper gastrointestinal endoscopy examination as part of an annual check‐up. Subjects without and with H. pylori infection numbered 1617 and 239, respectively, while 1544 had a post‐eradication status. The presence of FGP and degree of gastric mucosal atrophy were determined in each subject using an endoscopic method.ResultsEndoscopy findings showed FGPs in 1029 (30.3%) of all subjects. The prevalence ratio of FGP positivity in H. pylori‐negative, H. pylori‐positive, and post‐eradicated subjects was 51.9%, 1.7%, and 12.0%, respectively. Multiple logistic regression analysis revealed that female gender, older age, milder gastric mucosal atrophy, and anti‐secretory therapy were significant risk factors for FGP occurrence. As compared with H. pylori‐positive subjects, the odds ratios for H. pylori‐negative and post‐eradication status were 48.3 and 6.6, respectively (P < 0.001). In the post‐eradication status subjects, longer duration following bacterial eradication was a significant risk factor for occurrence of FGPs.ConclusionThe risk of FGP occurrence in individuals who have undergone H. pylori eradication treatment is lower as compared with those who have never been infected. However, that risk increases over time following eradication.

The clinicopathological characteristics of gastric polyps and the relationship between fundic gland polyps, Helicobacter pylori infection, and proton pump inhibitors

“…In contrast, the relationship between HP infection and the occurrence of fundic gland polyps has not yet been elucidated. Studies have shown that HP infection is negatively correlated with the incidence of fundic gland polyps (9), and the HP infection rate in patients with fundic gland polyps is significantly lower than that in patients with hyperplastic polyps (10). However, some studies have mentioned that although HP infection has been confirmed to be related to the occurrence of hyperplastic polyps and inflammatory fibrous polyps, there is no clear relationship between fundic gland polyps and HP infection (11,12).…”

Sporadic fundic gland polyps with dysplasia or carcinoma: Clinical and endoscopic characteristics

“…In the 1990s, FGPs were reported to be prevalent in 0.21%-2.0% of patients undergoing esophagogastroduodenoscopy[ 9 - 11 ]. However, since the launch of PPIs around 1990, an increase in the number and size of FGPs associated with PPI use has been reported, and reports since 2000 have shown an obvious increase in the prevalence of FGPs at 5.9%-30.3%[ 12 , 13 ]. FGPs have been reported to occur in 13.6%-36% of patients receiving PPI therapy[ 5 , 14 ].…”

“…Carmack et al [ 1 ] compared the prevalence of various polyps in the United States population over a one-year period from April 2007 to March 2008 with that in previous reports and noted an increase in FGP prevalence with PPI use. In addition, FGPs can occur in Helicobacter pylori ( H. pylori )-negative stomachs[ 1 , 12 , 13 ]. In the future, considering that the H. pylori infection rate has been decreasing in recent years[ 15 , 16 ], the prevalence of FGPs is expected to further increase along with the widespread and frequent use of PPIs.…”

“…Sporadic FGPs are negatively correlated with H. pylori infection. They are ordinarily observed in the H. pylori -uninfected stomachs without mucosal atrophy and occasionally in the post-eradication setting[ 1 , 12 , 13 , 23 ]. In addition, sporadic FGPs exhibit a positive correlation with PPI use; long-term PPI use has been reported to increase the number and size of FGPs[ 5 - 8 ].…”

“…In addition, sporadic FGPs exhibit a positive correlation with PPI use; long-term PPI use has been reported to increase the number and size of FGPs[ 5 - 8 ]. However, this change is reversible, and reducing or discontinuing PPI or switching to H2-receptor antagonists has been reported to reduce the increased number and size of FGPs[ 13 , 24 , 25 ].…”