Korean J Med.  2011 Jul;81(1):6-10.

Concerns on Atrophic Gastritis and Neoplasia: Unsafe Perspective

• Song CS
• Park DI

Abstract

Proton-pump inhibitors (PPI) have important roles in the management of acid-related disorders, especially gastro-esophageal reflux disease and peptic ulcer disease. They are considered safe, but some side effects, such as oxyntic cell hyperplasia, glandular cysts, hypergastrinemia and fundic gland polyps, are also reported. Long-term PPI administration in Helicobacter pylori (H. pylori) positive subjects promotes a shift from antral to corpus-predominant gastritis. The shift leads to corpus atrophy eventually that is known predisposing factor of gastric adenocarcinoma. It is recommended that patients being considered for long-term PPI therapy should be tested for H. pylori infection. And if present, H. pylori eradication should be preceded to PPI administration. Also, long-term PPI administration can cause enterochromaffin-like cell hyperplasia. Although the underlying mechanism and pathogenesis are not yet fully understood, it is possible that long-term PPI administration can promote the development of gastric carcinoid tumor. Therefore, to minimize the side effects, it should be used in adequate dose for a precise duration.

Keyword

Proton-pump inhibitor; Atrophic gastritis; Neoplasia

MeSH Terms

Adenocarcinoma
Atrophy
Carbamates
Carcinoid Tumor
Enterochromaffin-like Cells
Gastritis
Gastritis, Atrophic
Gastroesophageal Reflux
Helicobacter pylori
Humans
Hyperplasia
Organometallic Compounds
Parietal Cells, Gastric
Peptic Ulcer
Polyps
Carbamates
Organometallic Compounds