Fundic gland polyps: Should my patient stop taking PPIs?

Article Figures & Data

TABLE 1

Sporadic and syndromic fundic gland polyps compared

Feature	Sporadic fundic gland polyps	Syndromic (FAP-associated) fundic gland polyps
Number	< 20	≥ 20, often hundreds⁸
Location	Body of the stomach	Mostly in the body of the stomach, but can also be seen in the antrum
Presence of dysplasia	Rare	In 25%–40%⁵
Age	Older; average age 40	Under age 40
Sex	More common in females than males	Incidence similar in both sexes⁶
Other EGD findings	None known	Concurrent duodenal adenomas can be seen⁷

TABLE 2

Indications for long-term use of proton pump inhibitors

Definitive (> 8 weeks)	Conditional
Barrett esophagus (unrelated to GERD symptoms or esophagitis)	PPI-responsive, endoscopy-negative reflux disease with recurrence on PPI cessation
Erosive esophagitis Los Angeles classification grade C/D	PPI-responsive functional dyspepsia with recurrence on PPI cessation
Esophageal stricture due to GERD	PPI-responsive upper-airway symptoms with recurrence on PPI cessation
NSAID/antiplatelet users with increased risk of ulcers and bleeding	Refractory steatorrhea in chronic pancreatic insufficiency with enzyme replacement
Eosinophilic esophagitis	Secondary prevention of peptic ulcers without concomitant antiplatelet drugs
Pathological hypersecretory conditions (Zollinger-Ellison syndrome)
Prevention of progression of idiopathic pulmonary fibrosis

GERD = gastroesophageal reflux disease; NSAID = nonsteroidal anti-inflammatory drug; PPI = proton pump inhibitors
Based on information in references 21 and 22.