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Disappearance of Hyperplastic Polyps in the Stomach after Eradication of Helicobacter pylori: A Randomized, Controlled Trial

Toshifumi Ohkusa, MD; Ichizen Takashimizu, MD; Kazuhiko Fujiki, MD; Shinji Suzuki, MD; Kengo Shimoi, MD; Takao Horiuchi, MD; Toshiaki Sakurazawa, MD; Koichiro Ariake, MD; Kenichi Ishii, MD; Jiro Kumagai, MD; and Toru Tanizawa, MD
[+] Article, Author, and Disclosure Information

From Tokyo Medical and Dental University School of Medicine, Tokyo, Japan. Acknowledgments: The authors thank Dr. T. Kuroiwa for help in preparation of the English version of the manuscript. Requests for Reprints: Toshifumi Ohkusa, MD, First Department of Internal Medicine, Tokyo Medical and Dental University School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113, Japan; e-mail, ohmed1@med.tmd.ac.jp. Current Author Addresses: Drs. Ohkusa, Takashimizu, Fujiki, Suzuki, Shimoi, Horiuchi, Sakurazawa, Ariake, and Ishii: First Department of Internal Medicine, Tokyo Medical and Dental University School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113, Japan.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1998;129(9):712-715. doi:10.7326/0003-4819-129-9-199811010-00006
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Background: Helicobacter pylori infection is common in patients with hyperplastic gastric polyps.

Objective: To study the effect of eradication of H. pylori on the clinical course of patients with hyperplastic gastric polyps.

Design: Single-blind, randomized, controlled trial.

Setting: University-based gastroenterology outpatient clinic.

Patients: 35 patients with H. pylori infection and hyperplastic gastric polyps at least 3 mm in diameter.

Intervention: Patients were randomly assigned to a treatment group (n = 17), which received a proton-pump inhibitor (omeprazole or lansoprazole), amoxicillin, and either clarithromycin or ecabet sodium, or to a control group (n = 18), which received no treatment.

Measurements: Patients underwent endoscopy before enrollment and 12 to 15 months after the end of treatment. Serum gastrin levels and titers of IgG to H. pylori were measured.

Results: In the treatment group, the polyps had disappeared by 3 to 15 months (average, 7.1 ± 1.2 months) after the end of treatment in 12 of all 17 patients (71%) and in 12 of the 15 patients (80%) in whom H. pylori was eradicated. However, 12 to 15 months after the start of the study, no change in polyps or H. pylori status was seen in any controls (P < 0.001). Histologic findings of inflammation and activity, serum gastrin levels, and titers of IgG to H. pylori showed significant regression in the treatment group compared with the control group (P < 0.01).

Conclusions: Most hyperplastic polyps disappeared after eradication of H. pylori. Thus, eradication should be attempted before endoscopic removal is done in patients with hyperplastic gastric polyps and H. pylori infection.





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