Occurrence of a Duodenal Polypoid Lesion During Long-Term Acid Suppression Therapy and Its Regression After Drug Discontinuation

Formation of multiple fundic gland polyps or hyperplastic polyps in the gastric mucosa is one of the well-known adverse effects of the long-term acid suppression therapy for peptic ulcer disease. However, similar phenomenon has not been reported to occur in the duodenum. We report a case of duodenal polypoid lesion that developed after the long-term use of acid suppressants and disappeared after the cessation of the treatment. The patient was a 76-year-old man with a history of heavy cigarette smoking and excessive alcohol intake who had been treated with medication of gastric acid suppressants, including proton pump inhibitors and potassium-competitive acid blockers, for refractory gastroesophageal reflux disease. After receiving the acid suppression therapy for 3 years, a polypoid lesion of 10 mm in diameter was found at the portion of the duodenal bulb. This polypoid lesion disappeared 1.5 months after the cessation of treatment. We hypothesized that changes in serum gastrin levels caused by acid suppression therapy might have been associated with the development and regression of the duodenal polypoid lesion.

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Motion – Helicobacter pylori Causes or Worsens GERD: Arguments for the Motion

Canadian Journal of Gastroenterology ◽

10.1155/2002/576957 ◽

2002 ◽

Vol 16 (9) ◽

pp. 611-614 ◽

Cited By ~ 3

Author(s):

Colm A O’Morain ◽

Asghar Qasim

Keyword(s):

Helicobacter Pylori ◽

Epidemiological Data ◽

Acid Suppression ◽

Duodenal Ulcers ◽

Ulcer Disease ◽

Acid Suppression Therapy ◽

Premalignant Condition ◽

H Pylori ◽

Gerd Symptoms

There are several reasons for eradicating Helicobacter pylori in patients with chronic gastroesophageal reflux disease (GERD). Perhaps the most compelling is the evidence that chronic acid suppression therapy can lead to the development of atrophic gastritis, a premalignant condition, in patients with H pylori infection. Epidemiological data that suggest that H pylori is less prevalent in GERD patients than in control subjects may be susceptible to publication bias, and confounding social and environmental factors may also be involved. Although it has been thought that eradication of the organism might lead to increased esophageal acid exposure, this has not been demonstrated in practice. Studies that appeared to show that GERD could be provoked by antimicrobial therapy of duodenal ulcers also have methodological weaknesses. Underlying GERD symptoms might be unmasked after withdrawal of acid-suppression therapy, for reasons that are unrelated to H pylori. In fact, eradication of the organism has been shown to decrease heartburn in patients with peptic ulcer disease. When H pylori is successfully eradicated in patients with GERD, relapse rates are not increased, and the disease- free interval seems to be prolonged. Eradication of the organism is a wise policy in patients who face long term acid-suppression therapy for GERD.

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Effect of long-term acid suppression therapy with proton pump inhibitors or H2 receptor blockers on serum vitamin B12 levels in elderly population

Irish Journal of Medical Science (1971 -) ◽

10.1007/s11845-020-02399-w ◽

2020 ◽

Author(s):

Srinivasan Damodharan ◽

Gerard Marshall Raj ◽

M Sakthibalan ◽

Karthikeyan Dakshinamoorthy ◽

P Muraliswaran

Keyword(s):

Vitamin B12 ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Elderly Population ◽

Serum Vitamin ◽

Acid Suppression ◽

H2 Receptor Blockers ◽

Acid Suppression Therapy ◽

Receptor Blockers

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The Effect of Acid Suppression Therapy on the Natural History of Barrett Esophagus

The American Journal of Gastroenterology ◽

10.14309/00000434-200910003-00018 ◽

2009 ◽

Vol 104 ◽

pp. S7

Author(s):

Archana Patel ◽

Mark Friedman ◽

Sheetal Sharma ◽

Seth Richter

Keyword(s):

Natural History ◽

Acid Suppression ◽

Barrett Esophagus ◽

Acid Suppression Therapy ◽

History Of

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Choledochoduodenal fistula of ulcer etiology

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1006347c ◽

2010 ◽

Vol 138 (5-6) ◽

pp. 347-350 ◽

Cited By ~ 2

Author(s):

Radoje Colovic ◽

Nikica Grubor ◽

Mirjana Perisic ◽

Marjan Micev ◽

Stojan Latincic ◽

...

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Foreign Bodies ◽

Uneventful Recovery ◽

Ulcer Disease ◽

Choice Of Treatment ◽

History Of ◽

Choledochoduodenal Fistula ◽

The Common

Introduction Choledochoduodenal fistulas are very rare and in most cases are caused by a long-lasting and poorly treated chronic duodenal ulcer. They may be asymptomatic or followed by symptoms of ulcer disease, by attacks of cholangitis or bleeding or vomiting in cases of ductoduodenal stenosis. The diagnosis is simple and safe, however treatment is still controversial. If surgery is the choice of treatment, local findings should be taken into consideration. As a rule, intervention involving closure of fistula is not recommended. Case Outline The authors present a 60-year-old woman with a long history of ulcer disease who developed attacks of cholangitis over the last three years. Ultrasonography and CT showed masive pneumobilia due to a choledochoduodenal fistula. . As there was no duodenal stenosis or bleeding, at operation the common bile duct was transected and end-to-side choledochojejunostomy was performed using a Roux-en Y jejunal limb. From the common bile duct, multiple foreign bodies of herbal origin causing biliary obstruction and cholangitis were removed. After uneventful recovery the patient stayed symptom free for four years now. Conclusion The performed operation was a simple and good surgical solution which resulted in complication-free and rapid recovery with a long-term good outcome. .

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