Disappearance of Hyperplastic Polyps in the Stomach after Eradication of Helicobacter pylori

A Randomized, Controlled Trial

1 November 1998 | Volume 129 Issue 9 | Pages 712-715

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.

Author and Article 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.