Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Association between occurrence of multiple white and flat elevated gastric lesions and oral proton pump inhibitor intake

  • Rino Hasegawa (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Kenshi Yao (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Takao Kanemitsu (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Hisatomi Arima (Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University) ;
  • Takayuki Hirase (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Yuuya Hiratsuka (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Kazuhiro Takeda (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Kentaro Imamura (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Kensei Ohtsu (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Yoichiro Ono (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Masaki Miyaoka (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Takashi Hisabe (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Toshiharu Ueki (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Hiroshi Tanabe (Department of Pathology, Fukuoka University Chikushi Hospital) ;
  • Atsuko Ohta (Department of Pathology, Fukuoka University Chikushi Hospital) ;
  • Satoshi Nimura (Department of Pathology, Fukuoka University Chikushi Hospital)
  • Received : 2022.09.07
  • Accepted : 2022.11.27
  • Published : 2024.01.30
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Abstract

Background/Aims: Multiple white and flat elevated lesions (MWFL) that develop from the gastric corpus to the fornix may be strongly associated with oral antacid intake. Therefore, this study aimed to determine the association between the occurrence of MWFL and oral proton pump inhibitor (PPI) intake and clarify the endoscopic and clinicopathological characteristics of MWFL. Methods: The study included 163 patients. The history of oral drug intake was collected, and serum gastrin levels and anti-Helicobacter pylori immunoglobulin G antibody titers were measured. Upper gastrointestinal endoscopy was performed. The primary study endpoint was the association between MWFL and oral PPI intake. Results: In the univariate analyses, MWFL were observed in 35 (49.3%) of 71 patients who received oral PPIs and 10 (10.9%) of 92 patients who did not receive oral PPIs. The occurrence of MWFL was significantly higher among patients who received PPIs than in those who did not (p<0.001). Moreover, the occurrence of MWFL was significantly higher in patients with hypergastrinemia (p=0.005). In the multivariate analyses, oral PPI intake was the only significant independent factor associated with the presence of MWFL (p=0.001; odds ratio, 5.78; 95% confidence interval, 2.06-16.2). Conclusions: Our findings suggest that oral PPI intake is associated with the presence of MWFL (UMINCTR 000030144).

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References

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