Fundic Gland Polyps and Association with Proton Pump Inhibitor Intake: A Prospective Study in 1,780 Endoscopies

Abstract

Fundic gland polyps (FGPs) are incidentally found when an endoscopy is performed for a non-related indication. Some authors suggested a relationship with proton pump inhibitor (PPI) intake. We aimed to determine their prevalence and association with PPI intake. We prospectively studied 1,780 patients who underwent a gastroduodenal endoscopy at our ambulatory care center between June 2007 and August 2008. PPI intake during a period of at least 12 months, female gender and age were statistically evaluated as risk factors for the presence of FGPs. Then, a multiple logistic regression analysis was applied to these variables. Gastric polyps were found in 129 patients (7.2%) and 77 (4.33%) were FGPs. Five patients with no available histology were excluded for the assessment of risk factors. PPI intake was detected in 49 patients with FGPs (63.6%) and 264 without FGPs (15.5%) (P < 0.0001). Fifty-nine patients with FGPs (76.7%) and 987 without FGPs (58.1%) were women (P < 0.001). The mean age was 58.91 ± 11.82 years in patients with FGPs and 50.34 ± 15.04 years in patients without FGPs (P < 0.0001). The three variables remained significant in the multiple model: PPI intake: P < 0.0001, OR 9.00 (95% CI 5.44-14.89); female gender: P = 0.0001, OR 2.95 (95% CI 1.69-5.15); age: P = 0.001, OR 1.03 (95% CI 1.01-1.05). In our population, the prevalence of FGPs was high. Although female gender and age were also significant, PPI intake was the strongest risk factor associated with the presence of FGPs.