Article

Long-term proton pump inhibitor use and gastrointestinal cancer.

Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030, USA.
Current Gastroenterology Reports 01/2009; 10(6):543-7. pp.543-7
Source: PubMed

ABSTRACT Proton pump inhibitors profoundly affect the stomach and have been associated with carcinoid tumors in female rats. There is now sufficient experience with this class of drugs to allow reasonable estimation of their safety in terms of cancer development in humans. Long-term use of proton pump inhibitors is associated with an increase in gastric inflammation and development of atrophy among those with active Helicobacter pylori infections. The actual risk is unknown but is clearly low. However, it can be markedly reduced or eliminated by H. pylori eradication. It is thus recommended that patients being considered for long-term proton pump inhibitor therapy should be tested for H. pylori infection and, if present, this pathogen should be eradicated. Oxyntic cell hyperplasia, glandular dilatations, and fundic gland polyps may develop in patients not infected with H. pylori, but these changes are believed to be reversible and without significant cancer risk.

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Keywords

active Helicobacter pylori infections
 
female rats
 
fundic gland polyps
 
gastric inflammation
 
H. pylori infection
 
humans
 
long-term proton pump inhibitor therapy
 
Long-term use
 
Oxyntic cell hyperplasia
 
proton pump inhibitors
 
Proton pump inhibitors profoundly
 
reasonable estimation
 
significant cancer risk