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Association between occurrence of multiple white and flat elevated gastric lesions and oral proton pump inhibitor intake
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Rino Hasegawa, Kenshi Yao, Takao Kanemitsu, Hisatomi Arima, Takayuki Hirase, Yuuya Hiratsuka, Kazuhiro Takeda, Kentaro Imamura, Kensei Ohtsu, Yoichiro Ono, Masaki Miyaoka, Takashi Hisabe, Toshiharu Ueki, Hiroshi Tanabe, Atsuko Ohta, Satoshi Nimura
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Clin Endosc 2024;57(1):65-72. Published online May 9, 2023
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DOI: https://doi.org/10.5946/ce.2022.257
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 Graphical Abstract
 Abstract
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 - 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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Citations
Citations to this article as recorded by  - Endoscopic findings and outcomes of gastric mucosal changes relating to potassium‐competitive acid blocker and proton pump inhibitor therapy
Satoshi Shinozaki, Hiroyuki Osawa, Yoshimasa Miura, Hiroaki Nomoto, Hirotsugu Sakamoto, Yoshikazu Hayashi, Tomonori Yano, Edward J. Despott, Hironori Yamamoto
DEN Open.2025;[Epub] CrossRef - Clinicians should be aware of proton pump inhibitor–related changes in the gastric mucosa
Gwang Ha Kim
Clinical Endoscopy.2024; 57(1): 51. CrossRef - Drug-induced mucosal alterations observed during esophagogastroduodenoscopy
Masaya Iwamuro, Seiji Kawano, Motoyuki Otsuka
World Journal of Gastroenterology.2024; 30(16): 2220. CrossRef
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