Association between the chronic use of gastric acid suppressants and high-risk colorectal polyps.
colonoscopy
colorectal neoplasms
histamine‐2 receptor antagonists
polyps
proton pump inhibitors
Journal
JGH open : an open access journal of gastroenterology and hepatology
ISSN: 2397-9070
Titre abrégé: JGH Open
Pays: Australia
ID NLM: 101730833
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
16
12
2020
revised:
13
01
2021
accepted:
16
01
2021
entrez:
18
3
2021
pubmed:
19
3
2021
medline:
19
3
2021
Statut:
epublish
Résumé
Although gastric acid suppressants such as proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) are considered safe, the consequences of hypochlorhydria and hypergastrinemia caused by chronic use are unclear. This study aimed to investigate the association between the chronic use of gastric acid suppressants and high-risk colorectal polyps, focusing on polyp size. A population-based, nested case-control study was conducted using data from the Japanese Diagnosis Procedure Combination database between 2014 and 2019. Cumulative PPI or H2RA use prior to polypectomy was evaluated during the study period. Endoscopic polypectomy was categorized as polypectomy <2 cm, polypectomy ≥2 cm, and endoscopic submucosal dissection. Baseline characteristics were compared between the high-risk (≥2 cm polyps or polyps treated by endoscopic submucosal dissection) and low-risk (<2 cm polyps) endoscopic polypectomy groups. We calculated adjusted odds ratios (ORs) using multivariable logistic regression analysis. Of 27 694 patients who underwent endoscopic polypectomy, 2518 were treated with PPIs or H2RAs for >1 year prior to polypectomy. After adjusting for age, gender, and other confounders, a higher prevalence of high-risk colorectal polyps was noted with PPI (OR: 2.67; 95% confidence interval: 2.37-3.01) and H2RA (OR: 1.86; 95% confidence interval: 1.52-2.26) use. Longer PPI or H2RA use was associated with increased risks of high-risk colorectal polyps ( Chronic use of PPIs and H2RAs may be associated with high-risk colorectal polyps. Requirements for long-term gastric acid suppressant use should be reevaluated.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
Although gastric acid suppressants such as proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) are considered safe, the consequences of hypochlorhydria and hypergastrinemia caused by chronic use are unclear. This study aimed to investigate the association between the chronic use of gastric acid suppressants and high-risk colorectal polyps, focusing on polyp size.
METHODS
METHODS
A population-based, nested case-control study was conducted using data from the Japanese Diagnosis Procedure Combination database between 2014 and 2019. Cumulative PPI or H2RA use prior to polypectomy was evaluated during the study period. Endoscopic polypectomy was categorized as polypectomy <2 cm, polypectomy ≥2 cm, and endoscopic submucosal dissection. Baseline characteristics were compared between the high-risk (≥2 cm polyps or polyps treated by endoscopic submucosal dissection) and low-risk (<2 cm polyps) endoscopic polypectomy groups. We calculated adjusted odds ratios (ORs) using multivariable logistic regression analysis.
RESULTS
RESULTS
Of 27 694 patients who underwent endoscopic polypectomy, 2518 were treated with PPIs or H2RAs for >1 year prior to polypectomy. After adjusting for age, gender, and other confounders, a higher prevalence of high-risk colorectal polyps was noted with PPI (OR: 2.67; 95% confidence interval: 2.37-3.01) and H2RA (OR: 1.86; 95% confidence interval: 1.52-2.26) use. Longer PPI or H2RA use was associated with increased risks of high-risk colorectal polyps (
CONCLUSION
CONCLUSIONS
Chronic use of PPIs and H2RAs may be associated with high-risk colorectal polyps. Requirements for long-term gastric acid suppressant use should be reevaluated.
Identifiants
pubmed: 33732884
doi: 10.1002/jgh3.12503
pii: JGH312503
pmc: PMC7936615
doi:
Types de publication
Journal Article
Langues
eng
Pagination
371-376Informations de copyright
© 2021 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
Références
J Gastroenterol Hepatol. 2017 Jul;32(7):1295-1302
pubmed: 28092694
Am J Gastroenterol. 2008 Apr;103(4):966-73
pubmed: 18070237
Proc R Soc Med. 1965 May;58:295-300
pubmed: 14283879
Gut. 2019 Apr;68(4):762-764
pubmed: 29615489
BMJ Open. 2017 Jul 4;7(6):e015735
pubmed: 28676480
Colorectal Dis. 2013 Jun;15(6):e295-300
pubmed: 23527478
PLoS One. 2017 Dec 7;12(12):e0189114
pubmed: 29216279
J Clin Gastroenterol. 2011 Feb;45(2):177
pubmed: 20697292
Gastroenterology. 2017 Jul;153(1):35-48
pubmed: 28528705
BMJ. 2019 May 29;365:l1580
pubmed: 31147311
Korean J Fam Med. 2012 Sep;33(5):272-9
pubmed: 23115701
J Clin Invest. 1999 Apr;103(8):1119-26
pubmed: 10207163
Am J Gastroenterol. 2020 May;115(5):706-715
pubmed: 32205645
Am J Gastroenterol. 2016 Jul;111(7):913-5
pubmed: 27113114
Aliment Pharmacol Ther. 2016 Jan;43(1):73-82
pubmed: 26541643
Gastroenterology. 2007 Sep;133(3):755-60
pubmed: 17678921
Gastroenterology. 2019 Sep;157(3):682-691.e2
pubmed: 31152740
Gastroenterology. 2007 Sep;133(3):748-54
pubmed: 17678926
J Gastroenterol. 2020 Apr;55(4):453-461
pubmed: 31811561
Int J Mol Sci. 2019 Apr 18;20(8):
pubmed: 31003453
J Clin Invest. 1996 Oct 15;98(8):1918-29
pubmed: 8878444
World J Gastroenterol. 2019 Jun 14;25(22):2706-2719
pubmed: 31235994
Eur J Gastroenterol Hepatol. 2018 Dec;30(12):1395-1405
pubmed: 30028775
Asia Pac J Clin Oncol. 2013 Jun;9(2):192-3
pubmed: 23298363
Cancer Res. 2001 Jan 15;61(2):625-31
pubmed: 11212260
Surg Endosc. 2021 Mar;35(3):1164-1170
pubmed: 32166551