Parietal cell hypertrophy and fundic gland polyps: Causes and management Parietalzellhypertrophie und Drüsenkörperzysten: Ursachen und Management
Venerito M, Canbay A, Vieth M (2018)
Publication Type: Journal article, Review article
Publication year: 2018
Journal
Book Volume: 13
Pages Range: 90-97
Journal Issue: 2
DOI: 10.1007/s11377-018-0235-z
Abstract
Parietal cell hypertrophy is related to the trophic effect of hypergastrinaemia. Long-term therapy with proton pump inhibitors (PPI) is the most common cause of parietal cell hyperplasia. Further causes of hypergastrinaemia with parietal cell hypertrophy are atrophy of the oxyntic gastric glands following autoimmune gastritis or Helicobacter pylori infection, as well as the Zollinger–Ellison syndrome (ZES). In patients with parietal cell hypertrophy as a result of long-term PPI therapy or ZES, abrupt withdrawal of a PPI induces an acid-rebound that can lead to acid-related symptoms or their relapse. Therefore, patients on long-term PPI therapy should taper down PPI slowly. Fundic gland polyps were described long before PPI became available. Kurt Elster also first described their association with colorectal neoplasms in both patients with familial adenomatous polyposis (FAP) and those with sporadic colorectal neoplasias, which is why fundic gland polyps are called Elster’s fundic gland polyps in Germany. The molecular differences between sporadic and FAP-associated fundic gland polyps are still not completely elucidated. The risk of malignant progression is very low even among FAP patients with adenomas in the apical part of fundic gland polyps, and even lower among subjects with sporadic fundic gland polyps. Thus, routine biopsy examination for fundic gland polyps in regular gastric biopsy protocols is not recommended. The association of fundic gland polyps with colorectal neoplasms, even if not confirmed in some studies, justifies the recommendation to perform a colonoscopy. The association between fundic gland polyps and colorectal neoplasia is controversial. According to the current literature the authors recommend preventive colonoscopy according to current guidelines regardless of the presence of fundic gland polyps.
Involved external institutions
Germany (DE)How to cite
APA:
Venerito, M., Canbay, A., & Vieth, M. (2018). Parietal cell hypertrophy and fundic gland polyps: Causes and management Parietalzellhypertrophie und Drüsenkörperzysten: Ursachen und Management. Gastroenterologe, 13(2), 90-97. https://doi.org/10.1007/s11377-018-0235-z
MLA:
Venerito, M., A. Canbay, and M. Vieth. "Parietal cell hypertrophy and fundic gland polyps: Causes and management Parietalzellhypertrophie und Drüsenkörperzysten: Ursachen und Management." Gastroenterologe 13.2 (2018): 90-97.
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