Gastric polyps and nodules in children receiving long-term omeprazole therapy.
OBJECTIVE
Multiple gastric polyps have been reported to occur in adults receiving omeprazole therapy. There are little published data in children. We report our experience in monitoring the gross and histologic appearance of the stomach in children receiving long-term omeprazole therapy.


METHODS
This was a retrospective review of the charts of children who received omeprazole for more than 6 months for reflux esophagitis between 1989 and 1998. All patients had repeated endoscopic examinations until healing of the esophagitis was confirmed and then annually thereafter. At endoscopy, gastric mucosal swellings were classified as polyps or nodules based on histology.


RESULTS
Thirty-one children had long-term endoscopic follow-up while receiving omeprazole. Seven of 31 children had gastric polyps and/or nodules, noted between 10 and 48 months (mean = 28 months) of omeprazole therapy. Four had nodules only, one had a sessile hyperplastic polyp, and two had both a polyp (one hyperplastic and one fundic gland polyp) and nodules. All lesions were found in the gastric body. Nodules in four of the six children disappeared spontaneously while the children continued to receive omeprazole. The polyps persisted. There were no dysplastic changes in the gastric mucosa or polyps in any of the patients. There were no significant differences between the 7 children with and the 24 without polyps/nodules with respect to age, gastrin concentrations, or dose and duration of omeprazole therapy.


CONCLUSIONS
Gastric polyps and nodules may be found in children receiving long-term omeprazole therapy. The gastric changes in our patients were benign during the mean observation period of 31 months.
Pashankar
Dinesh S
DS
Division of Gastroenterology, British Columbia Children's Hospital, Vancouver, Canada.
Israel
David M
DM
D000293:Adolescent; D000897:Anti-Ulcer Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004791:Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D004942:Esophagitis, Peptic / Q000188:drug therapy; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005773:Gastroscopy; D006801:Humans; D007223:Infant; D008297:Male; D009853:Omeprazole / Q000009:adverse effects* / Q000627:therapeutic use; D011127:Polyps / Q000139:chemically induced* / Q000473:pathology; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000139:chemically induced* / Q000473:pathology
D000897:Anti-Ulcer Agents; D004791:Enzyme Inhibitors; D009853:Omeprazole