title: Qualitative analysis of anatomopathological changes of gastric mucosa due to long term therapy with proton pump inhibitors: experimental studies x clinical studies.
abstract: BACKGROUND
  For a few decades the long-term use of proton pump inhibitors has had wide application in the treatment of several gastrointestinal diseases. Since then, however, several studies have called attention to the possible development of anatomical and pathological changes of gastric mucosa, resulting from the long term use of this therapeutic modality. Recent experimental and clinical studies suggest that these changes have connection not only to the development of precancerous lesions, but also of gastric tumors.
  
  
  OBJECTIVE
  To present a qualitative analysis of anatomical and pathological changes of gastric mucosa resulting from the long-term use of proton pump inhibitors.
  
  
  METHODS
  The headings used were: proton pump inhibitors, precancerous lesions and gastric neoplasms for a non systematic review of the literature, based on Medline, Lillacs and Scielo. Twelve articles were selected from clinical (9) and experimental (3) studies, for qualitative analysis of the results.
  
  
  RESULTS
  The gastric acid suppression by high doses of proton pump inhibitors induces hypergastrinemia and the consequent emergence of neuroendocrine tumors in animal models. Morphological changes most often found in these experimental studies were: enterochromaffin-like cell hyperplasia, neuroendocrine tumor, atrophy, metaplasia and adenocarcinoma. In the studies in humans, however, despite enterochromaffin-like cell hyperplasia, the other effects, neuroendocrine tumor and gastric atrophy, gastric metaplasia and or adenocarcinoma, were not identified.
  
  
  CONCLUSIONS
  Although it is not possible to say that the long-term treatment with proton pump inhibitors induces the appearance or accelerates the development of gastric cancer in humans, several authors have suggested that prolonged administration of this drug could provoke the development of gastric cancer. Thus, the evidence demonstrated in the animal model as well as the large number of patients who do or will do a long-term treatment with proton pump inhibitors, justifies the maintenance of this important line of research.
authors: Iure Kalinine Ferraz
authors: IK
authors: de Souza
authors: Alcino Lázaro
authors: AL
authors: da Silva
authors: Alex
authors: A
authors: de Araújo
authors: Fernanda Carolina Barbosa
authors: FC
authors: Santos
authors: Bernardo Pinto Coelho Keuffer
authors: BP
authors: Mendonça
mesh_terms: D000818:Animals; D005069:Evaluation Studies as Topic; D005753:Gastric Mucosa / Q000187:drug effects* / Q000473:pathology*; D006801:Humans; D054328:Proton Pump Inhibitors / Q000494:pharmacology*; D013274:Stomach Neoplasms / Q000139:chemically induced; D013997:Time Factors
chemical_list: D054328:Proton Pump Inhibitors