title: Endoscopic and histopathologic gastric changes in chronic users of proton-pump inhibitors.
abstract: BACKGROUND
  Proton-pump inhibitors have been used for at least two decades. They are among the most commonly sold drugs in the world. However, some controversy remains about the indications for their use and the consequences of their prolonged use.
  
  
  OBJECTIVE
  To evaluate and compare the endoscopic and histopathologic gastric changes in chronic users of proton-pump inhibitors to changes in non-users.
  
  
  METHODS
  A prospective study performed at a tertiary Public Hospital involving 105 patients undergoing upper-gastrointestinal endoscopy. Subjects included 81 proton-pump inhibitor users and 24 non-users (control group). Biopsies of the antral-type mucosa, the antral-fundic transition, and the fundus were evaluated by the Sydney System. The presence of erosion or ulceration, lymphatic follicles, reactive gastropathy, and polypoid or epithelial hyperplasia was also determined. Serum levels of gastrin were measured.
  
  
  RESULTS
  We found two polyps, one in each group, both of which were negative for Helicobacter pylori. There were two cases of parietal cell hyperplasia in users of proton-pump inhibitors. Gastrin was elevated in 28 users of proton-pump inhibitors and in four members of the control group. We did not find statistically significant differences in the endoscopic or histopathologic findings between the two groups.
  
  
  CONCLUSIONS
  Chronic use of proton-pump inhibitors for the duration examined was not associated with significant gastric changes. An interesting finding was that the 4 chronic users of proton-pump inhibitors who had serum gastrin levels above 500 pg/mL also had positive serology for Chagas disease.
authors.affiliation: Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
authors.forename: Sílvia Maria Perrone
authors.initials: SM
authors.lastname: Camilo
authors.affiliation: Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
authors.forename: Élia Cláudia de Souza
authors.initials: ÉC
authors.lastname: Almeida
authors.affiliation: Universidade de Uberaba - UNIUBE, Uberaba, MG, Brasil.
authors.forename: Benito André Silveira
authors.initials: BA
authors.lastname: Miranzi
authors.affiliation: Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
authors.forename: Juliano Carvalho
authors.initials: JC
authors.lastname: Silva
authors.affiliation: Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
authors.forename: Rosemary Simões
authors.initials: RS
authors.lastname: Nomelini
authors.affiliation: Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
authors.forename: Renata Margarida
authors.initials: RM
authors.lastname: Etchebehere
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D014355:Chagas Disease / Q000097:blood; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000188:drug therapy / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use*; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D013272:Stomach Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology*; D055815:Young Adult
chemical_list: D054328:Proton Pump Inhibitors; D009853:Omeprazole