Fundic Gland Polyps From PPIs: Should You Stop Treatment?

Should You Stop PPIs If You Develop Fundic Gland Polyps?

Most patients with PPI-associated fundic gland polyps can safely continue their proton pump inhibitor therapy if there is a clear medical indication, as these polyps are generally benign with very low malignant potential. However, patients with high-risk features (more than 20 polyps or polyps larger than 1 cm) may need closer monitoring or consideration of PPI discontinuation based on individual risk-benefit assessment.

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Large PPI-Induced Gastric Polyps Can Disappear in 2 Months

Can Large PPI-Induced Gastric Polyps Actually Disappear?

Yes, even large proton pump inhibitor-induced gastric polyps can completely regress within as little as 2 months after PPI discontinuation, as demonstrated in these remarkable case reports. This rapid regression occurs because PPI-induced polyps are primarily hyperplastic responses to chronic hypergastrinemia rather than true neoplastic growths, allowing them to resolve quickly once the underlying stimulus is removed.

Dr. Kumar’s Take

These cases are remarkable because they show just how reversible PPI-induced changes can be. Even large polyps that might seem concerning can completely disappear in just 2 months - that’s incredibly fast for any tissue change in the body. This reinforces that PPI-induced polyps are fundamentally different from other gastric polyps. They’re essentially an overgrowth response to chronic gastrin stimulation, not true tumors. This gives us confidence that when PPI discontinuation is possible, even dramatic-looking polyps can resolve completely.

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