Disappearance of hyperplastic polyps in the stomach after eradication of Helicobacter pylori. A randomized, clinical trial.

BACKGROUND

Helicobacter pylori infection is common in patients with hyperplastic gastric polyps.

OBJECTIVE

To study the effect of eradication of H. pylori on the clinical course of patients with hyperplastic gastric polyps.

DESIGN

Single-blind, randomized, controlled trial.

SETTING

University-based gastroenterology outpatient clinic.

PATIENTS

35 patients with H. pylori infection and hyperplastic gastric polyps at least 3 mm in diameter.

INTERVENTION

Patients were randomly assigned to a treatment group (n = 17), which received a proton-pump inhibitor (omeprazole or lansoprazole), amoxicillin, and either clarithromycin or ecabet sodium, or to a control group (n = 18), which received no treatment.

MEASUREMENTS

Patients underwent endoscopy before enrollment and 12 to 15 months after the end of treatment. Serum gastrin levels and titers of IgG to H. pylori were measured.

RESULTS

In the treatment group, the polyps had disappeared by 3 to 15 months (average, 7.1 +/- 1.2 months) after the end of treatment in 12 of all 17 patients (71%) and in 12 of the 15 patients (80%) in whom H. pylori was eradicated. However, 12 to 15 months after the start of the study, no change in polyps or H. pylori status was seen in any controls (P < 0.001). Histologic findings of inflammation and activity, serum gastrin levels, and titers of IgG to H. pylori showed significant regression in the treatment group compared with the control group (P < 0.01).

CONCLUSIONS

Most hyperplastic polyps disappeared after eradication of H. pylori. Thus, eradication should be attempted before endoscopic removal is done in patients with hyperplastic gastric polyps and H. pylori infection.