Most reported mucosal alterations, including fundic gland polyps, hyperplastic polyps, multiple white and flat elevated lesions, cracked or cobblestone-like mucosa, black spots, gastric mucosal redness, white spots, and web-like mucus, are considered benign. Although endoscopic surveillance is not currently supported by evidence, awareness of these findings may be useful in patients receiving therapy for several decades. Endoscopic features,associated with hypergastrinemia and parietal- or enterochromaffin-like cell proliferation, may serve as tools to guide individualized prescribing and deprescribing strategies. Further research should include decade-long cohort studies, studies comparing PPIs and P-CABs, and trials evaluating on-demand and continuous regimens to optimize long-term safety.
Suda et al. (Wed,) studied this question.