A 52-year-old was sent to outpatients due to long-standing dyspepsia with partial improvement with omeprazole. Her personal history showed her to be allergic to streptomycin, hypertension, subacute thyroiditis, irritable bowel syndrome (with normal colonoscopy and laboratory tests for a year), functional dyspepsia (she underwent two upper endoscopies, the last being 5 years before, with normal findings and rapid urease being negative). She was being treated with omeprazole (20 mg/day), enalapril/hydrochlorothiazide and ASA (100 mg/day) (for vascular headache.) She underwent a new upper endoscopy that showed multiple polyps (over 30) in the greater curvature of the gastric body with variable size and morphology, the smaller (about 5 mm) being sessile and those larger (16-18 mm) being semi-pedunculated, with somewhat irregular and discoloured mucosal surface (Figures 1 and 2). Multiple biopsies were taken. Motility and distensibility of the area is preserved. Rest of the stomach, pylorus, duodenal bulb and second portion of the duodenum showed to be normal. She underwent also a urease test, with negative findings. The biopsy revealed hyperplastic polyps, so due to the patient's history of chronic use of proton pump inhibitors (PPIs) the patient is stopped being administered omeprazole being replaced by ranitidine.
A breath test also confirmed the absence of H. pylori. The patient underwent a control endoscopy 5 months later, showing a marked improvement in the number of polyps and in their size (Figures 3 and 4), taking biopsies again, confirming that they were hyperplastic polyps.