Vonoprazan Associated Gastric Mucosal Changes in Bangladeshi Patients: A Case Series
Keywords:
Vonoprazan, P-CAB, Web-like mucosa, White globe appearance, Gastric cracked mucosa, GERD, Helicobacter pylori, BangladeshAbstract
Background: Vonoprazan, a potassium-competitive acid blocker (P-CAB), has emerged as an effective therapy for gastroesophageal reflux disease (GERD) and Helicobacter pylori eradication. Since its global launch in 2015, several endoscopic mucosal changes associated with its long-term use have been reported, including white globe appearance (WGA), web-like mucosa (WLM), and gastric cracked mucosa (GCM). In Bangladesh, vonoprazan has only recently been introduced, and limited data exist regarding its mucosal effects.
Objective: To report three cases from Bangladesh showing characteristic gastric mucosal changes following vonoprazan therapy.
Result: All three patients developed distinct mucosal changes after vonoprazan use, including longitudinal erythema, web-like mucosa, and hemorrhagic gastric polyps. Mucosal abnormalities regressed or improved following cessation of vonoprazan and initiation of alternative acid-suppressive therapy (proton pump inhibitors or H2 blockers). All these mucosal changes occur at upper part of stomach.
Conclusion: This case series highlights the emergence of vonoprazan-associated gastric mucosal changes in Bangladeshi patients. Clinicians should remain vigilant and consider endoscopic follow-up during long-term P-CAB therapy.
