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The number of polyps / adenomas change after Whipple Surgery, and start of taking a Proton Pump Inhibitor(PPI) why?

 

 UPDATED Mar 16 2026

The number of polyps / adenoma, in my remaining colon, rectum and stomach, has increased since after my Whipple Surgery, and I started taking a Proton Pump Inhibitor.

The Whipple re-configures the digestive tract, and creates a new connection between the stomach and the small intestine (jejunum). Proton pump inhibitors (PPIs) are prescribed to patients after a Whipple to prevent ulcers and bleeding in the upper digestive tract.

Do Proton Pump Inhibitors (PPI) cause an increase the numbers of polyps with   Familial Adenomatous Polyposis, FAP? There is a study, Journal of Yeungnam Medical Science, that seems to suggest that using a Proton Pump Inhibitors (PPIs) for over 12 months is a significant risk factor for developing advanced colon polyps. As of June 17, 2025 there are now several small Fundic Gland Polyps in my stomach, this is the 1st time I can remember or seen any word of these, and not sure if this because I have been taking a PPI for over 19 months. I cut the dosage in1/2 and will see if this effects the appearance or number of the Fundic Gland Polyps. The number of Tubular Adenomas in my rectum and remaining colon has increased from 22 ( June 2025) to 53 ( Sept 2025) in 3 months. So far the Gi Doctor is just suggesting a repeat scope in 3 months. Not sure if the increase number is showing an acceleration of FAP or because of the PPI?

 A little of my story: I have lived with Familial Adenomatous Polyposis (FAP) for 45 years. I had a previous colectomy in March 1980, and have been undergoing regular follow up Endoscopy, and Colonoscopy since that time. Biopsies results from the Endoscopy, July 2023, showed low-grade dysplasia/adenoma
 ( some of the cells look abnormal) in the duodenum. Also there were numerous small polyps, and an extensive large flat adenoma. Aug 2023, after receiving the biopsies results, and talking to my GI doctor he explained he wasn’t confident he can remove the existing polyps/flat adenoma in the duodenum because of the location, the number of them, and scar tissue that is present making it more difficult. I was sent to see a surgeon for a second opinion, and to go over options. Both doctors suggesting the Whipple Surgery, to remove the duodenum, and the cancer risk. The Whipple Surgery, Nov 2023, went okay they tell me, but after I developed a pancreaticojejunostomy (PJ) leak, followed by a hepaticojejunostomy (HJ) leak, a gastrojejunostomy (GJ) leak, and a stubborn fistula. As a result of all the complications I spent 50 days in hospital following the surgery, then home for 3 weeks, and readmitted in Jan 2042 for an additional 90 days. Discharged in late Apr 2024, and home with a NJ feeding tube till early July 2024. More detail about the surgery and complications maybe seen here.

If you know anyone that can use this information for research, teaching/learning, or patient benefit please contact me, I am open to discussing the possibilities of using this medical information to help others. Cheers

June 18, 2025 cut dosage in half of Rabeprazole to 10 mg once a day in the morning. 

Mar 16, 2026

A. Stomach, polyps x 2, polypectomy
- Fundic gland polyps (x 2)
 
B. Rectum, polyps x 15, polypectomy
- Tubular adenoma (involving 13 fragments), negative for high-grade dysplasia

Dec 15, 2025

A. Stomach, polyp, polypectomy
- Gastric adenoma (foveolar type), negative for high-grade dysplasia

B. Colon, polyps x 23, polypectomy
- Tubular adenoma (17 fragments), negative for high-grade dysplasia

Sept 17, 2025

A. Colon, rectum, polypectomy (x57):
- Tubular adenomas x53, negative for high grade dysplasia

 June 17, 2025
A. Stomach Polyps Polypectomy:
-Fundic gland polyps
-Negative for gastritis, H. pylori and intestinal metaplasia
B. Colon Polyps Polypectomy:
-Tubular adenomas x 22
-Negative for high-grade dysplasia
 
Mar 10, 2025
A. Colon, polypectomy (x43):
- Tubular adenomas, thirty-five (35) fragments, negative for high grade dysplasia
- Additional nine fragments of colonic mucosa within normal limits; mild reactive/surface hyperplastic changes

Nov 26, 2024
Colon, sigmoid, x 36 Polypectomy:
- Tubular adenomas, negative for high grade dysplasia

Oct 3, 2024 Changed to Rabeprazole 20 mg, and cut dosage in half compared to Pantoprazole.

Aug 6, 2024
Colon Polyps x 26, Polypectomy:
- Tubular adenomas, negative for high grade dysplasia

May 3, 2024
Colon Polyps x 34 Polypectomy:
-Tubular adenomas x 30
-Negative for high-grade dysplasia
-Hyperplastic polyps x 4

Nov 18, 2023 Started pantoprazole 40 mg

Whipple Surgery Nov 17, 2023

July 18, 2023
Colon polyps x 11; polypectomy:
- 10 fragments of tubular adenoma; negative for high grade dysplasia
- 1 fragment of hyperplastic polyp
- 1 fragment of unremarkable colonic mucosa
Small intestine, duodenal polyp; endoscopic biopsy:
- Duodenal mucosa with low-grade dysplasia/adenoma

Nov 28, 2022
Rectal polyps x 11
Rectum, Polypectomy(s):
  - Tubular adenomas, eleven fragments, negative for high grade dysplasia

Apr 19, 2022
Ileum polyps x 4
Ileum Polyps:
  - Tubular adenoma x4 (vs fragmented) , negative for high-grade dysplasia

Sept 20, 2021
Colon x 28
Colonic Polyps:
  - Tubular adenomas, negative for high-grade dysplasia

Apr 5, 2021
Left colon polyps x 19
Left Colon Polyps x19 Polypectomy:
  - Tubular adenomas x19
  - Negative for high-grade dysplasia

Jan 5, 2021
Rectum Polyps x 4
Fragments of Colonic Polyps (Rectum):
  - Fragments of tubulovillous adenoma

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