2017 Volume 59 Issue 1 Pages 24-32
A 59-year-old woman visited our hospital with alternating episodes of bowel movement abnormalities and abdominal pain. The diagnosis of cap polyposis （CP） localized in the transverse colon was established by colonoscopy, histopathological findings and Barium enema examination. Helicobacter pylori（HP） infection was diagnosed by positive results in the rapid urease test during esophagogastroduodenoscopy （EGD） and serum examination of anti-HP IgG antibody. After written informed consent, the patient received H. pylori eradication therapy with 60 mg lansoprazole, 1,500mg amoxicillin, and 400 mg clarithromycin daily for 7 days, but primary eradication therapy was unsuccessful. At that time, the patient developed a new lesion limited to the region where endoscopic mucosal resection （EMR） （and clipping） of a polyp had been performed. The second eradication therapy consisting of 20 mg rabeprazole, 1,500mg amoxicillin, and 500mg metronidazole daily for 7 days was successful. After the second eradication therapy, her symptoms disappeared and the CP resolved. In cases where there is persistent HP infection, a systemic immune abnormality may lead to the pathogenesis of CP, and further mechanical stimulation （stimulation with EMR/clipping） is likely to act as an exacerbating factor. We recommend an HP test in all CP cases. If the test is positive, HP eradication therapy is necessary.
