Drug-induced mucosal alterations observed during esophagogastroduodenoscopy

Figure 4 Proton pump inhibitor-induced gastric mucosal changes. A-C: Cobblestone-like mucosa. Numerous, approximately 3-5 mm-sized, elevated mucosal lesions are seen in the gastric body of a proton pump inhibitor user. After indigo carmine dye spraying (B and C); D and E: Black spots. Dark, dot-like spots are observed in the gastric body; F and G: White globe appearance. A small, round, white deposit observed during esophagogastroduodenoscopy. Magnifying endoscopic observation with blue laser imaging emphasized the lesion (G).