# Olmesartan‐induced gastritis with no lower gastrointestinal symptoms: A case report

## TL;DR

A 74-year-old man developed gastritis from olmesartan, a medication, without typical lower digestive symptoms, and symptoms improved after stopping the drug.

## Contribution

Reports a rare case of olmesartan-induced gastritis without lower gastrointestinal symptoms.

## Key findings

- Gastritis symptoms improved after discontinuing olmesartan.
- Relapse occurred when olmesartan was readministered.
- Endoscopic findings helped confirm the diagnosis.

## Abstract

A 74‐year‐old man with decreased appetite, weight, and heartburn was referred to our hospital. His medications included olmesartan. Esophagogastroduodenoscopy (EGD) revealed antral‐dominant erosive gastritis and nodular mucosa. A gastric biopsy revealed inflammatory cell infiltration. The serum anti‐Helicobacter pylori immunoglobulin G antibody test result was negative. Famotidine was ineffective in relieving his symptoms, and esomeprazole failed to prevent overt gastric bleeding, which required endoscopic hemostasis. The working diagnosis was drug‐induced gastritis, particularly olmesartan‐induced gastritis. His appetite loss started to improve within a week of olmesartan withdrawal. The erosions healed on EGD 2 months later. Over the next 10 months, he remained in his usual state until olmesartan was inadvertently administered. Subsequent EGD revealed a mild gastritis relapse. We diagnosed olmesartan‐induced gastritis and discontinued olmesartan treatment. Mucosal healing was confirmed by EGD 1 year later. Olmesartan is known to cause angiotensin II receptor blocker‐induced enteropathy. Although angiotensin II receptor blocker‐induced enteropathy affects the stomach, angiotensin II receptor blocker‐induced gastritis without lower gastrointestinal symptoms is rare. The characteristic endoscopic appearance may provide a clue to the correct diagnosis.