What types of polyps are there?
The most common are polyps of the fundic glands: they are small, multiple, located in the body and vault of the stomach and very rarely degenerate; They are often associated with many years of taking drugs that reduce acidity. Hyperplastic polyps occur against the background of chronic gastritis and H. pylori infection, they are usually solitary, can reach a centimeter or more, and occasionally they contain foci of dysplasia. Adenomatous polyps are true benign tumors that are considered precancerous and are removed. A separate rare group is polyps in hereditary syndromes, which require monitoring of the whole family.
- Fundic gland polyps are the most common, the risk is minimal
- Hyperplastic - associated with gastritis and H. pylori
- Adenomatous - precancerous, subject to removal
- Inflammatory fibrous polyps
- Polyps in hereditary polyposis syndromes
Why do they appear?
Chronic inflammation of the mucous membrane plays a key role. H. pylori infection maintains gastritis for years, causes glandular atrophy and creates conditions for the growth of hyperplastic and adenomatous polyps. Long-term use of proton pump inhibitors for years is associated with the appearance of fundic gland polyps, which are usually harmless and often decrease after drug withdrawal, if possible. Age, heredity, autoimmune gastritis with vitamin B12 deficiency, and rare genetic syndromes in which polyps appear in both the stomach and intestines are also important.
- Chronic gastritis and H. pylori infection
- Atrophy of the gastric mucosa
- Long-term use of proton pump inhibitors
- Autoimmune gastritis
- Age over 50
- Hereditary polyposis syndromes
Symptoms
The vast majority of polyps do not manifest themselves in any way. Complaints appear when the formation becomes large or ulcerated: then dull pain and heaviness in the upper abdomen, nausea, and rapid satiety are possible. An ulcerated polyp may bleed, often hidden, and then the only symptom is iron deficiency anemia with weakness, shortness of breath and pallor. A large polyp located at the exit from the stomach can obstruct the passage of food and cause vomiting. Since there are usually no symptoms, polyps are discovered during gastroscopy prescribed for another reason.
- Most often are asymptomatic
- Heaviness and dull pain in the upper abdomen
- Nausea and early satiety
- Hidden bleeding and anemia
- Rarely - difficulty passing food
Diagnostics
The main method is gastroscopy. The doctor evaluates the number, size, location and appearance of the formations, examines the mucous membrane around them, takes a biopsy from the polyp and from different parts of the stomach to assess the condition of the mucous membrane as a whole. Be sure to check for the presence of H. pylori: with a stool antigen test, a breath test, or a biopsy examination. The final diagnosis is made by a morphologist. In case of multiple polyps, especially in young people, and with a family history, colonoscopy is also recommended and genetic testing is discussed.
- Gastroscopy with examination of all departments
- Biopsy of the polyp and surrounding mucosa
- Histological examination
- Tests for H. pylori
- Complete blood count and ferritin if anemia is suspected
- Colonoscopy for multiple polyps
Treatment and observation
Tactics vary by type and size. Adenomatous polyps are always removed, regardless of size. Hyperplastic ones are removed if they are larger than one centimeter, ulcerated or contain dysplasia, and small ones are observed. Fundic gland polyps usually do not require removal, except for large and suspicious ones. Removal is carried out endoscopically, during gastroscopy, most often without incisions; The resulting material must be sent for histology. When H. pylori is detected, a course of eradication is carried out - after this, hyperplastic polyps often decrease or disappear. A control gastroscopy is prescribed by a doctor.
- Endoscopic removal of adenomatous polyps
- Removal of hyperplastic polyps larger than 1 cm
- Observation of small fundic polyps
- Eradication of H. pylori when detected
- Mandatory histology of the removed material
- Control gastroscopy at the time specified by the doctor
- Reviewing long-term acid-reducing therapy with your doctor
