Gastric polyps Home A-Z Health Information Health Library A-Z Gastric Polyps Overview Gastric polyps are abnormal growths or lesions that develop on the lining of the stomach. While many gastric polyps are benign (non-cancerous), some types can be precancerous or lead to gastric cancer if left untreated. These growths can vary widely in size, shape, and type, and are typically discovered incidentally during procedures like endoscopy. Types There are several different types of gastric polyps, each with its own characteristics and potential risk factors. The major types include:Hyperplastic polyps:Hyperplastic polyps are the most common type of gastric polyp and are usually associated with chronic gastritis or inflammation of the stomach lining.These polyps are often benign but can sometimes be large and may cause bleeding or obstruction.Although rare, hyperplastic polyps can become precancerous, especially when they are large or numerous.Fundic gland polyps:Fundic gland polyps are typically small, benign growths found in the upper part of the stomach (the fundus).These polyps are often associated with the use of proton pump inhibitors (PPIs), which are medications that reduce stomach acid production. Long-term use of PPIs can increase the risk of developing fundic gland polyps.Fundic gland polyps are usually asymptomatic, and most do not require treatment unless they cause symptoms or are associated with an underlying condition, such as familial adenomatous polyposis (FAP), a genetic disorder that increases the risk of polyps throughout the body.Adenomatous polyps:Adenomatous polyps are the least common type of gastric polyp but are considered precancerous. They have the potential to transform into gastric cancer over time, so they require careful monitoring and management.These polyps may be larger than other types and are typically associated with chronic atrophic gastritis or H. pylori infection.If an adenomatous polyp is found, especially one with dysplastic changes (abnormal cells), it may need to be removed, as it has a higher risk of malignancy.Inflammatory polyps:Inflammatory polyps are generally benign growths that result from chronic inflammation or injury to the stomach lining, such as from gastritis or peptic ulcers.These polyps are typically small and are not usually associated with cancer. Inflammatory polyps can often resolve on their own with the treatment of the underlying condition.Hamartomatous polyps:Hamartomatous polyps are rare growths that arise from a disorganised growth of normal tissue. They are often associated with genetic conditions such as Peutz-Jeghers syndrome or Juvenile polyposis syndrome, which predispose individuals to developing multiple polyps throughout the gastrointestinal tract, including the stomach.These polyps can be benign but, in some cases, may increase the risk of gastrointestinal cancers. Symptoms Most gastric polyps do not cause symptoms, especially if they are small. However, larger polyps or those that cause complications can present with the following symptoms:Abdominal pain or discomfort: Larger polyps, especially those causing obstruction or bleeding, can result in discomfort or pain in the upper abdomen.Bleeding: Polyps, particularly hyperplastic or adenomatous polyps, can cause gastrointestinal bleeding, which may result in:Black, tarry stools (melena) due to digested blood.Vomiting blood (hematemesis), which may appear as bright red or coffee-ground-like material.Nausea and vomiting: If the polyps are large enough to cause partial obstruction of the stomach, nausea and vomiting may occur.Anaemia: Chronic blood loss from gastric polyps can lead to iron-deficiency anaemia, which can present as fatigue, weakness, and pallor.Indigestion: Some individuals may experience indigestion or a feeling of fullness due to polyps, especially if they are large enough to affect stomach function.Loss of appetite or weight loss: In cases where polyps cause significant gastrointestinal issues, a loss of appetite or unintended weight loss may occur. Diagnosis Gastric polyps are often discovered incidentally when a patient undergoes an upper gastrointestinal endoscopy (EGD) for another condition. The following diagnostic tools may be used:Endoscopy: The primary method for detecting gastric polyps. During an endoscopy, a flexible tube with a camera is inserted into the stomach, allowing doctors to visually identify and assess the size, number, and type of polyps.Biopsy: A small tissue sample may be taken from the polyp to determine whether it is benign or precancerous, especially in the case of adenomatous polyps.Imaging: CT scans or MRI are not typically used to diagnose gastric polyps but may be helpful if there are concerns about complications such as gastric outlet obstruction or perforation.Helicobacter pylori testing: If there is suspicion of H. pylori infection, which is linked to the development of some types of gastric polyps, testing via breath tests, blood tests, or stool tests may be conducted. Treatment The treatment of gastric polyps depends on the type, size, and whether there is a risk of malignancy. Options include:Endoscopic removal: Larger polyps, especially adenomatous polyps or those causing symptoms (e.g., bleeding or obstruction), may be removed via endoscopic polypectomy. This involves using endoscopic instruments to remove the polyp, and it is typically a minimally invasive procedure.Endoscopic removal is also recommended for precancerous polyps to prevent them from developing into gastric cancer.Surgical Intervention: Surgical resection may be necessary if the polyps are too large, if there are multiple polyps, or if there is a concern about cancer that cannot be addressed endoscopically. This is more common in cases of familial adenomatous polyposis (FAP) or other genetic conditions that predispose individuals to multiple polyps.Treatment of underlying conditions: If polyps are associated with an underlying condition such as H. pylori infection or the long-term use of proton pump inhibitors (PPIs), addressing these conditions may help reduce the risk of polyp recurrence or growth.For H. pylori-associated polyps, antibiotic treatment can help eradicate the infection, potentially reducing the number of polyps.Proton pump inhibitors (PPIs): If polyps are related to long-term PPI use, and the polyps are small and asymptomatic, the physician may suggest discontinuing or reducing the use of PPIs. However, this should be done cautiously, as PPIs are important for managing conditions like acid reflux and gastritis. Prevention While gastric polyps cannot always be prevented, there are several strategies that may reduce the risk of developing them or help with early detection:Helicobacter pylori eradication: Treating H. pylori infections can help prevent the development of certain types of gastric polyps, especially those associated with chronic gastritis.Limit use of NSAIDs: Long-term use of NSAIDs can increase the risk of developing gastric polyps, particularly in people with a history of gastritis or ulcers. Taking NSAIDs with food or using alternative pain-relief medications may help reduce the risk.Avoid smoking and excessive alcohol: Smoking and heavy drinking both contribute to inflammation and can increase the risk of developing gastric diseases, including polyps.Regular monitoring: For individuals with genetic conditions like familial adenomatous polyposis (FAP) or Juvenile polyposis syndrome, regular screening with endoscopy is important for early detection and removal of polyps.