Brief overview
- Causes and risk factors: Decreased gastric juice production, hereditary factors, possibly medications and external influences (smoking, alcohol).
- Symptoms: Usually no symptoms; with large polyps, feeling of fullness, pressure and loss of appetite possible
- Examination and diagnosis: gastroscopy, usually with examination of a tissue sample (biopsy) of the polyps.
- Treatment: Removal of gastric polyps during gastroscopy; separate surgery for larger polyps, if necessary.
- Course of disease and prognosis: degeneration into gastric cancer possible, therefore early removal of polyps is usually advisable; sometimes gastric polyps develop again after removal
What are gastric polyps?
Gastric polyps are benign mucosal growths that protrude from the stomach wall into the gastric cavity. They sometimes occur singly, but in many patients they also occur in groups. Physicians then speak of multiple gastric polyps. If there are particularly many of these tumors, it may be a so-called polyposis syndrome.
The mucosal tumors are classified either by their shape or by their origin.
Gastric polyps: Variable shape
Gastric polyps: Variable origin
According to their origin, gastric polyps, which arise from glandular tissue in the mucosa, are distinguished from other forms. The glandular growths are the most common and are also called adenomas by physicians.
Less frequently, polyps of the gastrointestinal tract develop in the context of hereditary diseases, for example in Peutz-Jeghers syndrome and familial juvenile polyposis. Here, doctors speak of hamartomatous polyps. In some cases, a fluid-filled cavity in a mucosal gland (glandular cyst) is also behind a gastric polyp.
Who gets gastric polyps?
Gastric polyps occur about equally often in men and women and are most common after the age of 60. They are much less common in younger people. Since hereditary factors also play a role in the development of polyps, sometimes several members of a family are affected.
What causes gastric polyps?
An exact cause for the development of gastric polyps is not yet known. However, it is known that reduced gastric juice production increases the risk of polyps. In addition, mucosal tumors develop as a result of inflammation, for example in gastritis.
In many cases, there is a family history of gastric polyps. So-called polyposis syndromes are a special case: this is a group of hereditary diseases in which thousands of small polyps sometimes form throughout the gastrointestinal tract. These often tend to degenerate into malignant tumors.
Last but not least, external factors play a role in the development of polyps. Smoking and alcohol consumption, for example, promote the formation of the mucosal growths. A high-fat, low-fiber diet may also promote gastric polyps.
What are the symptoms?
Most polyps – especially smaller ones – remain unnoticed for a long time. They are often only discovered during a gastroscopy. Only when they reach a certain size do gastric polyps trigger symptoms. The following are possible signs of gastric polyps:
- Feeling of fullness
- Loss of appetite
- Feeling of pressure and/or pain in the upper abdomen
Occasionally, the polyps bleed. Heavy bleeding may lead to vomiting blood (hematemesis) or black stools (tarry stools, melena).
Many patients with gastric polyps also suffer from gastritis at the same time, which in turn is often accompanied by stomach pain and nausea.
How fast do gastric polyps grow?
About one in ten adenomatous gastric polyps develops into a malignant gastric tumor in the course of time. This process usually takes several years. Nevertheless, it is recommended to treat and remove gastric polyps at an early stage.
Examinations and diagnosis
Gastric polyps are detected by a specialist for the gastrointestinal tract – a gastroenterologist – with a gastroscopy. Because benign polyps do not cause discomfort for a long time, they are often discovered by chance during a routine gastroscopy. In the case of prolonged discomfort in the upper abdomen, this examination is often used anyway to avoid overlooking a possible stomach cancer.
In addition, a tissue examination (biopsy) of the polyps is useful. For this purpose, the physician usually removes the entire polyp during the gastroscopy – rarely only a small part of it – and examines it more closely under the microscope. This method enables him to distinguish benign from malignant growths. An X-ray examination with contrast medium, on the other hand, is now only performed on the stomach in isolated cases.
Gastric polyps: Treatment
Larger, broad-based polyps are sometimes not so easy to remove, so a separate operation is necessary. In this, the doctor opens the abdominal wall and removes the polyp(s) along with a small portion of the stomach wall.
Polyps are removed completely if possible. This is because, on the one hand, there is a risk that some gastric polyps may degenerate, and on the other hand, in rare cases, gastric cancer looks similar to a polyp-like gastric mucosal lesion.
Course of the disease and prognosis
If gastroscopy with polyp removal is performed correctly, complications are extremely rare. Only in isolated cases does bleeding or injury to the stomach wall occur, very rarely necessitating surgery.
In many patients, gastric polyps reappear some time after successful treatment. It is therefore advisable for those affected to have another gastroscopy once or twice a year as a check-up.
