Gastric polyps represent protrusions of the gastric mucosa and are also referred to as benign tumors or growths. Along with intestinal polyps, gastric polyps are the most common neoplasms of the mucous membranes of the gastrointestinal tract (GI tract). In particular, people who have passed the age of 60 are more frequently affected by gastric polyps.
What are gastric polyps?
Stomach pain is the most noticeable symptom of gastric polyps. A gastric polyp is a benign (benign) neoplasm of the stomach lining that manifests as a mucosal protrusion into the lumen of the stomach. In more than 90 percent of cases, gastric polyps are adenomas that have developed from adenomatous (gland-forming) tissue and have an increased risk of degeneration (formation of cancer cells). Initially, gastric polyps usually do not cause any symptoms. Only at an advanced stage and from a size of about 1 cm can complaints such as a feeling of fullness, loss of appetite as well as pain in the upper abdomen occur. In some cases, gastric polyps can lead to hematemesis (vomiting blood) or tarry stools (black stools). Gastric polyps are also differentiated into neoplastic and non-neoplastic types. While neoplastic gastric polyps arise from newly formed tissue (20 percent of cases) and, like adenomas, have an increased risk of degeneration, non-neoplastic polyps form from glandular cysts and often appear as localized clusters (multiple gastric polyps).
Causes
The underlying causes for the development of gastric polyps have not yet been clarified. What is known is that people of older age are more at risk. It is suspected that dietary habits such as a high-fat and low-fiber diet as well as nicotine and alcohol consumption play a role. Since in many cases a familial clustering of gastric polyps can be detected, especially in genetic polyposis syndromes such as Gardner syndrome, Peutz-Jeghers syndrome or juvenile polyposis, genetic factors are also discussed. In addition, infections with Helicobacter pylori bacteria are considered as favoring factors that can cause gastric ulcer or gastritis (inflammatory disease of the gastric mucosa) as causes of gastric polyps. For example, gastritis results in regression of gastric mucosal tissue, which is thought to be compensated for by increased polyp formation. In addition, decreased gastric juice production has been shown to increase the risk of gastric polyp manifestation.
Symptoms, complaints, and signs
Gastric polyps do not present with symptoms in the vast majority of cases. Small polyps usually go unnoticed. Symptoms occur accordingly only with larger polyps and the possible accompanying symptoms. The symptoms of larger polyps, on the other hand, include several complaints. They are intensified if gastritis also develops, which is more common in people with gastric polyps. The symptoms include pain in the upper abdomen of varying intensity. Likewise, perceptible stomach pain occurs, which can range from a slight feeling of pressure to a strong stabbing sensation. In the course of this, there is often a feeling of fullness in the stomach and loss of appetite. There may be seemingly unfounded nausea, and occasionally sufferers are disgusted by eating meat. If bleeding occurs due to the polyps, sufferers sometimes vomit this blood. However, this is rare. Most gastric polyps do not damage the stomach that much. Therefore, in most cases, vomiting blood is a symptom of a degenerated gastric polyp or other injury in the stomach. Due to bleeding, there may also be occult blood in the stool. In the case of gastric polyps, weight loss may also occur – despite the fact that no symptoms are noticed at all.
Diagnosis and course
Unexplained discomfort in the upper abdomen provides an initial indication of the possible presence of gastric polyps. The diagnosis is confirmed by gastroscopy (gastroscopy), by means of which the condition of the interior of the stomach and the gastric mucosa can be examined and a biopsy (removal of tissue) from the gastric mucosa can be performed. A subsequent histological (fine tissue) analysis of the tissue sample enables statements to be made on the malignancy or benignity of the tissue removed and determines the further therapeutic procedure.Gastric polyps have a good prognosis when therapy is started early, but should be consistently monitored at follow-up visits after successful completion of therapy because of their high recurrence rate.
Complications
Because of the gastric polyps, the patient experiences various discomforts and limitations in daily life. Usually, this involves pain in the abdominal and gastric regions. The patient’s quality of life is significantly reduced by this pain, and it is not uncommon to experience a loss of appetite. The loss of appetite can also lead to malnutrition and underweight, both of which have a very negative effect on the patient’s health. Likewise, there is a feeling of fullness and further also vomiting of blood. The resilience of the affected person decreases significantly due to the stomach polyps and it is not uncommon for psychological complaints to occur due to the pain. It is not uncommon for patients to be irritable and feel unwell. Gastric polyps can be detected relatively easily by gastroscopy, so that this complaint can be treated immediately. The gastric polyps can be removed in the process. Furthermore, those affected are dependent on taking various medications. Further complications usually do not occur as long as the stomach polyps have not developed into cancer. In this process, and he life expectancy of the patient is usually not reduced.
When should you go to the doctor?
In many patients, gastric polyps do not cause any symptoms or day-to-day impairment. This complicates the signals that indicate the need to see a doctor. If large polyps are present or if the number of gastric polyps present increases, there are clear symptoms that need to be evaluated by a physician. Pain in the upper abdomen is evidence of an irregularity that should be investigated and treated. Pain medication should not be taken without consulting a medical professional, as various complications may arise. If the existing symptoms persist for several days or increase in intensity, a visit to the doctor is necessary. In case of nausea, vomiting or a feeling of fullness, consultation with a physician should be made. If there is vomiting of blood or blood in the stool, immediate action is required. A visit to the doctor is necessary so that the cause can be determined. Without medical attention, serious injury to the stomach can occur, which can cause life-threatening consequences. If there is a loss of appetite or an unwanted decrease in body weight, a doctor should also be contacted. If the affected person suddenly feels disgusted by foods that were previously liked, this should be understood as a warning sign from the organism. General disorders or irregularities of the digestive tract should be presented to a doctor as soon as they persist for several days.
Treatment and therapy
Gastric polyps are differentiated into adenomatous and nonadenomatous types depending on the histologic findings. Nonadenomatous gastric polyps are usually merely biopsied and not ablated. Adenomatous gastric polyps (adenomas) are classified as precancerous and in many cases follow the adenoma-carcinoma development sequence. Because of this increased risk of degeneration, adenomatous gastric polyps are completely ablated minimally invasively during endoscopic mucosal resection or polypectomy. While in a polypectomy the individual polyp is detached from the gastric mucosa and removed by means of a snare or clips looped around its base, in a mucosal resection the entire adjacent mucosal area is removed. The latter is usually performed in the presence of pernicious anemia (vitamin B12 anemia) or larger, broad-based gastric polyps to prevent possible spread of tissue cells that may degenerate into carcinoma cells. If larger tumors are present, a full-wall excision (open or laparoscopic removal of the stomach wall) or partial resection (partial removal) of the stomach may be required. Because gastric polyps have a relatively high recurrence rate (reoccurrence), regular endoscopic follow-up is necessary to detect possible local recurrences early and, if necessary, resect the gastric polyp again.
Prospect and prognosis
Overall, gastric polyps have a favorable prognosis.If the diagnosis is made quickly and treatment is given without delay, the patient is usually discharged from therapy within a short time as symptom-free. In the course of life, gastric polyps may recur at any time. If treatment measures are taken quickly, the prognosis in these cases is also favorable. The challenge is early diagnosis. Often, gastric polyps go unnoticed for a long time because they do not cause any symptoms, especially in the early stages. A long-term improvement is achieved as soon as a change in lifestyle takes place. The diet should be optimized and the consumption of harmful substances should be refrained from. This contributes significantly to an improvement in general health as well as the prevention of gastric polyps. In particular, patients who have already developed gastric polyps should pay attention to optimizing their diet as the disease progresses. If the course of the disease is unfavorable, gastric polyps can lead to the development of carcinomas. In these cases, the prognosis is considerably worse. If left untreated, the affected person will die prematurely. It is therefore of particular importance to consult a physician at the first signs of irregularity. In addition, adults should regularly participate in the preventive examinations offered for the detection of health impairments.
Prevention
Since the causes for the development of gastric polyps have not yet been fully elucidated, no measures exist to directly prevent the disease. However, known risk factors should be minimized. For example, gastritis can be prevented by a healthy diet (avoidance of excessive nicotine, alcohol and coffee consumption). In addition, people over the age of 50 should have regular checks for gastric polyps.
Follow-up
Once gastric polyps have been completely removed, polyp follow-up is recommended based on the patient’s individual risk (concomitant diseases, diverticulosis, family history, histologic examination). For example, if small, non-neoplastic polyps were removed, a follow-up colonoscopy is recommended at ten-year intervals; if three to ten polyps were removed, a follow-up examination should be performed after three years. If more than ten polyps have been removed, close monitoring is initially performed every two to six months, followed by colonoscopy at three to five year intervals. The goal of the follow-up examinations is to detect renewed growth as early as possible and then treat it accordingly. If symptoms such as changes in bowel movements, blood in the stool, pain or weight loss occur between polyp follow-ups, a doctor must be consulted immediately. Normally, after the polyps have been removed, the patient is informed by the attending physician about the measures or therapies that have been carried out or which therapies still seem necessary. Further check-ups and follow-up examinations can then also be arranged with an established physician in the vicinity of the patient’s place of residence. In addition, during a follow-up examination, there is the possibility of being able to contact a special specialist with any problems or questions.
Here’s what you can do yourself
Gastric polyps usually need to be removed during a gastroscopy or through surgery. Self-treatment with over-the-counter medications is not recommended, as polyps can enlarge or even become malignant. To prevent recurrence, a high-fiber diet with a high vegetable content should be emphasized. Processed meat products as well as cured or heavily salted foods can, under certain circumstances, damage the gastric mucosa and promote the development of gastric polyps. If the gastric polyps are accompanied by chronic gastritis, very fatty and highly sugary foods should also be avoided. Several small meals are easier for the stomach to process than three large ones, and food should not be eaten too cold or too hot. Natural medicinal plants such as turmeric, oregano and thyme have a digestive effect and can replace salt and hot spices in cooking. Ideally, digestion begins in the mouth: food that is sufficiently long and carefully chewed puts far less strain on the stomach than large pieces that are swallowed hastily.Stomach patients often tolerate carbonated drinks poorly, tea preparations from chamomile, mallow and lemon balm, on the other hand, soothe an irritated stomach lining. Excessive alcohol consumption and nicotine should be avoided completely if possible. Regular check-ups ensure that polyps growing from new can be detected and removed as quickly as possible.
