Many of the stomach’s functions are dependent on this organ being a hollow cavity. It has to allow for the entry of food and fluid. Hydrochloric acid and digestive enzymes are released into the cavity. The stomach walls contract strongly to mix and crush food. The partially digested food, fluid, acid and digestive enzymes (known as gastric chyme) are released from the stomach into the small intestine. Collectively this requires a cavity without abnormal growths and obstructions within the stomach.
What is a gastric polyp?
A gastric polyp is an abnormal growth that protrudes from the stomach wall. Gastric is a medical term for the stomach. Polyps are not unique to the stomach. These growths can occur in any cavity within the body, such as the bowels or even the nose. Most of these polyps are benign (non-cancerous). However, a small number of stomach polyps may be precancerous, meaning that it has to the potential to become a cancer.
There are several different types of stomach polyps and most of the time these growths arise due to persistent inflammation in the stomach. It is not uncommon for stomach polyps to be missed. Most of the time these abnormal growths do not cause any symptoms. However, when identified and if there is no sign of the polyp shrinking then surgical removal of the growth may be necessary.
Causes of Stomach Polyps
Although most stomach polyps are non-cancerous (benign) and do not cause symptoms (asymptomatic), it is nevertheless important to understand what causes these abnormal growths. Inflammation is the body’s response to tissue damage. Sometimes it can arise even when there is no threat to any tissue or part of the body. Stomach polyps mainly arise due to persistent inflammation of the stomach wall.
There are several reasons why inflammation may be present. Inflammation of the stomach is known as gastritis and it most commonly arises from infections like H.pylori or with chronic irritation of the stomach by gastric acid due to other causes. However, some types of polyps may be caused by the same drugs that are used to treat these conditions. Advancing age is another risk factor for stomach polyps, as are a family history.
Read more on gastritis.
Types of Stomach Polyps
Polyps are growths that protrude from the wall of cavity. These growths are usually due to an overgrowth of certain types of cells. Normally cell growth is limited in any tissue. New cells only grow to replace old, damaged or dead cells. However, this process can be distorted and cells may grow excessively at one site. Polyps are a result of this excessive growth when it occurs in a cavity like the stomach.
Usually the cells of the polyps resemble the normal healthy cells of the tissue from where it originates (hyperplasia). However, there are instances where these cells may show some abnormality in shape and/or structure (dysplasia). This may be a sign of cancer potential and this type of growth is pre-cancerous. There are different types of stomach polyps, depending on the cause and type of cell from which it grows.
- Hypertophic polyps: This type of polyp is more likely to be seen with chronic gastritis, a common condition mainly due to H.pylori infection or excessive use of NSAIDs. Hypertrophic polyps are therefore the most common type of stomach polyp. The cells of this type of polyps is normal although there is overgrowth.
- Fundic gland polyps: These types of stomach polyps were relatively uncommon and associated with familial adenomatous polyposis (FAP). However, many recent cases have been associated with prolonged and excessive use of proton pump inhibitors (PPIs), a drug that reduces stomach acid production.
- Adenomas: This type of polyp can arise with any type of chronic inflammation of the stomach wall. It may include long term gastritis and also a history of familial adenomatous polyposis (FAP). These polyps hold a higher risk of becoming cancerous.
Signs and Symptoms
Most stomach polyps do not cause any symptoms (asymptomatic). Instead the symptoms that may be present are due to the causative conditions, like gastritis, and not due to the polyp itself. These signs and symptoms may include a gnawing ache or burning pain in the stomach region, nausea, vomiting in some instances and changes in appetite. Gastritis symptoms also tend to worsen during the early hours of the morning which can affect sleep.
However, there are some cases of symptomatic stomach polyps. These symptoms may not always be easy to differentiate from gastritis or other stomach and upper gastrointestinal conditions. The symptoms of polyps may include:
- Abdominal pain, usually in the left upper quadrant (LUQ) of the abdomen.
- Nausea and sometimes vomiting, including small amounts of blood in the vomitus.
- Stomach bleeding, which may occur from the causative condition or polyp itself.
Large stomach polyps that are closer to the exit of the stomach (pylorus) may cause partial obstruction. The movement of food may therefore be impeded and this can affect gastric emptying. Other symptoms can therefore arise over time.
Read more on stomach pain.
Treatment for Stomach Polyps
Since the signs and symptoms of stomach polyps are largely similar to many other stomach conditions, the presence of polyps needs to be diagnosed with the relevant investigations. Usually an endoscopy is conducted to visualize the growths. It may also be removed (biopsy) and the tissue is sent for microscopic examination to exclude the possibility of a cancerous growth.
The choice of treatment for stomach polyps depends on the type of polyp and its size. Often the polyps may be removed endoscopically during an upper GI endoscopy for diagnostic purposes. However, a separate procedure to remove the polyps may be necessary at other times. Not all polyps require surgical removal. The most common type of polyp, a hypertrophic stomach polyp, can resolve without medication.
Non-surgical treatment of these polyps may require medication to treat the underlying cause. For example, if chronic gastritis is due to H.pylori infection then eradication of these bacteria can resolve the gastritis. As a result, the polyp may shrink and eventually resolve as well. However, the excessive use of proton pump inhibitors (PPIs) is discouraged. These acid-suppressing drugs can contribute to polyp formation.