Gastric Polyps

What are gastric polyps?

Gastric polyps are abnormal growths on the inner lining of your stomach. Most are harmless and don’t cause symptoms. But some of them turn into cancer.

Your stomach is the organ that receives chewed-up food. The stomach contains acid. It kills many of the bacteria in swallowed food. It also contains juices that aid in digestion. The innermost layer of the stomach has a lining of cells called the epithelium. Most gastric polyps come from an abnormal growth of cells in a section of the epithelium.

Gastric polyps are not cancerous. But some may turn into cancer. There are many types of gastric polyps. They happen for different reasons. Most have little or no risk of becoming cancer. Sometimes polyps have a higher risk of turning into cancer.

Abnormal tissue growth is called dysplasia. Gastric polyps with dysplasia are the ones most likely to turn into cancer.

In the U.S., fundic gland polyps are the most common type of gastric polyp. The second most common are hyperplastic polyps. Hyperplastic polyps are common in places that have a higher rate of H. pylori infections. Gastric polyps are more common in older adults.

What causes gastric polyps?

Gastric polyps can happen for different reasons. Anything that causes your stomach cells to grow abnormally can lead to this problem. Some of the causes of gastric polyps include:

• Chronic inflammatory stomach issues

• H. pylori infection

• Pernicious anemia

• Stomach erosion, such as from an ulcer

• The use of proton-pump inhibitor medicines, such as omeprazole

Some of these causes may increase your risk for certain types of gastric polyps, but not others. For instance, an H. pylori infection raises your risk for hyperplastic polyps. Proton-pump inhibitor medicines may increase your risk for fundic gland polyps.

Genetics also play a role. You may also have a higher risk of gastric polyps if they run in your family. Certain genetic conditions that cause a lot of lower intestinal polyps also cause gastric polyps.

What are the symptoms of gastric polyps?

Most gastric polyps don’t cause any symptoms. Most people learn they have a gastric polyp after having a test for another reason. This test is called an upper endoscopy. In this test, a thin tube with a tiny camera looks into your stomach.

Your chance of symptoms depends on the type of polyp you have. Larger polyps may be more likely to cause the following symptoms:

• Stomach pain

• Vomiting, which can lead to anemia

• Bleeding, especially if the polyp is ulcerated

• Symptoms from stomach blockage, such as weight loss or intense vomiting

Gastric polyps that become cancer may cause other symptoms.

How are gastric polyps diagnosed?

Most gastric polyps are diagnosed during an upper endoscopy.

To diagnose the type of polyp, your healthcare provider will do a biopsy. In a biopsy, you will have a sample of the gastric polyp and nearby tissue taken out. This happens during an endoscopy. A specialist then looks at the sample under a microscope. They can then diagnose the type of polyp you have. Your healthcare provider may also ask about your health history and give you an exam. This can sometimes give helpful clues about the type of polyp.

In some cases, cancerous growths look like gastric polyps on an upper endoscopy. Because of this, some people who are told they have a gastric polyp at first may actually have cancer.

Sometimes the polyps show up on a barium X-ray test, such as an upper GI (gastrointestinal) series.

How are gastric polyps treated?

Treatment for gastric polyps varies. Your treatment may depend on:

• Polyp type

• Polyp size

• Polyp shape

• Polyp location

• The number of polyps you have

• Your symptoms

• Your other risk factors for stomach cancer, such as your age and smoking history

A fundic gland polyp has only a small chance of becoming cancer. At first, your healthcare provider will biopsy the polyp. Then a specialist can check for early signs that the polyp might become cancer. They will look for signs of dysplasia.

If the polyp doesn’t look like it may become cancer, you may not need any treatment. If you have a dysplastic polyp, you will likely have it removed. If you have a very large polyp, you also may need to have it taken out.

If you have another type of gastric polyp, such as a hyperplastic polyp, your treatment may be different. This type of polyp carries a higher risk for cancer. Again, your healthcare provider will want to biopsy the polyp and check for signs of cancer. You will likely need to have very large or dysplastic polyps removed. Even if your polyps don’t look dysplastic, your healthcare provider may watch them. You may need to have more endoscopies.

Adenomatous polyps have a high risk of turning into cancer. Because of this, your healthcare provider will likely want to remove them.

Your healthcare provider will remove any growth that becomes cancer. They will also take out any type of polyp with dysplasia. If the dysplasia or cancer has spread into nearby tissue, your healthcare provider may remove part of that tissue as well. Depending on how much it has spread, you may have this done through an endoscopy. Or you may need surgery to remove part of your stomach. Your healthcare provider will also likely remove any polyps that cause symptoms.

What are possible complications of gastric polyps?

The main complication of gastric polyps is stomach cancer. The following is a list of some of the main types of gastric polyps and their cancer risk.

If you have multiple gastric polyps, this can also cause problems. For instance, familial adenomatous polyposis is a genetic condition. It causes polyps to grow all along your digestive tract. This leads to a very high risk for colon cancer.

Having your polyps removed can also cause complications. These include bleeding.

Can gastric polyps be prevented?

You may be able to lower your risk for new gastric polyps. For instance, your healthcare provider may tell you to stop using proton-pump inhibitor medicines if you have fundic polyps. You may be able to reduce your risk for hyperplastic polyps if you take an antibiotic for an H. pylori infection.

To lower your risk for problems from gastric polyps, see your healthcare provider as often as they suggest. Follow the care plan that they prescribe.

When should I call my healthcare provider?

Call your healthcare provider if you have any symptoms that could be from a gastric polyp. These may include stomach pain, unexplained weight loss, intense vomiting, or blood in your stool.

Key points about gastric polyps

• Gastric polyps are abnormal growths on the lining of your stomach. Most are harmless and don’t cause symptoms. But some may turn into cancer.

• There are several types of gastric polyps. Your risk of cancer depends on the type of polyp you have.

• Your healthcare provider will likely do a biopsy of your polyp. This is done during an upper endoscopy. This can tell what type of polyp you have.

• Your treatment depends on the size, location, appearance, and type of polyp you have. If you have dysplastic polyps or cancerous growths, your healthcare provider will remove them.

• Your healthcare provider may do follow-up testing to check on your polyps.

• Following treatment recommendations, including regular checkups with your healthcare providers, is an important part of managing gastric polyps.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.