Polyps in the stomach are benign tumor-like epithelial formations that rise above the mucous membrane and grow into the cavity of the organ.. At the beginning of their formation, they do not cause any symptoms, sometimes they are accidentally discovered during an examination prescribed for another disease..

Polyps grow into the cavity of the stomach, rising above the mucous membrane. Pathology usually occurs in middle-aged people (45-55 years), but there are cases of its detection at a younger age and in children. It is twice as common in male patients. The most common localization is the pylorus zone (sphincter, which is located between the stomach and duodenum).

The disease is dangerous in the event of complications, in particular, when the growth transforms into a malignant neoplasm..

Depending on the clinical course and structure of the polyps, the patient's treatment tactics may be expectant, in which the underlying disease that provoked the polyposis is treated, or active surgical.

Classification Polyps according to their morphological features can be glandular (adenomatous) or hyperplastic.

Most often, the development of hyperplastic formations occurs. Hyperplastic neoplasms are the most common type found in the stomach.. Occurs 16 times more often than other formations. It has an extremely low probability of transformation into a malignant tumor.

Adenomatous formations, or adenomas, are a type of benign tumors that develop from the glandular epithelium.. They are dangerous due to the high risk of malignancy (degeneration into cancer), especially when they reach large sizes (more than 20 mm).

According to the histological structure, adenomas are classified as follows:.

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Description.

tubular.

With a predominance of tubular glandular cells.

Papillary.

With a predominance of papillary formations.

Papillotubular.

Mixed - papillary and tubular structures are equally represented.

Depending on the number of formations in the wall of the organ, there are single, multiple polyps and diffuse familial polyposis (genetically determined disease).

CausesOne of the most common theories for the appearance of neoplasms in the mucous membrane of an organ is inflammatory. According to this theory, the long-term persistence of an infectious agent in the organ wall causes a violation of local regulatory mechanisms, provoking excessive proliferation of the epithelium, respectively, the appearance of polyps..

The presence of the bacterium Helicobacter pylori is one of the trigger factors for the appearance of polyps in the stomach. Factors that increase the risk of neoplasm formation:.

age over 40, male;

hereditary predisposition (hereditary colon cancer syndrome: familial intestinal adenomatosis - a disease in which the risk of developing not only colon cancer, but also stomach formations);

Helicobacter pylori infection (the bacterium Helicobacter pylori is found in most of the world's population, it has been proven that it can be an etiological factor in gastritis);

taking certain drugs (for example, the use of proton pump inhibitors in the treatment of gastroesophageal reflux disease can cause fundic gland polyps);

smoking, alcoholism.

Symptoms The disease may be asymptomatic for a long time.. The presence of symptoms from the digestive system is possible, however, with small uncomplicated polyps, it often indicates in favor of gastritis.

One of the symptoms of the pathology is intense cramping pain in the abdomen. Since gastritis can cause formations, the characteristic symptoms of inflammatory processes in the mucous membrane should be noted.. Patients may complain of dyspeptic symptoms: heartburn, nausea, epigastric pain, vomiting, stool disorders, etc..

Symptoms indicating the presence of a polyp are nonspecific. They can appear when the nutrition or integrity of the neoplasm is disturbed, it reaches a large size, etc.. In this case, the following symptoms are observed:.

signs of stomach bleeding: melena (tarry stools indicating bleeding in the stomach), vomiting coffee grounds, vomiting blood;

obstructive syndrome: large growths can prevent the passage of chyme into the duodenum, blocking the sphincter. As a result, food lingers in the stomach for a long time, causing bad breath, fetid vomiting.;

intense cramping pains radiating throughout the abdomen, under the sternum: associated with infringement of the neoplasm by the pylorus;

anemic syndrome: occurs due to gastric bleeding.

Diagnosis It is most often not possible to suspect the presence of a neoplasm in the organ, even after interviewing the patient with details of his complaints, collecting an anamnesis of life and disease, due to the non-specificity of the clinical picture. Usually a preliminary diagnosis is gastritis or stomach ulcer.. Then the patient is sent to confirm the diagnosis for additional studies..

Fibrogastroduodenoscopy Fibrogastroduodenoscopy (FGDS) is a modern and most informative diagnostic method that allows you to visualize the gastric mucosa, neoplasms and other pathological processes.

Fibrogastroduodenoscopy is highly informative for making a diagnosis. Fibrogastroduodenoscopy is a special flexible optical device that is inserted into the patient through the oral cavity.. It allows you to examine the inner wall of the esophagus, stomach and duodenal bulb.

During FGDS, when a pathological formation is detected, a biopsy of the area of \u200b\u200bdamaged tissue is usually taken and sent to the laboratory for cytological and histological examination..

Other diagnostic methods pH-metry is also carried out - determining the level of the acid-base state of the contents of the organ. Normal pH of the stomach is acidic, on average - 1.5–2.

In some cases, an X-ray examination with contrast is prescribed. Another method is an X-ray examination using a contrast agent.. In this case, the patient drinks a special solution and x-rays are taken after a certain time.. If the polyp has reached a large size, the configuration of the organ wall and its relief change, with the introduction of contrast, the altered zone is clearly visible in the picture.

If there are no obvious signs of gastric bleeding, it is possible to prescribe a fecal occult blood test..

To detect Helicobacter pylori infection are prescribed:.

PCR (polymerase chain reaction): to detect pathogen DNA;

ELISA (enzymatic immunoassay): to detect antibodies to the pathogen.

TreatmentThere is no conservative treatment for gastric polyps. However, with small uncomplicated hyperplastic formations, the doctor may recommend expectant tactics, in which the patient is prescribed a special diet, other gastroenterological diseases or other diseases are treated..

The choice of treatment method is determined individually depending on the type of formation, its size and other factors. The use of traditional medicine methods, including decoctions / infusions of celandine, in the treatment of gastric polyps has no evidence base and is not recommended..

With expectant management, the patient needs dispensary observation with regular (at least 1-2 times a year) EGD examination. The doctor notes the dynamics of growth, the nature of the surface (presence of ulceration, bleeding, irregularities, erosion), the appearance of new formations.

If one or more signs change, complications appear, or the risk of malignancy increases, surgical treatment is recommended..

PolypectomySurgery to remove a polyp (polypectomy) is the most optimal treatment, the basis for its implementation are gastric adenomas larger than 10 mm.

Polypectomy can be performed endoscopically - without making incisions, access is through the oral cavity. This method is less traumatic, with minimal risk of side effects.. However, it is shown only with small single growths.. Removal is carried out using an electric loop by electroexcision or electrocoagulation.

Healing of mucosal defects occurs within two to nine weeks. After endoscopic removal, dispensary observation with control endoscopy after 10–12 weeks is necessary..

Frequent endoscopy with the collection of pathological biomaterial is not recommended, as this can provoke an increased growth of the polyp, and in case of malignant processes, biopsy increases the risk of metastasis.

Resection of the stomach With multiple, large neoplasms, it is possible to perform a resection of the stomach.

Gastric resection is a direct access operation in which a part of the organ is removed with further restoration of the continuity of the gastrointestinal tract.

Resection is an extreme measure, it is justified only in case of life-threatening complications or malignant processes in the wall of the organ.

Complications With a timely undiagnosed and untreated polyposis, the following complications may occur:.

stomach bleeding;

anemia;

pinching;

gastric obstruction;

polyp necrosis;

malignancy (malignancy of a neoplasm).

PreventionThere are no specific preventive measures to prevent the formation of polyps.. In view of the fact that the main etiological factor of this process is an inflammatory lesion of the inner wall of the organ - gastritis, the main measures should be aimed at preventing its occurrence..

Fractional nutrition is a prevention of the development of pathology. Preventive measures include:.

adherence to the rules of a balanced diet and food intake: frequent, fractional 4–5 meals a day in small portions with the correct ratio of proteins, fats and carbohydrates are recommended;

getting rid of bad habits: smoking, drinking alcohol;

a cautious approach to drug therapy: it is necessary to exclude or minimize the use of drugs that have a gastrotoxic effect, including non-selective non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen, indomethacin).

Patients with an identified polyp should limit the use of foods that irritate the gastric mucosa (salted, smoked, peppered, fried, sour, spicy) and foods that can increase the secretion of gastric juice.

Avoid alcohol and cigarettes completely. Alcohol has a destructive effect on the gastric mucosa, which can lead to ulceration of the polyp, erosion, bleeding. Smoking reduces the protective properties of the inner wall of the organ and increases the production of gastric juice.

Non-selective non-steroidal anti-inflammatory drugs are contraindicated in patients with gastric polyposis.

Prognosis With timely removal of the neoplasm, the prognosis is favorable.

However, surgical treatment does not exclude the possibility of recurrence, so regular dispensary observation is a necessity, as it will allow early diagnosis and conduct the necessary therapy during repeated processes.. Recovery is usually complete.

In order to find out why there are symptoms from the digestive system and why it is dangerous, you need to contact a general practitioner or gastroenterologist. Prolonged course of the disease without adequate therapy can lead to the development of stomach cancer..

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