Gastric polyps

Gastric polyps represent protrusions of the gastric mucosa and are also known as benign tumors or swellings. In addition to intestinal polyps, gastric polyps are the most common neoplasms in the mucous membranes of the gastrointestinal tract (gastrointestinal tract). In particular, people over the age of 60 are more often affected by gastric polyps.

What are gastric polyps?

As Gastric polyps is a benign (benign) formation of the gastric mucosa, which manifests itself as a protrusion of the mucous membrane in the lumen of the stomach. In over 90 percent of cases, gastric polyps are adenomas that have arisen from the adenomatous (glandular) tissue and have an increased risk of degeneration (formation of cancer cells).

Initially, gastric polyps usually do not cause any symptoms. Only in the advanced stage and from a size of about 1 cm can symptoms such as bloating, loss of appetite and 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 develop from the glandular cysts and often occur as local clusters (multiple gastric polyps).

causes

The underlying causes of the emergence of Gastric polyps could not yet be clarified. It is known that older people are more at risk. It is believed that eating 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 accumulation of gastric polyps can be ascertained, especially in genetically determined polyposis syndromes such as Gardner syndrome, Peutz-Jeghers syndrome or juvenile polyposis, genetic factors are also discussed. In addition, infections with Helicobacter pylori bacteria, which can cause gastric ulcer or gastritis (inflammatory disease of the lining of the stomach), are considered to be the causes of gastric polyps.

For example, gastritis leads to a regression of the gastric mucosal tissue, which is supposed to be compensated for by increased polyp formation. In addition, decreased gastric juice production has been shown to increase the risk of developing gastric polyps.

Symptoms, ailments & signs

In the vast majority of cases, gastric polyps do not present with symptoms. Small polyps usually go unnoticed. Symptoms appear accordingly only with larger polyps and the possible accompanying symptoms. The symptoms of larger polyps, on the other hand, comprise several complaints.

They are aggravated if gastritis also develops, which is more common in people with gastric polyps. The symptoms include pain in the upper abdomen of varying intensity. There is also noticeable stomach pain, which can range from a slight feeling of pressure to a strong stinging sensation. This often leads to a feeling of fullness in the stomach and loss of appetite. Seemingly unfounded nausea can occur, and people sometimes feel disgusted with eating meat.

If bleeding occurs due to the polyps, people sometimes vomit this blood. However, this is rare. Most gastric polyps do not damage the stomach as much. The vomiting of blood is usually a symptom of a degenerate gastric polyp or other injury in the stomach.

Occult blood may also appear in the stool due to bleeding. In the case of gastric polyps, weight loss can also occur, despite the fact that no symptoms are perceived at all.

Diagnosis & course

Unexplained complaints in the upper abdomen give an initial indication of the possible presence of Gastric polyps. The diagnosis is confirmed by a gastroscopy (gastroscopy), by means of which the condition of the inside of the stomach and the gastric mucosa can be examined and a biopsy (tissue removal) can be carried out from the gastric mucosa.

A subsequent histological (fine tissue) analysis of the tissue sample enables statements to be made about the malignancy or benignity of the removed tissue and defines the further therapeutic procedure. Stomach polyps have a good prognosis if therapy is started early, but should be consistently monitored after the successful end of therapy due to their high recurrence rate as part of follow-up controls.

Complications

Due to the gastric polyps, the patient experiences various complaints and restrictions in everyday life. As a rule, this leads to pain in the abdomen and stomach. The patient's quality of life is significantly reduced by this pain, and it is not uncommon for them to lose their 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. There is also a feeling of fullness and, furthermore, vomiting of blood. The resilience of the person concerned drops significantly due to the gastric polyps and it is not uncommon for psychological complaints that occur due to the pain.

It is not uncommon for patients to be irritable and uncomfortable.Stomach polyps can be found relatively easily with a gastroscopy, so that this complaint can be treated immediately. The stomach polyps can be removed. Furthermore, those affected are dependent on taking various medications. Further complications usually do not occur as long as the gastric polyps have not developed into cancer. In doing so, and as a rule, the life expectancy of the patient is not reduced.

When should you go to the doctor?

Many patients experience no symptoms or everyday problems with gastric polyps. This complicates the signals that indicate the need to see a doctor. If there are large polyps or if the number of gastric polyps increases, there are clear symptoms that must be clarified by a doctor. Upper abdominal pain is an indication of an abnormality that should be investigated and treated. Do not take pain medication without consulting a doctor, as this can lead to various complications. If the existing symptoms persist for several days or if they increase in intensity, a doctor's visit is necessary.

If you feel sick, vomit or feel full, you should consult a doctor. If there is vomiting of blood or there is blood in the stool, immediate action is required. A doctor's visit is necessary so that the cause can be determined. Without medical care, serious stomach injuries can occur, which can lead to life-threatening consequences. In the event of loss of appetite or an unwanted decrease in body weight, a doctor should also be contacted. If the person concerned is suddenly disgusted with food that was previously liked, this is to be understood as a warning 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 & Therapy

Gastric polyps are differentiated into adenomatous and non-adenomatous types depending on the histological findings. Non-adenomatous gastric polyps are usually only biopsied and not removed.

Adenomatous gastric polyps (adenomas) are classified as precancerous diseases and in many cases follow the adenoma-carcinoma development sequence. Because of this increased risk of degeneration, adenomatous gastric polyps are completely removed in a minimally invasive manner as part of an endoscopic mucosal resection or polypectomy.

While in a polypectomy the individual polyp is detached from the gastric mucosa and removed by means of a loop or clips that are looped around its base, in a mucosal resection the entire adjacent mucosal area is removed. The latter is usually carried out in the presence of pernicious anemia (vitamin B12 anemia) or larger, broad-based gastric polyps in order to prevent the possible spread of tissue cells that can degenerate into carcinoma cells.

If larger tumors are present, a full-thickness excision (open or laparoscopic removal of the stomach wall) or a partial resection (partial removal) of the stomach may be necessary. Since gastric polyps have a relatively high rate of recurrence (recurrence), regular endoscopic follow-up checks are necessary in order to detect possible local recurrences at an early stage and, if necessary, to resect the gastric polyps.

Outlook & forecast

Overall, gastric polyps have a favorable prognosis. If the diagnosis is made quickly and treatment is immediate, the patient is usually discharged from therapy within a short period of time as symptom-free. In the course of life, gastric polyps can develop again at any time. If treatment measures are taken quickly, the prognosis in these cases is also favorable.

The challenge is to make an early diagnosis. The gastric polyps often go unnoticed for a long time, as they do not cause any symptoms, especially in the early stages. 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 avoided. This goes a long way towards improving overall health and preventing gastric polyps. In particular, patients who are already suffering from gastric polyps should ensure that their diet is optimized in the further course.

If the disease progresses unfavorably, gastric polyps can lead to the development of carcinomas. In these cases, the prognosis is significantly worse. If left untreated, the affected person dies prematurely. It is therefore of particular importance to consult a doctor as soon as the first irregularities occur. In addition, adults should regularly take part in the preventive examinations offered for the detection of health problems.

prevention

As the causes of the emergence of Gastric polyps could not be fully clarified so far, there are no measures that directly prevent the disease. However, the known risk factors should be minimized. For example, gastritis can be prevented through a healthy diet (avoiding excessive consumption of nicotine, alcohol and coffee). In addition, people over the age of 50 should be checked regularly for gastric polyps.

Aftercare

If the gastric polyps have been completely removed, polyp follow-up is recommended, depending on the patient's individual risk (concomitant diseases, diverticulosis, family history, histological examination). For example, if small, non-neoplastic polyps have been removed, a follow-up colonoscopy is recommended every ten years; if three to ten polyps have been removed, a follow-up examination should be carried out after three years.

If more than ten polyps have been removed, they are checked closely every two to six months, followed by a colonoscopy every three to five years. The aim of the follow-up examinations is to identify new 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 the polyp follow-up care, a doctor must be consulted immediately.

Normally, after the polyps have been removed, the treating doctor informs the patient about the measures or therapies carried out or about which therapies still appear necessary. Further check-ups and follow-up examinations can then also be arranged with a resident doctor near your place of residence. In addition, during a follow-up examination, there is the option of being able to turn to a special specialist with any problems or questions.

You can do that yourself

Stomach polyps usually need to be removed by gastroscopy or surgery. Self-treatment with over-the-counter medication is not advisable, as the polyps can enlarge or even become malignant.

To prevent recurrence, emphasis should be placed on a high-fiber diet with a high vegetable content. Processed meat products as well as cured or heavily salted dishes can damage the stomach lining and promote the development of gastric polyps. If the gastric polyps are associated with chronic gastritis, very fatty and high-sugar foods should also be avoided. Several small meals are easier for the stomach to process than three large ones; the meals should not be consumed 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 when 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 hastily swallowed.

Stomach sufferers often have problems with carbonated drinks, while tea preparations made from chamomile, mallow and lemon balm, on the other hand, soothe irritated gastric mucosa. Excessive alcohol consumption and nicotine should be avoided completely if possible. Regular check-ups ensure that newly growing polyps can be discovered and removed as quickly as possible.