What Are Gastric Polyps?

Gastric polyps refer to the protruding papillary tissues that grow on the surface of the gastric mucosa. They are often small and have no obvious symptoms. They are usually found accidentally during barium meal imaging, gastroscopy or other reasons. The name "polyp" usually refers only to the bulges observed with the naked eye.

Basic Information

English name: polypofthestomach
Visiting department: Gastroenterology

Common symptoms: Abdominal pain, abdominal distension
Contagious: no

Causes of gastric polyps

The cause is currently unknown. Gastric polyps are bulging lesions that originate from gastric mucosal epithelial cells protruding into the stomach.

Clinical manifestations of gastric polyps

The disease is usually asymptomatic in the early stages or without complications. Symptoms often appear as epigastric pain, bloating, discomfort, and a few may appear nausea and vomiting. Patients with erosion or ulcers may have upper gastrointestinal bleeding, which are mostly positive for fecal occult blood test or melena, and vomiting is rare. The pedicled polyps located in the pylorus can be dislodged into the pyloric duct or duodenum and pyloric obstruction occurs. Polyps that grow near the cardia can have difficulty swallowing.

Gastric polyp examination

Laboratory inspection

Patients with mucosal erosions or gastric ulcers mostly showed positive fecal occult blood tests or melena.

2. Other inspections

(1) Endoscopic examination . Round or oval bulge-like lesions on the surface of the mucosa can be seen under endoscopy. Adenomatous polyps tend to be redder than the surrounding mucosa, while hyperplastic polyps are similar to the surrounding mucosa. Endoscopic biopsy and histological examination can clarify its nature and type, and can be treated at the same time.

(2) X-ray barium meal examination showed filling defects. This method is of certain value in diagnosing gastric polyps, but its detection rate is lower than that of gastroscopy, and it is suitable for those who have contraindications for endoscopy.

Gastric polyps diagnosis

Gastric polyps often have no clinical symptoms and are difficult to diagnose. They are often found by X-ray barium meal imaging and gastroscopy.

Gastric polyps complications

Patients with erosion or ulcers may have upper gastrointestinal bleeding, which are mostly positive for fecal occult blood test or melena, and vomiting is rare. The pedicled polyps located in the pylorus can be dislodged into the pyloric duct or duodenum, and there is a manifestation of pyloric obstruction. Polyps can have difficulty swallowing when they grow near the cardia.

Gastric polyps treatment

Endoscopic treatment

Endoscopic resection is the first choice for the treatment of gastric polyps, mainly including high-frequency electrocoagulation resection, laser and microwave cauterization, nylon wire ligation, and argon ion coagulation.

(1) High-frequency electrocoagulation resection is currently the most widely used method, and its principle is to use the thermal effect of high-frequency current to coagulate and necrotize tissue to achieve the purpose of resection of polyps.

(2) Microwave cauterization method The principle that microwave can make polar molecules vibrate to produce a thermal effect, so that the tissue can be solidified and vaporized for polypoid cauterization, and it has hemostatic effect. One-time ablation, the larger one requires multiple treatments.

(3) Laser method The high-energy laser light generated by the laser is irradiated to the diseased area through the optical fiber introduced through the endoscopic biopsy hole, and the tissue protein is coagulated, degenerated and destroyed by the thermal energy of light energy conversion to achieve the therapeutic purpose. Mostly used for the treatment of wide pedicles or pedicled polyps.

(4) Nylon wire and rubber band ligation method By ligating the root of the polyp, it ischemia and necrosis to achieve the purpose of treatment. Polyps fall off and form superficial ulcers within 1 week after ligation, and white scars form and heal at 3 to 4 weeks.

(5) argon ion coagulation argon can conduct high-frequency electric energy generated by tungsten electrodes through ionization to cause coagulation of tissues. In recent years, it has been applied to endoscopic treatment and has received good curative effects. It is mainly suitable for polyps without wide pedicles and less than 1.5 cm in diameter.

(6) Freezing method Spray the refrigerated gas directly on the surface of the polyp through the endoscope biopsy hole through a special catheter, or use a special freezing rod to freeze the lesion to make the tissue necrotic and fall off.

(7) Radio frequency method Radio frequency is a 200-750kHz electromagnetic wave. After entering the diseased tissue, the local heat generation causes its water to evaporate and dry, and the tissue is necrotic to achieve the therapeutic purpose.

(8) Alcohol injection method Endoscopic use of absolute alcohol to make a point injection around the base of the polyp is generally used for the treatment of wide-based polyps.

2. Anti-Hp treatment

Recent studies have shown that H. pylori (Hp) infection is closely related to the occurrence of proliferative polyps. After successful removal of Hp infection in patients with Hp-positive proliferative polyps, about 40% of them have completely subsided.

3. Surgical treatment

The indications for surgery are:

(1) sessile or broad-based polyps larger than 2 cm.

(2) Progressive increase in polyps.

(3) Patients with adenomatous polyps with dysplasia, suspicious canceration and canceration.

Prognosis of gastric polyps

Gastric polyps are generally benign, and asymptomatic patients do not require treatment. Hyperplastic polyps are non-neoplastic polyps, because malignant lesions generally do not occur, and the effect is better after symptomatic treatment in medicine. Adenomatous polyp cancer can reach a rate of 30% to 58.3%, and biopsy pathology examination should be treated surgically.