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Glossary


Benign gastric polyps

A benign polyp of the stomach is non-cancerous growth that does not spread (metastasize) to other parts of the body and is not usually life-threatening. A gastric polyp is a growth that develops in the lining of the stomach (mucosa). Most gastric polyps are benign, and they are the most common benign condition of the stomach.

 

Polyps grow in different ways:

  • Sessile polyps are wide and flat. They grow along the surface of the mucosa.
  • Pedunculated polyps grow out from the mucosal surface and look like a mushroom with a head and a stalk.

Types of benign gastric polyps

There are a number of different types of gastric polyps.

Hyperplastic polyps

Hyperplastic polyps are the most common type of benign gastric polyp.

  • more common as people get older
  • slightly more common in women than men
  • found as single polyps
  • usually small (less than 1 cm)
    • Rarely, hyperplastic polyps larger than 2 cm may develop dysplastic changes that can then become malignant.

 

Hyperplastic polyps are changes in normal gastric mucosa where too much tissue grows. They develop in reaction to areas of inflammation and damage to the mucosa caused by:

  • Helicobacter pylori infection
  • pernicious anemia
  • gastric ulcers
  • previous stomach surgery
  • gastroesophageal reflux disease (GERD)

Fundic gland polyps

Fundic gland polyps occur in the fundus and upper body of the stomach. They are most often found in people with familial adenomatous polyposis (FAP). FAP is an inherited disease characterized by a large number of polyps in the colon. However, fundic gland polyps can occur in people without FAP.

  • multiple, small (less than 1 cm) and sessile
  • considered benign when found in people without FAP
    • Fundic gland polyps may become malignant in people with FAP because of the large number of polyps that are found in this disease.

 

Long-term use of drugs that reduce the amount of acid made in the stomach (such as proton pump inhibitors) is under investigation as a possible risk factor for fundic gland polyps.

Inflammatory fibroid polyps

Inflammatory fibroid polyps are rare gastric polyps.

  • also called eosinophilic granuloma or Vanek tumour
  • single polyps, usually 4 cm or less
  • may be sessile or pedunculated
    • Some inflammatory fibroid polyps may develop an ulcer.
  • found in men and women of all ages
  • most commonly found in the lower part of the stomach (antrum) near the pylorus
  • may be associated with low levels of stomach acid or an absence of stomach acid

Xanthoma (xanthelasma)

A xanthoma is a benign growth that contains fat, including cholesterol. While they are more common on the skin, they can occur in the stomach.

  • more common as people get older
  • more common in men than women
  • may be single or multiple
  • usually very small (1–2 mm)
  • often found in areas of the stomach with
    • chronic gastritis
    • intestinal metaplasia
    • bile reflux gastropathy – occurs when bile from the liver flows backward from the small intestine into the stomach, causing inflammation and pain

Polyposis syndromes

Polyposis syndromes are inherited (genetic) conditions in which large numbers of polyps develop in the gastrointestinal (GI) tract, usually the colon or small intestine. Benign gastric polyps can occur in the following polyposis syndromes:

  • Peutz-Jeghers syndrome
    • This syndrome is associated with polyps made up of an overgrowth of cells and tissues normally found in the area (hamartomatous polyps).
  • juvenile polyposis
    • Large numbers of polyps develop during the first 20 years of life.
    • Juvenile polyposis increases the risk of developing colon cancer, but the risk of developing stomach cancer is also increased.
  • Cowden disease
    • Benign tumours and cysts develop in several organs of the body, such as the skin, breasts and the mucosa lining of the GI tract, including the stomach.
  • Cronkhite-Canada syndrome
    • This is an extremely rare condition.
    • Polyps occur in the stomach and other areas of the GI tract.
    • Other signs include hair loss, skin colour changes and thinning of the nails.

Signs and symptoms

Gastric polyps rarely cause signs and symptoms. Most small gastric polyps are found accidentally during an upper gastrointestinal endoscopy being done for other reasons. Signs and symptoms may appear if the polyp grows very large:

  • vague stomach or abdominal discomfort
  • bleeding
    • may show up as blood in vomit or stool
    • may lead to anemia
  • gastric outlet obstruction – A large polyp may block the opening from the stomach to the small intestine.  
  • digestive problems
    • loss of appetite
    • heartburn (indigestion)
    • feeling full after a small meal (early satiety)
    • difficulty swallowing
    • nausea
    • vomiting

Diagnosis

If the signs and symptoms of benign gastric polyps are present, or if the doctor suspects a benign gastric polyp, tests will be done to make a diagnosis. Tests may include:

Treatment

Treatment options for benign gastric polyps depend on:

  • size of polyp
  • number of polyps
  • type of polyp
  • whether the polyp is causing signs or symptoms

 

Treatment may not be needed for small (less than 1 cm) polyps that are not causing any signs or symptoms.

 

The standard treatment for gastric polyps is surgery. The types of surgery include:

  • endoscopic removal of the polyp
    • used for single polyps 2 cm or less
    • removed during an upper gastrointestinal endoscopy
    • area around the polyp may be examined
  • gastrostomy
    • uses an incision in the stomach wall to remove polyps
    • may be used for very large polyps (greater than 5 cm), multiple polyps or if the polyp is sessile
  • removal of part of the stomach (partial gastrectomy)
    • may be used for multiple polyps

References

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