What are the causes of gastric polyps? Are they something to be concerned about?

B.

Gastric polyps are small protrusions in the lining of the stomach, often similar in appearance to the polyps found in the colon. It is not unusual for people to have gastric polyps. In fact, such polyps are detected in up to 25 percent of patients who undergo an upper endoscopy examination.

The vast majority of gastric polyps are benign, with no potential to become cancerous. The most common type, the hyperplastic polyp, is composed of many tiny, dilated glands. Another benign polyp, the fundic gland polyp, is also composed of glands and is typically found in the upper part of the stomach (the fundus). A third type of benign gastric polyp is the inflammatory polyp. This polyp, composed of enlarged cystic glands, is often found at the point where the stomach has been connected to the small intestine after a surgical procedure. There is a possible connection between inflammatory polyps and the bacterium Helicobacter pylori.

A rare type of polyp, the adenomatous polyp, is composed of glands that are growing in a premalignant fashion. As is the case with many colon polyps, adenomatous polyps can be a precursor to cancer. If an adenomatous polyp is found in the stomach, it must be completely removed.

The problem with treating gastric polyps is that it is impossible for a doctor to tell whether a polyp is benign or adenomatous simply by looking at it through an endoscope. So, doctors generally remove all gastric polyps, especially those that are larger than 1cm. In patients who have many small polyps, doctors usually try to remove at least the five largest ones.

Once the polyp is removed and the tissue is examined under the microscope, the type can be determined. Only gastric polyps of the adenomatous variety will need further endoscopic follow-up. Some experts also recommend follow-up of benign hyperplastic polyps if they are large (greater than 1-2cm).