Hyperplastic polyp of the stomach - what is it? Polyps are considered benign tumors on the gastric mucosa. They can be single or multiple. All formations are divided into adenomatous and hyperplastic. Hyperplastic are formed from epithelial cells, they occur more often, but less often go into cancer pathology. Pathology usually does not bother the patient and is detected during the diagnosis of other diseases.
Causes and symptoms
A hyperplastic polyp is an overgrowth of the mucous epithelium that occurs most often against the background of infectious changes. In contrast to this species, the adenomatous form of pathology is the formation of glandular cells.
A hyperplastic polyp of the stomach can form for several reasons:
- Infection with Helicobacter pylori, which causes inflammatory changes in the mucosa.
- Peptic ulcer of the stomach.
- Human papillomavirus infection provoking various neoplasms.
- Increased steroid formation.
- Unfavorable life factors: increased radiation, environmental degradation. This provokes disturbances in biochemical processes and the growth of gastric tissue cells.
- Disorders of the diet: consumption of nitrates, overeating, the use of alcoholic beverages, smoked meats with carcinogenic properties.
- Taking medications that lead to unhealthy cell division. For example, these are proton pump inhibitors, non-steroidal anti-inflammatory drugs.
- Hereditary factor. The disease has a genetic predisposition.
The presence of polyps usually does not manifest itself as symptoms, especially with small sizes. As the formation grows, discomfort and pain in the stomach appear. If the polyp is pinched, the pain can be acute.
And also possible:
- nausea, vomiting,
- a feeling of heaviness in the stomach
- a feeling of rapid satiety - with a significant growth of the polyp,
- flatulence, putrid breath,
- when the polyp is injured, bleeding occurs, feces acquire the color of tar.
There is also difficulty in transferring food to the duodenum, as a result of which vomiting acquires a rotten odor, an unhealthy bad breath is noticeable. There are intestinal disorders, a state of weakness, weight loss, increased or decreased appetite. With internal bleeding, anemia occurs.
A gastroenterologist for any of these symptoms during an external examination cannot detect the formation of a polyp. Sometimes, the crimson color of the lips, the mucous membrane of the oral cavity and the palms of the patient is visible. But for the diagnosis it is necessary to carry out instrumental diagnostics.
Disease Diagnosis and Treatment
Hyperplastic stomach polyps can be diagnosed in different ways:
- X-ray examination using a contrast agent - performed from morning to meal, takes about 20 minutes. The patient drinks a solution of barium, the radiologist takes pictures. The method allows you to diagnose polyps, duodenal ulcers, tumors.
- Fibrogastroduodenoscopy allows you to analyze the condition of the mucosa from the inside using a special device with a camera. During the procedure, tissue is taken for histology - tissue research.
- Endoscopic ultrasonography allows you to distinguish between the nature of education (benign or oncological).
- Study of hemoglobin and antibodies in the blood.
- Coprological examination of feces for the presence of blood.
Hyperplastic polyps of the stomach are usually removed. Small ones are removed on endoscopy, to eliminate large ones, they perform an operation with an abdominal incision. Usually, doctors are of the opinion that with small sizes of formations, conservative treatment and diet therapy can be used.
The goals of symptomatic treatment:
- elimination of the inflammatory process,
- normalization of gastric acidity,
- reduction of epithelial damage,
- pain relief.
Surgical treatment of polyps and prevention
Polyposis can be removed with an endoscope or through abdominal surgery.
Endoscopic surgical removal (polypectomy) happens:
- Mechanical removal is performed using an endoscope. The polyp is removed by loop. The operation is performed under general anesthesia.
- Electroexcision is an electrosurgical operation, the formation is also removed by a loop.
- Electrocoagulation is the removal of pathology by means of biopsy forceps, which heat up and evaporate overgrown cells.
Endoscopy cannot guarantee that the polyp does not form again. Interventions are not carried out for patients with pacemakers, with bleeding disorders and in serious conditions. Such operations cannot be carried out often, since the risk of repeated polyposis increases.
During open abdominal surgery, formations are removed with a scalpel under general anesthesia.
Indications for abdominal surgery:
- a single polyp of a large volume - more than 3 centimeters,
- several polyps located together
- wide base of the polyp.
The patient is injected into artificial sleep and the polyp is removed with a scalpel. A tissue sample is necessarily sent for histological analysis. Tissues are sutured, the patient is awakened.
Abdominal surgery is fraught with various complications:
- infection of the postoperative suture,
- atelectasis (decay) of the lung,
- venous blood clots,
- bowel obstruction.
Sometimes they perform a resection - removal of part of the stomach. The method is used for numerous polyps. If cancer cells are found in the course of histological examination, there is a risk of the oncological formation transferring to the remaining part of the stomach. In this case, the stomach is completely removed.
To avoid the reappearance of pathology, doctors recommend a diet and not eat spicy, fried, salty foods. It is also important preventive examination once every six months.
The danger of the disease lies in the asymptomatic course. Rarely, patients may be disturbed by:
- discomfort and pain in the pancreas,
- dull pain with ulceration or inflammation of the polyp,
- severe pain when pinching a polypous body with a moving leg.
With the location of the growth in one place, obstruction of the main digestive organ develops, which is accompanied by:
- vomiting yesterday’s food
- fast saturation
- pungent breath
With the formation of a large polyp in the stomach, bleeding begins, which is manifested by blood in the feces and vomit. Possible complications:
- Obstruction of the food paths from the stomach to the intestines, which manifests itself with large growths in the space surrounding the canal.
- The prolapse of the tumor on the leg from the hollow organ to the 12th duodenal process, its infringement at the border with the intestine.
- Bleeding that occurs with ulceration of the polyp.
- Rebirth in a malignant tumor.
A hyperplastic polyp does not belong to precancerous conditions, but relapses of the disease are possible.
Causes of hyperplastic gastric polyp
- Helicobacter pylori infection. The microbe causes inflammation of the stomach, which disrupts its work. Organisms survive in an acidic environment. They are endowed with the ability to create an acid resistant alkaline shell.
- Infection with human papillomovirus, which provokes the growth of neoplasms.
- Unfavorable living conditions: poor ecology, high radiation level. This causes a malfunction in the course of biochemical processes, provokes active growth and cell division in the gastric tissues.
- Improper diet and diet: eating foods with a high concentration of nitrates, overeating, long breaks in food.
- Taking certain medications, such as Streptomycin. The drug negatively affects the mucosa, causing the formation of polyps.
- Genetic factor. Disorders at the chromosomal level leads to an acceleration of the process of cell division with the formation of polyps. The disease is hereditary.
- Testing feces for occult blood.
- Enzyme immunoassay.
- Determination of the chain of polymerization reactions.
- Fibrogastroscopy. Visualizes the condition of the inner walls of the stomach. An endoscopic examination of the organ is carried out in order to determine the degree of inflammation, the number of tumors. Hyperplastic growth is visualized as a round tumor with irregular borders.
- FGDS biopsy sample. Allows you to examine tissue histology in order to determine the nature of the tumor.
- Radiography with contrast (barium mixture). Held on an empty stomach. After swallowing the contrast and its progression through the organs of the gastrointestinal tract, an analysis of the obtained images takes place. The method allows you to determine the functional state of the stomach and nearby organs, to diagnose polyps, cancer, changes in the 12-finger process. Small polyps during the examination are not visualized.
- Ultrasound of the stomach. It is used to clarify the diagnosis.
Hyperplastic type growths are not amenable to drug and alternative treatment. Antibacterial therapy can give a positive result if Helicobacter is the source of inflammation. The only treatment with proven efficacy is resection. Two techniques are applied:
- Endoscopic surgery. It is used when detecting 1 or 2 foci of medium size on the mucous membrane. To completely remove pathological tissue, electroexcision and electrocoagulation are performed. During the procedure, a biopsy is taken for histology. 14 days after endoscopy, a control study is scheduled.
- Full abdominal surgery. It is used for multiple clusters of overgrowth or large diameter with a wide leg of one polyp. At the same time, a biopsy is done to exclude malignancy of the process.
A large-scale operation is shown if:
- the polyp is malignant,
- there are bleeding
- impaired patency of the stomach,
- tissue necrosis detected.
Today's medicine is powerless in the field of prevention of gastric polyposis. After surgical treatment, a routine examination by a gastroenterologist is prescribed up to twice a year.. To prevent hyperplastic growths, general recommendations apply:
- Correction of the diet.
- Refusal of alcoholic drinks, smoking.
- Reducing the amount of painkillers, anti-inflammatory drugs.
- An annual endoscopic examination to exclude the recurrence of the disease during its surgical treatment in the past.
- Dietary food based on the exclusion of food that is aggressive for the stomach: spicy, salty, sour, fried, oily, smoked.
Hyperplastic polyp of the stomach
This form of the disease is the proliferation of its own epithelial cells of the mucous membrane. It is for this reason that the hyperplastic form of polyps rarely causes cancer in a patient. Often the disease occurs against the background of a bacterial infection Helicobacter pylori, which causes the patient to develop gastritis, and he, in turn, provokes a hyperplastic polyp of the stomach.
This disease does not have any specific symptoms. Depending on the localization of the process, the number and size of neoplasms, the patient may experience various symptoms. Among the most common are obstruction of the stomach, nausea, vomiting, pain on palpation and pain in the epigastric region. Any manifestations of violations in the digestive tract are the reason for the diagnostic examination of the patient.
Hyperplastic polyp: symptoms, complications
Hyperplastic polyps of the stomach is a benign proliferation of the mucous membrane. Small overgrowths of the stomach have no clinical symptoms. Only large formations are capable of provoking bleeding, hampering the passage of food, and provoking cramping pains.
Polyps on the stalk can pass through the pylorus of the stomach into the duodenum 12 - the cause of mechanical intestinal obstruction.
Symptoms of adenomatous polyposis depend on the morphological form of growths:
- The villous (papillary) adenoma has wide outgrowths on its own layer of the mucous membrane,
- Papillotubular adenoma is represented by tubular and papillary structures,
- Tubular adenoma consists of branching glands that are surrounded by the mucous membrane.
Causes of Hyperplastic Polyps
Hyperplastic polyps of the stomach are detected in people over 40 years old. Provoking factors of polypous adenomas:
- Helicobacter pylori infection,
- Hereditary predisposition
- Excessive secretion of steroid hormones.
Types of polyps are divided into 2 categories:
Hyperplastic appearance is detected more often. Forms are never maligned.
The adenomatous variant consists of glandular cells, is capable of cancerous degeneration.
Hyperplastic Polyp Treatment
Treatment of hyperplastic polyposis is carried out when the size of the growth is more than 3 cm. Many doctors consider the optimal measure - the removal of any types of formations. If you leave the pathology unattended, the risk of growth, cancerous transformation of foci increases.
If the patient refuses endoscopic removal, doctors prescribe diet therapy, the intake of vitamin and mineral balance. Dynamic monitoring is preferably carried out at least 2 times a year. Multifocal polyposis is a dangerous condition. Growths become malignant, erosion covered, bleed. With complications, the risk of cancerous conversion increases, so experts strongly recommend surgical removal.
Excision of pathological tissues is carried out by electrocoagulation, electroexcision. 2 weeks after the intervention, a control endoscopic examination is performed to verify the complete neutralization of the overgrown epithelium.
Endoscopic monitoring should not be done frequently. Regular interventions injure the mucous membrane, which increases the likelihood of repeated polypous growths. Endoscopy increases the risk of cell metastasis in cancerous epithelial degeneration.
A large hyperplastic polyp on a wide stalk is eliminated by resection of the stomach. The operation is performed according to the following indications:
- Obstruction of the stomach
- Pinched nerve
- Necrotic conditions
Conservative treatment of polyposis does not exist, therefore, surgery is the only effective method of treatment of nosology.
With Helicobacter pylori infection, pathogen erradication should be carried out. For these purposes, antibiotic therapy is prescribed (clarithromycin, oxacillin). Drugs help to avoid an increase in the secretory activity of the stomach. Conservative therapy reduces the risk of complications of polypous growths.
Doctor's recommendations for conservative treatment of the disease:
- Diet correction with the exception of acute, toxic foods,
- Smoking cessation and alcohol,
- Limiting the use of anti-inflammatory and analgesic drugs.
To prevent an increase in the number of overgrowths, disease prevention should be carried out.
Preventive measures for polyps of the stomach
There are no specific measures for the prevention of hyperplastic polyps of the stomach. Medical practice shows that the symptoms and manifestations of polyposis are reduced with constant diet therapy, the selection of drugs with no hepatotoxic effect. Non-steroidal anti-inflammatory drugs are contraindicated for all patients with gastric polyps.