What are gastric polyps?

Gastric polyps are abnormal growths on the inner lining of your stomach. Most are harmless and don’t cause symptoms. But some of them can turn into cancer.

Your stomach is the organ that receives chewed-up food. The stomach contains acid. The acid kills many of the bacteria in swallowed food. It also contains juices that help with digestion. The innermost layer of the stomach has a lining of cells called the epithelium. Most gastric polyps come from an abnormal growth of cells there.

Gastric polyps are not cancerous. But some may turn into cancer. There are many types of gastric polyps. They happen for different reasons. Most have little or no risk of becoming cancer. But some have a higher risk of turning into cancer.

Abnormal tissue growth is called dysplasia. Gastric polyps with dysplasia are the ones most likely to turn into cancer.

In the U.S., fundic gland polyps are the most common type of gastric polyp. The second most common are hyperplastic polyps. Hyperplastic polyps are common in places that have a higher rate of H. pylori infections. Gastric polyps are more common in older adults.

What causes gastric polyps?

Gastric polyps can happen for different reasons. Anything that causes your stomach cells to grow abnormally can lead to this problem. Some of the causes of gastric polyps include:

• Chronic inflammation of the stomach.

• H. pylori infection.

• Pernicious anemia.

• Being close to stomach erosion, such as from an ulcer or gastroenterostomy tube sites.

• The use of proton-pump inhibitor medicines, such as omeprazole.

Some of these causes may increase your risk for certain types of gastric polyps. For instance, an H. pylori infection raises your risk for gastric-hyperplastic polyps (GHPs). Proton-pump inhibitor medicines may increase your risk for fundic gland polyps.

You may also have a higher risk of gastric polyps if they run in your family. Certain genetic conditions like Familial Adenomatous Polyposis (FAP) cause a lot of lower intestinal polyps. They also cause gastric polyps.

What are the symptoms of gastric polyps?

Most gastric polyps don’t cause any symptoms. Most people learn they have a gastric polyp after having a test for another reason. This is typically a test called an upper endoscopy. In this test, a thin tube with a tiny camera is put down your throat to look into your stomach.

Your chance of symptoms depends on the type of polyp you have. Larger polyps may be more likely to cause symptoms, including:

• Stomach pain.

• Heartburn.

• Vomiting with blood, which can lead to anemia.

• Bleeding, especially if the polyp has a sore on it.

• Symptoms from stomach blockage, such as weight loss or intense vomiting.

• Fatigue.

• Lack of iron in the body.

• Feeling full after eating only a small amount of food.

Gastric polyps that become cancer may cause other symptoms.

How are gastric polyps diagnosed?

Most gastric polyps are diagnosed during an upper endoscopy (esophagogastroduodenoscopy or EGD) test.

To diagnose the type of polyp, your health care provider will do a biopsy. In a biopsy, a sample of the gastric polyp and nearby tissue is taken out. This is done during an endoscopy. A specialist then looks at the sample under a microscope. Your provider may also ask about your health history and give you a physical exam. This can sometimes give helpful clues about the type of polyp you may have.

In some cases, cancerous growths look like gastric polyps when viewed in an upper endoscopy. Because of this, some people who are told they have a gastric polyp at first may actually have cancer.

Sometimes the polyps show up on a barium X-ray test, such as an upper GI (gastrointestinal) series.

How are gastric polyps treated?

Treatment for gastric polyps varies. Your treatment may depend on:

• Polyp type, size, shape, or location.

• The number of polyps you have.

• Your symptoms.

• Your other risk factors for stomach cancer, such as your age and smoking history.

If you test positive for the bacteria H. Pylori, medicine will be prescribed.

Treatment for fundic gland polyps:

A fundic gland polyp has only a small chance of becoming cancer. At first, your health care provider will biopsy the polyp. Then a specialist can check for early signs that the polyp might become cancer. They will look for signs of dysplasia.

• If the polyp doesn’t look like it may become cancer, you may not need any treatment.

• If you have a polyp that has abnormal tissue growth (dysplasia), you will likely have it removed.

• If you have a very large polyp, you may need to have it taken out.

• If you have been taking a proton-pump inhibitor medicine for a long time, your doctor may recommend stopping it or changing to another medicine

Treatment for gastric hyperplastic polyp (GHPs):

• A GHP polyp with dysplasia will likely be removed.

• For GHP without dysplasia, a repeat endoscopy will be done in a year.

Treatment for adenomatous polyps:

These have a high risk of turning into cancer. Because of this, your provider will likely want to remove them and do follow-up endoscopies.

Your provider will remove any growth that becomes cancer. They will also take out any type of polyp with dysplasia. If the dysplasia or cancer has spread into nearby tissue, your provider may also remove part of that tissue. Depending on how much it has spread, you may have this done through an endoscopy. Or you may need surgery to remove part of your stomach. Your provider will also at that time likely remove any polyps that cause symptoms.

What are possible complications of gastric polyps?

The main complication of gastric polyps is stomach cancer. Here are some of the main types of gastric polyps and their cancer risk.

Having many gastric polyps can also cause problems. For instance, familial adenomatous polyposis causes polyps to grow all along your digestive tract. This leads to a very high risk for colon cancer.

Having your polyps removed can also cause problems. These include bleeding, holes in the tissue, and infection.

Can gastric polyps be prevented?

You may be able to lower your risk for new gastric polyps. For instance, your health care provider may have you stop using proton-pump inhibitor medicines if you have fundic polyps. You may be able to reduce your risk for hyperplastic polyps if you take an antibiotic for an H. pylori infection.

To lower your risk for problems from gastric polyps, see your provider as often as they suggest. Follow the care plan that they prescribe. And follow their recommendations about dietary and lifestyle changes. This may include:

• Drinking less alcohol.

• Quitting smoking.

• Eating less dietary fat.

• Eating more fiber.

When should I call my doctor?

Call your health care provider if you have any symptoms that could be from a gastric polyp. These may include stomach pain, unexplained weight loss, intense vomiting, or blood in your stool.

Key points about gastric polyps

• Gastric polyps are abnormal growths on the lining of your stomach. Most are harmless and don’t cause symptoms. But some may turn into cancer.

• There are several types of gastric polyps. Your risk of cancer depends on the type of polyp you have.

• Your health care provider will likely do a biopsy of your polyp to find out which one you have. This is done during an upper endoscopy.

• Your treatment depends on the size, location, appearance, and type of polyp you have. If you have dysplastic polyps or cancerous growths, your provider will remove them.

• Your provider may do follow-up testing to check on your polyps.

• Following treatment recommendations, including regular checkups with your providers, is an important part of managing gastric polyps.

Next steps

Tips to help you get the most from a visit to your health care provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis. Note any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you don't take the medicine or have the test or procedure.

• If you have a follow-up visit, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.