Gastric polyps are abnormal growths found on the mucosal lining of the stomach. They are uncommon and are often found by chance during an upper gastrointestinal (GI) endoscopy used to look for other problems. If a polyp is found during such an exam, a biopsy is generally conducted to determine whether it is a hyperplastic polyp, fundic gland polyp, or adenoma.
Hyperplastic polyps are the most common form of gastric polyps. They may occur singly or in groups, and are most often found in the lowest portion of the stomach, called the antrum. Hyperplastic gastric polyps are typically smooth, round growths and sometimes protrude on a stalk from the stomach lining. They often develop in the presence of chronic inflammation, such as in the case of gastritis or H. pylori infection. Treatment, if needed, may involve medication to treat the inflammation or infection these polyps are often associated with; hyperplastic polyps rarely become cancerous.
Fundic gland polyps are a type of gastric polyp that usually occurs in the upper part of the stomach, called the fundus. These polyps do not cause cancer, except in people with familial adenomatous polyposis (FAP). FAP is a genetic disorder that significantly increases a person’s risk for stomach and colon cancer. One possible cause of fundic gland polyps is long-term use of a proton-pump inhibitor (PPI) — a type of medication used to treat ulcers and dyspepsia. Fundic gland polyps rarely require treatment; those caused by PPI use may resolve spontaneously upon PPI discontinuation.
Adenomas are the least common type of gastric polyp. Like gastric hyperplastic polyps, they are often found in the antrum and occur in the presence of chronic inflammation. Unlike hyperplastic polyps, however, adenomas significantly increase the risk of cancer. They are generally singular growths, and those that reach about .78 inches (2 cm) or more in diameter are at greatest risk for becoming cancerous. Because of this, surgical removal is generally recommended; adenomas may be removed during endoscopy or via an incision in the stomach.
While small gastric polyps usually cause no symptoms, larger polyps may cause stomach pain, nausea, vomiting, or a sense of fullness, even after eating a small portion of food. The chronic inflammation associated with hyperplastic polyps and adenomas may also cause these symptoms, as well as bloating, gas, and bleeding. Anyone who experiences any of these symptoms usually should be evaluated by a health care provider. Also, people who have had gastric polyps in the past, especially adenomas, are typically encouraged to have regular exams to ensure the polyps do not return.