Introduction
Polyp means 'a small growth'. A gastric polyp, also known as a stomach polyp, is an unusual growth of tissues within the inner stomach lining. It usually appears as bunches of growth anywhere in the inner lining of the stomach. The area of occurrence of the polyps helps in identifying its type. Most polyps are asymptomatic, but larger ones may show symptoms like bleeding, anemia (decreased blood cell count), abdominal pain, and obstruction. Even if most polyps are non-cancerous, some may become cancerous masses.
What Are the Different Types of Gastric Polyps Seen in Older Adults?
Stomach polyps can be neoplastic (cancerous) or non-neoplastic (non-cancerous or benign). Epithelial polyps are the most common among the types of gastric polyps. It includes fundic gland polyp (FGP), hyperplastic polyp, and adenomatous polyp. Less common epithelial polyps include:
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Neuroendocrine tumors (cancers that begin in specialized cells called neuroendocrine cells).
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Ectopic pancreatic tissue (pancreatic tissues found outside the usual location of the pancreas).
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Pyloric gland adenoma (rare tumor in the gastric lining).
The main causes of gastric polyps are stomach lining inflammation or gastritis due to Helicobacter pylori infection (H. pylori). The infection can lead to ulcers and gastritis and gradually causes polyps. People suffering from acidity or heartburn usually take medications like proton pump inhibitors, which may lead to the development of stomach polyps. Stomach erosions like ulcers can also cause polyps. Genetics also plays a vital role in the development of gastric polyps.
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Fundic Gland Polyp (FGP) - These polyps form on the upper part of the stomach called the fundus and are one of the most common types of gastric polyps. These polyps rarely develop into cancer and are diagnosed as small, smooth, flat bumps. It is sometimes associated with PPI-proton pump inhibitors (medications that reduce gastric acid secretion), and the doctors may ask the patient to stop the intake of PPIs.
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Hyperplastic Polyp - It is the second most common type of gastric polyp. It is found scattered throughout the stomach and appears in bunches. It is found to be associated with chronic gastritis (inflammation of the lining of the stomach), pernicious anemia (decreased red blood cells due to a reduction in absorption of vitamin B12), and Helicobacter pylori gastritis (gastritis due to H. pylori infection). Such cases can be effectively treated by managing the underlying infections and inflammatory agents. The cancerous transformation of hyperplastic polyps is rare but may show the same in the case of chronic gastritis.
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Adenomatous Polyp - It is a neoplastic type (cancerous) polyp and is common in the bottom part of the stomach, the antrum. It can be the initial stage of stomach and intestinal cancer and indicates cancer development in some body parts. Removal of the cancer is necessary to prevent further complications due to the spread of the same.
What Are the Symptoms of Stomach Polyps in the Elderly?
Most stomach polyps remain asymptomatic, and the person may get usually diagnosed when accidentally detected while testing for a different problem. Symptoms depend on the type of polyp and the area of occurrence. Usually, large polyps are the ones showing symptoms like:
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Stomach pain.
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Vomiting.
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Anemia (decrease in the number of red blood cells).
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Weight loss.
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Bloody stool.
How to Diagnose Stomach Polyps in Older Adults?
Since the symptoms will usually be less or the condition may be asymptomatic, the doctor may not detect the polyps just by asking about the symptoms or by examination. Most stomach polyps get diagnosed in adults during an upper endoscopy. In this test, the inner part of the stomach may be viewed by a tiny camera attached to a thin tube. To diagnose, the healthcare provider may also carry out a biopsy, where a polyp sample and nearby tissues will be taken for examination under a microscope. The diagnostic methods and the symptoms the patient has will help the doctor diagnose the type of gastric polyp.
How to Manage Gastric Polyps in the Elderly?
It is necessary to seek medical help if the person gets abdominal pain, bloody stool, or other symptoms related to stomach polyps. The treatment of gastric polyps depends on the shape, size, location, type, and number of polyps. It also depends on the symptoms. A fundic gland polyp has only less chance of becoming cancerous. At first, the healthcare provider may remove the tissue as a part of a biopsy. Large polyp and dysplastic (presence of abnormal cells) polyps must be surgically removed. Hyperplastic and adenomatous polyps are more likely to become cancerous, and the healthcare provider will take steps to remove them completely.
The doctor may also take measures to treat the underlying health conditions responsible for the development of gastric polyps. Gastritis caused by Helicobacter pylori infection may be treated with a combination of medicines, including antibiotics. Treating such infections can reduce the recurrence rate of the polyps.
Depending on the type of gastric polyp, the doctor may advise taking another endoscopy after one year to check for the development of new polyps. For patients with a cancerous polyp and treatment related to that, follow-up endoscopies are preferred to take every six months for the initial three years. An individual with a family history of gastric polyps should undergo regular endoscopies every one to two years. Proton pump inhibitors induced gastric polyps may be managed by the healthcare provider by giving an alternative medicine or stopping the current medicine.
What Are the Complications of Gastric Polyps?
The transformation into cancerous cells is the main complication of stomach polyps. Rare cases of gastric polyps, like adenomatous polyps, can become cancerous. Polyps may also be an indicator of developing cancers in different body parts. Multiple polyps can be problematic. Familial types of gastric polyps may multiply rapidly and spread throughout the digestive tract. It can also lead to colon cancer (cancer of the longest part of the large intestine). Polyp removal procedures may also have complications like bleeding.
Conclusion
The risk of gastric polyps increases with age due to an increased chance of infection and the use of proton pump inhibitors. The risk of multiplication or spread of the polyps can be lowered by taking timely check-ups, following up, stopping the intake of proton pump inhibitors, and taking adequate medicines to treat underlying infections. Following the care plan, the doctor has advised, is the key to stopping the development of new polyps.
