Managing Multiple Gastric Polyps: Concerns and Treatment Options

Q: Managing Multiple Gastric Polyps: Concerns and Treatment Options

Hello： Generally speaking, multiple gastric polyps are almost always benign, and it is very difficult to remove them all through endoscopy. <br>The results of the removal often show that they regrow after a period of time. <br>Therefore, usually, only larger polyps are biopsied,

Multiple gastric polyps

Hello Dr.
Chen! In November 2010, I underwent an endoscopy which diagnosed me with multiple gastric polyps.
Most of the polyps were located in the body and fundus of the stomach.
At that time, most of the polyps were removed with forceps and sent for biopsy, and the results were benign.
There were also some small polyps that were not addressed.
Therefore, I had another endoscopy in May 2011, which revealed many more polyps, totaling over thirty, with sizes ranging from 0.5 to 0.6 mm.
Again, most of the polyps were removed, but some small ones were left untreated.
I am very concerned and would like to know what to do if those polyps reappear during the next endoscopy.
Is the only solution to regularly remove the gastric polyps, or are there other options available? In the worst-case scenario, would I need to have my stomach removed? Thank you for your response.

Lin Sheng, 40~49 year old female. Ask Date: 2011/05/11

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello: Generally speaking, multiple gastric polyps are almost always benign, and it is very difficult to remove them all through endoscopy.
The results of the removal often show that they regrow after a period of time.
Therefore, usually, only larger polyps are biopsied, and if they are benign, they can be monitored.
Completely removing all polyps is fundamentally challenging; on one hand, it prolongs the duration of the endoscopic procedure, and on the other hand, it increases the risk of complications associated with endoscopy.
Wishing you good health.
Sincerely, Dr.
Chi-Feng Chen, Taoyuan Hospital.

Reply Date: 2011/05/11

More Info

Managing multiple gastric polyps can indeed be a source of concern, especially when they recur frequently. Based on your history of multiple gastric polyps diagnosed in 2010 and subsequent procedures, it’s understandable that you have questions regarding the management and potential implications of these findings.

Firstly, it’s important to clarify what gastric polyps are. Gastric polyps are abnormal growths of tissue that form on the lining of the stomach. While many gastric polyps are benign (non-cancerous), some types can have the potential to develop into cancer over time, particularly if they are associated with certain conditions such as familial adenomatous polyposis (FAP) or chronic gastritis. The most common types of gastric polyps include fundic gland polyps, hyperplastic polyps, and adenomatous polyps. Your previous biopsies indicating benign results are reassuring, but ongoing monitoring is essential.

Given that you have experienced multiple occurrences of polyps, your gastroenterologist may recommend a surveillance strategy. This typically involves regular endoscopic examinations to monitor the size and number of polyps. The frequency of these examinations can vary based on individual risk factors, the type of polyps, and any associated symptoms. In your case, since you have a history of multiple polyps, it may be advisable to have follow-up endoscopies every 1 to 3 years, depending on the findings.

Regarding the management of the polyps, the primary treatment is endoscopic removal, which you have already undergone. This procedure is effective in removing polyps and can alleviate concerns about potential malignancy. However, if polyps continue to recur, it raises the question of whether there are underlying conditions contributing to their formation. For instance, chronic inflammation of the stomach lining (chronic gastritis) can lead to the development of hyperplastic polyps. Addressing any underlying conditions, such as Helicobacter pylori infection, may help reduce the recurrence of polyps.

As for your concern about the worst-case scenario of needing gastric resection, this is generally reserved for cases where there is a significant risk of cancer or if the polyps are causing obstruction or other complications. In most cases, especially when polyps are benign and asymptomatic, surgical intervention is not necessary. However, if there is a concern about dysplasia (precancerous changes) in the polyps or if they become too numerous or large, your gastroenterologist may discuss more invasive options.

In addition to regular monitoring and endoscopic removal, lifestyle modifications can also play a role in managing gastric health. This includes dietary changes, such as reducing the intake of processed foods, alcohol, and irritants like caffeine and spicy foods, which can exacerbate gastric issues. Maintaining a healthy weight and managing stress through relaxation techniques may also contribute positively to your gastric health.

In summary, while the recurrence of gastric polyps can be concerning, regular surveillance and endoscopic removal are effective management strategies. It’s crucial to maintain open communication with your gastroenterologist about your concerns and any changes in your symptoms. They can provide personalized recommendations based on your specific situation and help you navigate the best course of action moving forward. If you have any family history of gastric cancer or polyposis syndromes, it may also be worth discussing genetic counseling for further evaluation.

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