What causes gastric polyps?

Gastric polyps are a relatively common disease, and there are many causes of gastric polyps. From the current clinical point of view, the cause is not particularly clear, but generally gastric polyps are abnormal protrusions of the gastric mucosa leading to lesions, including hyperplastic polyps and adenomatous polyps, which are mostly related to long-term chronic inflammation. When gastric polyps appear, it is necessary to conduct a timely diagnosis and examination to determine the cause and then treat it.

What causes gastric polyps?

The cause is currently unknown. Gastric polyps refer to raised lesions that originate from the gastric mucosal epithelial cells and protrude into the stomach. Pathogenesis: Gastric polyps generally occur in the gastric antrum, and a few can also be seen in the upper gastric body, cardia and fundus. Pathologically, they are mainly divided into hyperplastic polyps and adenomatous polyps. 1. Hyperplastic polyps This type of polyp accounts for about 75% to 90% of gastric polyps. It is a polyp-like substance formed by inflammatory mucosal hyperplasia and is not a true tumor. The polyps are small, generally less than 1.5 cm in diameter, round or olive-shaped, with or without pedicles, smooth surface, and may be accompanied by erosion. Histologically, hyperplasia of gastric foveolar epithelium and hyperplasia of lamina propria glands can be seen. The epithelium is well differentiated, nuclear division figures are rare, inflammatory cell infiltration is seen in the lamina propria, and some polyps are accompanied by intestinal metaplasia. A small number of hyperplastic polyps may undergo dysplasia or adenomatous transformation and become malignant, but the canceration rate generally does not exceed 1% to 2%. 2. Adenomatous polyps are benign gastric tumors originating from the gastric mucosal epithelium, accounting for about 10% to 25% of gastric polyps. They are generally large in size, spherical or hemispherical in shape, most are sessile, with a smooth surface, and a few are flat, strip-shaped or lobed. Histologically, it is mainly composed of surface epithelium, foveal epithelium and glandular hyperplasia. The epithelial differentiation is immature, and nuclear division is common. It can be divided into tubular, villous and mixed adenomas, often accompanied by obvious intestinal metaplasia and dysplasia. The polyp stroma is loose connective tissue with a small amount of lymphocyte infiltration. There was no obvious proliferation of the muscularis mucosa and no dispersion of muscle fibers. The canceration rate of this type of polyp is high, reaching 30% to 58.3%, especially those with a tumor diameter greater than 2 cm, villous adenoma, and grade III dysplasia.

Diagnosis: Gastric polyps often have no clinical symptoms and are difficult to diagnose. Most of them are discovered through X-ray gastric barium meal fluoroscopy and gastroscopy. When gastric polyps become inflamed, there will be gastritis-like symptoms, including upper abdominal pain, fullness, nausea, belching, loss of appetite, heartburn, diarrhea, etc. When polyps occur in the cardia, there is a feeling of swallowing obstruction. When it occurs in the pyloric duct, pyloric obstruction or incomplete obstruction is likely to occur, with aggravated abdominal pain and distension accompanied by vomiting. When polyps ulcerate or become cancerous, black stools and vomiting blood may occur. Gastric polyps rarely have positive physical signs. When combined with inflammation, there may be tenderness in the upper abdomen, and those with heavy bleeding may have symptoms of secondary anemia. X-ray gastric barium meal fluoroscopy and gastroscopy are the main methods for diagnosing gastric polyps. X-ray gastric barium meal fluoroscopy shows circular or semicircular filling defects with neat and clear borders and smooth surfaces in the gastric cavity. Most of them are about 1 cm in size, and those with pedicles can be seen moving. Gastroscopy is necessary for diagnosis. Under the microscope, round or semicircular protrusions can be seen on the gastric wall mucosa. They are generally smaller than 2 cm, with clear boundaries, smooth and flat surfaces, normal mucosal color or bright red, soft texture, with or without pedicles, single or multiple. Some polyps appear cauliflower-like, with erosion or ulcers on the surface. Cauliflower-like polyps and those larger than 2 cm in size may become malignant, and biopsy can help with differential diagnosis. Laboratory examination: Patients with combined erosion or ulcer often present with positive fecal occult blood test or black stool.