Polyps of the stomach - Causes, symptoms and treatment. MF.

The situation when a gastric polyp is found in a gastroscopy in a patient is quite common in recent times. This is due to poor ecology, unbalanced nutrition and, as a consequence, hidden or obvious inflammatory processes on the mucous membrane of the stomach.

Mucosal polyps is a limited area on the inner wall of the stomach with a benign growth of its surface layer - the epithelium. In other words, it is a benign tumor resembling in appearance a rounded smooth or bulging bulge and located on a pedicle or on a wide base.

Polyps can be single, multiple and diffusely located throughout the inner wall of the stomach. In the latter case, this disease is called family intestinal polyposis.

There are adenomatous and hyperplastic variants of polyps. Their difference is that in the first type in 60% of cases in the tumor there are neoplastic cells, which are glandular cells of the intestinal epithelium, which are normal in the stomach should not be. These cells can quickly transform into malignant cells. In the second type, such cells are absent.

Adenomatous type is called gastric adenoma. Its danger is that it more often than other polyps is malignant, that is, it degenerates into gastric cancer( adenocarcinoma).

Hyperplastic polyps( potentially non-dangerous) occur in 80 to 90% of cases, while glandular adenoma is 10%.

Causes of the appearance of polyps in the stomach

The main reason for the formation of tumorous formations is the malfunctioning of genetic structures in cells. In this case, the cells seem to be reconstructed, cease to perform their immediate functions( for example, the production of gastric secretions) and begin to expand more than they normally do, increasing their number and mass. Why this is happening, scientists have so far not accurately and unclear, but identified the risk factors that such processes can accelerate. These include:

- chronic inflammation called gastritis, especially caused by the Helicobacter pylori bacterium, leads to disruption of cell activity in the inflammatory focus,
- adverse environmental conditions can cause a malfunction in the biochemical processes inside cells,
- taking medications, for example, prolongedthe use of streptomycin, has an irritant effect on the mucosa,
- the infection of the body with viruses, in particular the human papillomavirus
- genetic mutations, whichThey disrupt the process of cell division and cause the emergence of family polyposis( a disease transmitted by inheritance and characterized by diffusely located polyps inside the stomach and large intestine).

Symptoms of the disease

As a rule, the occurrence of polyps proceeds asymptomatically. Nevertheless, the patient should be alerted to symptoms that may indicate the development of chronic gatritis. These include:
- pain in the upper abdomen called epigastrium, and in the peripodal area arising after eating or on an empty stomach,
- discomfort and heaviness in the abdomen,
- frequent eructations, especially with acidic or bitter aftertaste, nausea,vomiting,
- unstable stool, alternating diarrhea with constipation,
- pallor, weakness and weight loss associated with impaired absorption of substances in the stomach, as well as a decrease or a complete lack of appetite.

If there are blood vessels in the tumor, they can bleed, and then the blood is excreted with vomit masses of black or dark color, or with feces, which acquires a tarry character of dark color.

Diagnosis

In most cases, the patient consults a doctor about the above complaints, not specific for the stomach polyp. The doctor may suspect first of all gastritis or a stomach ulcer, for which he appoints additional diagnostic methods. The most important of them is fibrogastroscopy, or PHEGS, which allows you to visually assess the state of the stomach from the inside.

Polyps biopsy with

gastroscopy

When carrying out a gastroscopy, the polyp looks like a rounded formation that has a smooth or uneven surface. In the latter case, it resembles a mulberry or cauliflower. In addition to the presence of the polyp, the degree of inflammation of the gastric mucosa is assessed, especially in the area of ​​the tumor, and a piece of polyp tissue is plucked for subsequent histological examination of the material under the microscope. This is called a biopsy. Biopsy is a painless process, as well as the procedure of gastroscopy itself, therefore, in no case should you refuse this research proposed by a doctor, if there are no contraindications to it.

In addition to EGFD, a survey can be prescribed, such as:
- a general blood test for determining hemoglobin and anemia,
- feces occult blood test,
- Helicobacter infection test,
- internal ultrasound.

Treatment of stomach polyps

The tactic of treating a stomach polyp is surgical, although for small sizes and with a confirmed hyperoplastic type of tumor, wait-and-see tactics and patient monitoring are allowed. Adenomatous type should be removed operatively as soon as possible after receiving biopsy results, especially if its size reaches several centimeters.

In case the size of the polyp does not exceed 5 mm, it can be removed with gastroscopy using forceps used for biopsy. If the size is more than 5 mm, you will need a special loop - trap, which picks up the polyp under the base and cuts it. In any case, the surgery for removal of polyps is carried out endoscopically, that is, using a probe inserted through the mouth. In rare cases laparotomic access is required with dissection of the anterior abdominal wall and the stomach wall.

Technique for endoscopic polypectomy using the

trap loop Contraindications to endoscopic polypectomy are a patient's severe condition and a high risk of bleeding, for example, in patients with disorders of the blood coagulation system.

In addition to surgical treatment, it is obligatory to carry out eradication therapy for Helicobacter pylori infection, that is, the appointment of antibiotics - clarithromycin, amoxicillin and metronidazole, as well as drugs that reduce the production of hydrochloric acid in gastritis with high acidity( omeprazole, famotidine) or preparations with natural gastric juice atatrophic gastritis with low acidity.

Lifestyle

Regardless of which type of polyp the patient has and what kind of stomach disease has caused it, dieting is required, regular nutrition sufficient caloric content, as well as adequate rest and stress elimination. If after the operation the patient continues to ignore recommendations for proper nutrition, there is a risk of exacerbation of gastritis and the re-emergence of the polyp in the same or another place of the mucosa.

In this regard, the patient is recommended:
- to eat food at least 4-6 times a day, observing a comfortable temperature regime, excluding too hot or cold dishes,
- it's better to cook food in steam, boiled or stewed, instead of takingfried foods,
- it is necessary to exclude fatty, spicy, salty, spicy, smoked products, as well as canned goods, carbonated drinks, alcohol, chocolate and coffee,
- preference should be given to dishes from lean meat, cereals, cereals, stewed vegetables and baked fruits, fermented milkproducts and eggs( in the form of omelettes and casseroles two to three times a week).

Complications of

Complications of stomach polyps occur rarely if the polyp has not significant dimensions. Otherwise, it is possible to develop bleeding from the vessels of the tumor and torsion of the polyp with its infringement, when it is located on the leg and is sufficiently mobile.

This complication, such as malignancy, or malignancy of the polyp, develops more often with adenomatous( 21-75%) than in the hyperplastic type( 1 - 2%).Polyps larger than 2 cm are degenerated into a malignant tumor more often.

Prevention of complications is timely access to a doctor, a full examination with the use of gastroscopy, as well as surgical treatment of polyps, carried out on time.

Complications after a polypectomy surgery are extremely rare, including bleeding from the bed of a distant tumor and perforation of the stomach wall.

Forecast

The prognosis for small uncomplicated polyps is favorable. The frequency of recurrence of polyps in the implementation of the doctor's recommendations is minimal.

When gastric polyp is malignant, the forecast is unfavorable, since stomach cancer is a much more dangerous disease than polyps.

Doctor therapist Sazykina O.Yu.