Polyps in the stomach: treatment and symptoms, and removal
Diseases of the stomach and inflammatory and neoplastic nature are quite common and every year there is an increasing amount. In many ways, the increase in the frequency of pathology of this organ is connected with the peculiarities of nutrition of modern man and his way of life. Among patients with gastritis or polyps in the stomach can often find young adults, and the possibility of malignant transformation of these processes forces conduct endoscopic examination of a fairly large number of people.
Polyps in the stomach – a fairly common phenomenon among people of different ages, and they make up to 10% of all benign tumors of the organ.
Identifying them, even when asymptomatic has been made possible by a gastrofibroscopy broad range of individuals with disorders of the gastrointestinal tract. With this result of the study, many patients wonder: is it dangerous? Do I need to take immediate action or a simple observation? There is no single answer, as further actions of the doctor will depend on the structure of the polyp: hyperplastic if it is possible to wait, if adenomatous – definitely remove in connection with the risk of malignant transformation.
Colorectal polyps: polyps are tumor growths of the mucous membrane, prominent in the lumen of the stomach. Among patients with this diagnosis is dominated by people of Mature and elderly, although young people and even children also possible their detection. Growth of polyps are more prone to men who have the tumor diagnosed almost twice as often.
Favorite localization of the polyp is considered to be pyloric and antral sections of the stomach, although the possible rise in the body, in the cardiac unit, where polyps are more dangerous because of the high risk of malignancy (malignancy). A polyp is solitary but often several of them. A total lesion of the stomach (polyposis) are quite rare, but is considered a precancerous process in which a malignant tumor develops in almost all patients.
Since theoretically every tenth polyp may sooner or later become cancer of the stomach, such a process requires a lot of attention from both the patient and the doctor. Modern methods of treatment allow you to quickly and effectively get rid of tumors and patients should carefully monitor their health and lifestyle, to avoid re-occurrence.
The types and causes of stomach polyps
Polyp – a benign tumor formation, consisting of cells of the gastric mucosa. It can be single or multiple, on a thin stalk or broad base, thick or soft consistency. The size of polyps ranges from a few millimeters to 2-3 cm, and with increasing diameter and increasing the risk of malignant transformation.
The features of histological structure determine not only the form of a polyp, but further tactics of the doctor. Release:
- Hyperplastic polyps, which may be recommended for dynamic observation;
- Adenomatous, similar in structure to the tumor and therefore subject to deletion.
Hyperplastic polyp is the absolute majority among all such entities. It appears with increased cell proliferation of the surface epithelium in response to inflammation, including infectious nature. Gastritis caused by H. pylori, is accompanied by damage of the gastric mucosa, the response of the inflammatory reaction and the appearance of erosions. If untreated, the disease is chronic and recurrent in nature, and recurring exacerbations provoke active reproduction of the cells lining and the growth of the polyp.
Hyperplastic polyps are often found in the edge of chronic ulcers, where the alternation of periods of exacerbation and healing is accompanied by excessive proliferation of the mucous membrane. In such cases, the polyp is evidence of imperfect regeneration in the area of the ulcer, but the source of the cancer it is getting very rare.
Adenomatous polyp resembles the structure of a benign tumor – adenoma. In cells such entities can detect signs of atypia, and therefore the risk of malignancy is much higher than in hyperplastic polyp options. Adenomatous polyps can reach 2-3cm in diameter, which is considered unfavourable in respect of the cancer indicator.
Among the reasons for the emergence of polyps in the stomach include:
Older age and male gender considered predisposing factors poledourisbasil, and if they are combined with chronic inflammation, then the probability of this pathology is even higher. It is noticed that use of certain drugs (proton pump inhibitors used in the pathology of the gastrointestinal tract) can also cause the growth of polyps, therefore, the duration of treatment should be agreed with the doctor, and exceed it should not be.
Manifestations and ways to detect polyps of the stomach
The perfidy of polyps is their frequent asymptomatic when the tumor grows, the patient does not even suspect about its presence. Because the polyps are usually formed in the presence of gastritis or ulcers, the symptoms often associated with these diseases. Usually patients concerned about dull pain in the abdomen, nausea, belching, feeling of fullness of the stomach after a meal. If the polyp is inflamed and rotiruetsya, the pain is worse.
Some dangerous are polyps pyloric and antrum on a long thin stalk, which can hinder or completely stop the promotion of food mass into the duodenum. The patient will feel intense abdominal pain, vomits food eaten the day before. If the infringement of the education in the area of the outlet of the stomach appears strong cramping pain that is forced immediately to seek help.
Sometimes, polyps cause stomach bleeding, which, however, rarely wears a massive character. Usually has a constant trauma to the tumor with a small chronic blood loss, which is found in the chair in conducting the relevant tests. Over time, anemia, a weakness, dizziness, pallor of the skin.
Malignancy polyp unpredictable, nobody knows when it might occur, and signs that talked about it, no. Suspected cancer the overwhelming number of patients in weight reduction, lack of appetite, severe weakness, but a tumor with such symptoms is quite big.
The main method of diagnosis of gastric polyps is considered fibrogastroscopy, which takes place not only in hospitals but also in outpatient clinics. The main advantage of the method compared to x-rays is the ability to target biopsy, when the doctor takes a fragment of the gastric mucosa from the suspicious area. To determine the type and presence of signs of malignancy is possible only with histological examination of the tissue of the polyp. Setting the type and malignant potential of a polyp, the doctor will decide on further treatment.
Treatment of gastric polyps
Treatment of stomach polyps doctors do gastroenterologists together with endoscopists and surgeons. The choice of tactics is determined by the kind of education, the number and size of the polyp, the technical possibilities of their removal and condition of the patient.
The approach can be expectant or radical, aimed at the complete removal of the tumor. Expectant management is acceptable only in hyperplastic polyps of the small sizes (up to 2cm) of course, after a preliminary histological examination and exclude the possibility of malignant transformation. Given that such polyps are most often formed on the background of inflammation caused by H. pylori, appropriate use of conservative therapy to eliminate the gastritis. As a rule, after treatment hyperplastic polyps regress themselves.
Patients with hyperplastic polyps is necessary, endoscopic monitoring of changes in the mucous membrane, one to two times during the year. If the physician at the next study note that the size of the polyp is rapidly increasing, there are signs of malignancy, then immediately resolved the issue of removing education.
In the case of glandular or adenomatous polyps experts prefer the radical approach, according to most, they must be removed, which is understandable, because these polyps can give rise to cancer of the stomach, can promote inflammatory changes and bleeding, and while in the exit area of the stomach and possible obstruction of impaired patency of the body.
Methods for removal of a polyp is determined by the size and number of tumors. Possible:
- Endoscopic polypectomy with excision or electrocoagulation of tumors;
- Resection of the stomach;
- Total gastrectomy.
Gastric surgery is always traumatic, and the risk of complications in the early postoperative period is still high, therefore, for such interventions need a very good reason. Usually, the doctor tries to solve the problem in a more gentle way.
Endoscopic polypectomy is the removal of education in gastroscopy with the help of endoscopic tools introduced into the stomach through the mouth and esophagus. This operation can be performed ambulatory and does not require serious preparation on the part of the patient.
Indications for endoscopic polypectomy are the detection of one or more small polyps, especially adenomatous structure as well as the risk of malignancy of tumors, and the futility of conservative treatment. However, the procedure gastrofibroscopy will wear both diagnostic purpose and therapeutic.
The impossibility of this procedure may be associated with a very serious condition of the patient, when even the smallest thing dangerous to life, as well as with the presence of coagulation disorders of the blood, which is a very high risk of bleeding during the procedure, removal of a polyp. If there is a total lesion of the stomach, especially in combination with intestinal polyposis, endoscopic removal of polyps is not performed, and the method of treatment is more radical.
It is successful in eradicating the most common way to remove a polyp, which is used for single tumors. In the case of small polyps on a thin stalk removal is not difficult, but if the patient discovered a polyp on a broad basis, relatively large size (2.5-3cm), it makes sense to remove it in parts. This approach is due to the fact that extraction from whole tumors entails the formation of a large area of the wound surface on the mucous membrane, in the healing process forms a scab at the rejection of which may damage large blood vessels with the development of bleeding and even perforation of the stomach wall. To avoid such dangerous complications the doctor makes the removal of small polyp fragments.
The downside of such an operation can prevent a thorough histological study of the obtained sections of the polyp, so it is very important to have regular inspections after the procedure, and the first follow-up examination is recommended after 10-12 days.
During one endoscopic intervention can be removed to 5-7 polyps of small size, and with increasing their number increases the risk of complications, the procedure takes more time and, consequently, worse tolerated. In addition, the amount of interference depends on the skill of the doctor: the endoscopist will remove per session to 50 small tumors and a doctor with less experience will prefer to conduct the treatment in multiple sessions.
If the patient discovered a polyp with a diameter of 0.5 cm, but due to the peculiarities of its structure needed to be removed, preference will be given electrocoagulation of tumors because of the inability to capture a small polyp with a loop and extract entirely. Electrocoagulation destroys the source of growth of the polyp, so histological control should be done before the procedure and after it, the patient should be regularly undergo fibrogastroscopy (at least once a year).
The procedure of endoscopic polypectomy is generally well tolerated by patients, but in the case of older individuals with various comorbidities, it is better to spend in hospital. Complications are quite rare and are usually related to bleeding or perforation of stomach walls, which always requires surgical treatment. However, you should not be afraid, these effects are rare and constitute less than 1% of all cases of polypectomy.
The recurrence of the polyp after removing it is most often associated with breaches of intervention, and newly identified polyps are, as a rule, do not relapse, and education that occurred outside the areas of excision or coagulation of previous tumors.
Operative methods of treatment of polyps of the stomach are used less, because they are quite dangerous for its complications, and the postoperative period is fraught with the difficulties of rehabilitation of the patient. Still, in some cases, can not do without surgery. Multiple character growth and a suspicion of malignancy of a polyp of large size have recently had occasion to remove part or all of the stomach, but today the high qualification of endoscopist helps to avoid such interventions.
Among the possible operations applied gastrectomy (removal of part of the body) or total gastrectomy (removal of whole stomach).
The main indication for resection of the stomach remains proven malignancy of tumors, and during the operation surgeon is guided by the rules of the operative treatment of malignant tumors.
If signs of cancerous transformation found in the surface portion of the polyp, it can be endoscopic removal with a thorough endoscopic control in the future, but in the case of detection of malignant growth at the base of the formation treatment is always radical.
Gastrectomy, or the removal of the entire stomach, is very traumatic and a crippling operation. The risk of death and still high and reaches 15%, and the frequency of complications of serious digestive problems, hypoglycemic syndrome, etc., and even higher. The doctors are trying to avoid such interventions, and to conduct them only in extreme cases with diffuse polyposis, when at least one of the entities recognized as malignant in the course of histological examination. Rehabilitation after removal of a polyp endoscopically is often positive, but the patient must know certain rules further lifestyle, which are associated not only with conducted interference, but also with the risk of polypoetry in the future. The focus of the patient should be given to their nutrition and diet after the removal of polyps is aimed at respect for the digestive tract (with the exception of sharp, fatty and fried, strong coffee, alcohol, carbonated beverages, etc.). Principles of food stacked in the so-called the digestive table (No. 1).
Treatment of folk remedies in the pathology of the stomach, it is better not to get involved, because any tool can cause an irritating effect on the mucous membrane and cause inflammation and thus new growth of the polyp. If the temptation is still great, you should discuss this with your doctor or herbalist, who will advise gastric tea or any other herbal safe for a particular patient.
Conservative treatment is not able to get rid of existing glandular or adenomatous polyps, but it is always assigned to the gastroenterologist in the complex therapy. In the presence of marked inflammation used anti-inflammatory drugs, and if proved the infectious nature of gastritis, the doctor will prescribe appropriate antibiotic therapy scheme.
Preventive measures in case of tumor pathology of the stomach directed to the normalization of food, lifestyle and treatment of the existing pathology. All patients from the risk group is recommended at least once a year to undergo fibrogastroscopy to monitor the status of the gastric mucosa.