Do gastric polyps always need to be removed?

Written by Jiang Guo Ming
Gastroenterology
Updated on August 31, 2024
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Gastric polyps first require a gastroscopy examination, combined with pathological examination to determine the nature of the lesion, because there are many types of gastric polyps, such as hyperplastic polyps, inflammatory polyps, hamartomatous polyps, fundic gland polyps, and adenomatous polyps, etc. After a definitive diagnosis, symptomatic treatment can be applied. Common inflammatory or hyperplastic polyps are related to Helicobacter pylori infection. If they are relatively small, eradication of Helicobacter pylori and regular follow-up can be performed. If the polyps are adenomatous, they generally have a family history, and there is a possibility of malignancy in such cases, generally requiring removal via gastroscopy. Additionally, if the polyp exceeds two centimeters in size, regardless of the type, removal is generally advocated.

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Written by Zhu Dan Hua
Gastroenterology
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Should gastric polyps be removed?

Gastric polyps are relatively common in clinical practice. For patients with gastric polyps, regular follow-up visits are the main focus, especially when the polyps are small, and particularly when they are less than 0.5 centimeters in size. We recommend that these patients have regular follow-up appointments, with a gastroscopy examination about every six months to a year being appropriate. Of course, if a patient has a history of gastric cancer and develops gastric polyps, especially larger ones over 1 centimeter in size, we recommend aggressive endoscopic removal. After removal, the polyps should be sent for examination to clarify their nature. Subsequent regular follow-up appointments are also necessary, typically involving a gastroscopy check every six months to a year. If gastric polyps continue to form, aggressive endoscopic removal treatment is advised. Therefore, treatment choices for gastric polyps vary depending on the size, location, and nature of the polyp, with regular follow-up as the primary approach and endoscopic removal when necessary.

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Written by Zhu Dan Hua
Gastroenterology
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Do you need anti-inflammatory medication after gastric polyp surgery?

The treatment of gastric polyps generally involves endoscopic removal. After the surgery, patients are usually advised to fast to protect the stomach and anti-inflammatory treatment is typically not necessary. Normal eating can usually resume after one to two days, and stomach protection might be appropriate for about 2 to 4 weeks, generally without the need for anti-inflammatory medication. Therefore, anti-inflammatory treatment is usually not necessary. The incidence of gastric polyps is increasing, and most patients do not exhibit specific symptoms. These polyps are often discovered incidentally during physical exams or gastroscopic examinations. Typically, gastric polyps are not large; those smaller than 0.5 cm can be observed, while those larger than 1 cm, or those that increase in size or number over time, can be treated endoscopically. Currently, endoscopic treatment of gastric polyps is a safe and effective method. Most of these polyps are benign, with fewer being malignant, so patients need not worry excessively.

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Written by Zhu Dan Hua
Gastroenterology
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How often should gastric polyps be rechecked?

Patients with gastric polyps are generally advised to have a gastroscope re-examination every six months to a year. If the polyp does not grow during the swelling process, and remains roughly the same, we recommend continuing with follow-up. Of course, if the polyps increase in number or size, especially if larger than one centimeter, we recommend timely endoscopic removal. Gastric polyps are actually a common condition clinically, and patients generally do not have any specific symptoms. Most patients discover the polyps incidentally during a gastroscopy. Most gastric polyps we find are benign, but a small proportion of patients may progress to cancer over time. Therefore, patients with gastric polyps do not need to be overly concerned, just undergo regular gastroscopic re-examinations, and perform gastroscopic removal when necessary. The exact cause of gastric polyp formation is not clear, and patients may undergo further tests, such as screening for Helicobacter pylori. If Helicobacter pylori infection is detected, we recommend treatment for Helicobacter pylori.

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Written by Zhu Dan Hua
Gastroenterology
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Symptoms of gastric polyps

Gastric polyps are also relatively common in clinical practice, especially in the outpatient department of gastroenterology. The symptoms of gastric polyps can generally be divided into several types. The first type is asymptomatic; patients undergo gastroscopy due to abdominal discomfort or incidental findings, discovering gastric polyps that are generally small, usually less than 0.5 cm. From a treatment perspective, regular observation can be sufficient without intervention, and a gastroscopy recheck every six months to a year is advisable. However, a small portion of patients may experience certain symptoms such as nausea, early satiety, burping, and belching, etc. Generally, the symptoms are mild and do not affect daily life or sleep, so there is no need for undue concern. The treatment of gastric polyps generally falls into two categories; the first is regular observation, possibly because the polyps are relatively small; the second, if the polyps are larger, or if they have been found to increase in size during regular check-ups, considering removal through endoscopy might be necessary.

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Written by Zhu Dan Hua
Gastroenterology
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Can gastric polyps recur?

For patients with gastric polyps, it is necessary to regularly re-examine the gastroscopy to be alert for recurrence after endoscopic removal, as some patients are likely to relapse clinically. Therefore, it is mandatory for patients with gastric polyps to have a gastroscopy check every six months to a year. Of course, it is advised that patients further screen for Helicobacter pylori, and if Helicobacter pylori is positive, proactive anti-Helicobacter pylori treatment is recommended. Clinically, gastric polyps are relatively common and are usually benign lesions, so there is no need to overthink or bear a heavy psychological burden. Patients generally seek medical advice for abdominal discomfort and this is most commonly seen in the department of gastroenterology, presenting symptoms such as bloating, abdominal pain, belching, and even nausea. Therefore, it is recommended that such patients undergo thorough gastroscopic examination, as the diagnosis of gastric polyps mainly relies on gastroscopy.