5 questions about stomach polyps, answered

When you hear the word “polyp,” you may think of the colon. But that’s not the only place in your body where they can develop. In fact, you may have stomach polyps without ever knowing it.

These small masses inside the lining of the stomach can lead to cancer, but more often they’re benign. They are usually discovered when patients have an upper endoscopy that may be for reasons unrelated to the actual polyps.

1. Who is more likely to develop stomach polyps?

It’s not always clear what causes stomach polyps – especially if they’re not causing symptoms. But, Paul Mansfield, M.D., says, there are factors that can increase your risk of developing them “The most common factor for stomach polyps is inflammation, which can come from different sources.”

One of the main causes of stomach polyps in the U.S. is use of proton pump inhibitors. These medications are available over-the-counter to help suppress stomach acid to treat heartburn and other common gastric issues.  “The problem is they are so good at what they do that they shut down acid production,” Mansfield says.

Your stomach needs those acids to maintain balance and work properly. Without acid, some cells in the stomach work overtime to increase production of a hormone called gastrin, which in turn encourages cells to increase acid production in your stomach. 

Infections of the bacterium H. pylori are not as common in the U.S. as they are in other parts of the world, but they can also increase your risk of developing polyps and some cancers.

Genetics may play a role in stomach polyps, too. A genetic condition called familial adenomatous polyposis, or FAP, is usually associated with developing polyps in the colon but can also increase your risk of developing polyps in the stomach and small intestine. 

2. What are the different types of stomach polyps?

There are several different types of stomach polyps. They differ based on where they’re found, what causes them and whether they’re likely to be cancerous.  

• Adenomatous polyps are more likely to become cancerous than other types of polyps. They’re usually found near the bottom of the stomach and are often associated with a genetic condition.
  
  
• Fundic gland polyps are more common in the U.S. They occur in the upper portion of the stomach. These can be caused by proton pump inhibitors.
  
  
• Hyperplasltic polyps can be caused by conditions like gastritis and H. pylori. These polyps can occur all over the stomach and can become cancerous if left untreated.

Rarely, there are also pseudo-polyps. They’re caused when a foreign body, like part of a toothpick, lodges in the wall of the stomach. “These aren’t traditional polyps, but they can look similar because your body tries to get rid of it and forms a shell around the foreign body,” Mansfield says.

3. How are stomach polyps diagnosed?

Stomach polyps are almost always found because of stomach-related issues. “If you have indigestion or reflux, your gastroenterologist will want to see what’s going on inside,” Mansfield says. Polyps are usually found during a procedure called an endoscopy, which is a procedure that uses a snake-like camera to examine the upper part of your digestive tract. 

4. How are stomach polyps treated?

Treatment for stomach polyps depends on the type, how big they are and what’s causing them.

For fundic gland polyps caused by proton pump inhibitors, simply switching to another type of antiacid may make the polyps go away.

Antibiotics targeting H. pylori can relieve hyperplastic polyps – and may even eliminate cancerous polyps in some cases. “Once the infection goes away, the cancer can go away, too,” Mansfield says.

Patients with familial adenomatous polyposis will have regular screening endoscopies so their care team can find any concerning polyps.

“If a polyp is bigger than one centimeter, we will probably remove it,” Mansfield says. This can be done during the endoscopy, or if you have many polyps, your doctor may recommend surgery called a gastrectomy to remove part or all of your stomach.

The lining of the stomach has a unique texture with many folds, which makes surgery complex. “It’s a good idea to seek care from a stomach cancer expert to make sure you understand your treatment options and the potential risks and benefits,” Mansfield adds.

In some cases, stomach polyps don’t need to be removed. “Just because you can remove them doesn’t mean you should— especially if the polyps are small, don’t harbor a significant risk of cancer and aren’t causing you any discomfort,” Mansfield says.

He suggests talking with your care team to see which types of polyps you have and understand your risk for them developing into cancer.

5. How can you reduce the risk of developing stomach polyps?

Controlling the conditions that can cause stomach polyps is one way to reduce your risk of developing them.

Maintaining a healthy weight and diet can help reduce gastrointestinal issues like indigestion and reflux, which will help reduce the need for proton pump inhibitors.

And finally, Mansfield stresses: “Know your family history and talk to your care team about your individual risk.”

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