Gastric polyps

Endoscopy allows a better diagnosis and treatment of gastric polyps. Current methodology includes a detailed examination of the stomach after good insufflation, necessary to diagnose small fundic polyps, biopsies of the polyp as well as of the surrounding mucosa (antrum and fundus). Endoscopy allows a preliminary diagnosis based on the number, location and size of the polyps. Resection is not performed at initial endoscopy as it is not necessary for all polyps and may be risky if vascular lesions are confused with polyps. Glandulocystic fundic polyps are the most frequent (50%), are always associated with a normal gastric mucosa and sometimes with omeprazole. Resection and follow-up are not indicated. Hyperplastic polyps represent 25% of gastric polyps, are located everywhere, with a mean size of 1 cm, and sometimes erosions or superficial necrosis. Gastritis is present, Helicobacter pylori is frequent and eradication may cause regression or disappearance of polyps. The small risk of cancer and the risk of bleeding increase with size. Polypectomy and follow-up are thus indicated in most cases. Adenomatous polyps, although similar in appearance to hyperplastic polyps concerning macroscopy and gastritis have a higher risk of cancer in the polyp or in the stomach. Polypectomy and follow-up are thus mandatory.