Gastric Polyps – Frequency,Types, Endoscopic Features and Associations

Gastric polyps are not uncommonly identified at endoscopy. Studies differ on the type, frequency and associations of gastric polyps.

We aimed to study the frequency, location, endoscopic features and associations of gastric epithelial polyps in a large cohort of patients undergoing endoscopy. Endoscopic database spanning 3 years from 2000 to 2003 was reviewed to identify patients with gastric polyps.

Among the 7213 patients who underwent endoscopy, 158 (2.91%) were noted to have gastric polyps. The median age was 59 years (range 20–91) and the male to female ratio was 1.9 to1. Gastric corpus was the main site of involvement (103 patients, 65.2%) followed by antrum (35, 22.2%) and fundus (20, 12,7%). At histology, no polypoid features were identified in 40 (25.3%) of patients. Fundic gland polyps (FGP) were the commonest type (66.9%), while hyperplatic polyps were identified in 24 patients (20.33%). Other types included carcinoids (7 patients), foveolar hyperplasia (6), inflammatory fibroid polyp (1) and gastrointestinal stromal tumor (1) respectively. Among patients with FGP, 34.17% were on long term proton-pump inhibitors while 64.5% were 'true sporadic' and 1 patient had FAP. Helicobacter pylori was not detected at histology in all but one of the patients with FGP while 67% of patients with hyperplastic polyps were H. pylori positive. Among the 32 patients with FGP who underwent colonoscopy, 19 (59.3%) had colonic polyps.

Benign fundic gland polyps are the commonest type of gastric polyps in this large cohort. A Significant proportion of patients with fundic gland polyps have co-existent colorectal polyps.