Esophageal Polyp: Symptoms, Treatment, Causes, Diagnosis

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2024-01-15 19:51

Esophageal polyp: causes, symptoms, treatment, complications

The content of the article:

1. The reasons
2. Symptoms of esophageal polyps

3. Diagnostics

   Differential diagnosis

4. Treatment of polyps of the esophagus
5. Possible complications, prevention
6. Video

Esophageal polyps grow from the epithelial membrane of the organ, can have a wide base or a narrow stem, be single or multiple. Such growths are benign esophageal neoplasms, diagnosed quite rarely and mainly in men over the age of 40.

To identify polyps, you need to consult a gastroenterologist and conduct the necessary research

Tumors can be found anywhere in the esophagus, but most often they are located on the anterior wall in places of physiological narrowing. From 80 to 85% of such outgrowths are localized in the lower third of the organ. At the same time, 57–58% of patients have neoplasms on a broad base at the site of the gastroesophageal junction, and in the middle and lower third - polyps on a thin stem, prone to erosion.

The appearance of growths is usually not accompanied by pronounced symptoms. The diagnosis of pathology is carried out by a gastroenterologist by means of contrast radiography, esophagogastroduodenoscopy and histology.

Polyps can be localized in different parts of the gastrointestinal tract

Self-selection of medicines or traditional medicine methods for treating the disease is ineffective, since getting rid of neoplasias with the lowest risk of recurrence is possible only with the help of an operation - laser coagulation, endoscopic electro excision, ligation, electrocoagulation or clipping.

The reasons

The most common reason why tumors form in the esophagus is the frequent exposure of the mucous membrane of this region of the digestive tract to damaging factors.

The mechanism of the development of the disease is based on the hyperregeneration of the epithelial tissue of the organ due to the effects of trauma, inflammatory processes, irritating food or chemically active substances. As a result, on some parts of the mucous membrane, foci of hyperplasia are formed, from which polyps grow.

In the border regions of the esophagus and stomach there is a specific transitional epithelium, which is most sensitive to the action of damaging factors

The structure of the outgrowths depends on what type of cells is involved in the neoplastic process. They can be:

• hyperplastic: with a typical cellular structure;
• adenomatous: with dysplasia of glandular epithelial cells.

An important role in the appearance of the disease is played by a hereditary tendency to hyperregeneration, which is accompanied by multiple polyposis.

Factors contributing to the development of esophageal outgrowths include:

• eating behavior: frequent consumption of rough, sour, spicy and hot foods leads to irritation of the epithelial layer, stimulates hyperregeneration of the esophageal mucosa, which potentiates polyproduction;
• alcohol abuse;
• the presence of inflammatory processes of the alimentary canal: neoplasms in 80–85% of patients are detected in chronic esophagitis and gastroesophageal reflux disease, which occur against the background of damage to the mucous membrane of the organ due to exposure to infectious agents;
• mechanical trauma to the epithelium, thermal or chemical burns, linear ruptures of the esophageal mucosa in Mallory-Weiss syndrome.

It is assumed that a possible cause of polyproduction at the site of the cardioesophageal transition may be a violation of the development of the mucous membrane in the embryo, which leads to a dystopia of the tissues from which epithelial growths are formed.

Symptoms of esophageal polyps

Usually, the disease is not accompanied by severe symptoms for a long period, since the size of the neoplasms at the initial stages is small, and they grow slowly. Over time, the patient begins to feel slight discomfort and pain when swallowing solid food.

The disease is characterized by nausea after eating and moderate pain syndrome.

When the tumors get larger, the following are added to the manifestations:

• breathing disorders;
• belching;
• nausea and vomiting after eating;
• persistent or recurrent moderate chest pain.

If a neoplasm on a thin pedicle is localized in the lower part of the esophagus, most often patients complain of sharp pain in the epigastrium. This symptom is a consequence of the infringement of the growth when the lower esophageal sphincter (cardia) is closed.

Diagnostics

Most often, tumors are discovered by chance, during endoscopy for another disease of the gastrointestinal tract. Since the formation and growth of neoplasms are asymptomatic, at the initial stage of the disease, the diagnosis is difficult.

Polyps are most often detected during endoscopy

The doctor can assume the presence of polyps in cases where the patient complains of long-standing chest pain and intermittent dysphagia of unknown origin.

To clarify the diagnosis, the gastroenterologist directs the patient to complex instrumental and laboratory studies of the upper parts of the digestive tract, namely:

Study	Characteristic
Esophagogastroduodenoscopy	It is carried out through a flexible endoscope, allows for the collection of material for morphological analysis. During the examination, bright red or pink rounded growths on the pedicle are revealed, partially blocking the lumen of the esophagus. When the instrument touches the tumor, it begins to bleed
X-ray of the esophagus	The patient is given an oral contrast agent, and then a series of X-rays are taken, which may show neoplasms. The outgrowths, the size of which exceeds 1 cm, in the picture have the appearance of a rounded defect with clear contours. Smaller growths are visualized as a thickened fold of the organ mucosa
Biopsy histology	Tissue samples taken during endoscopy are used to determine the type of polyps and to confirm whether they are benign or malignant. Formations of the esophagus are characterized by the absence of atypical cells with pathological mitoses and the preservation of the histological structure of each layer of the mucous membrane
Clinical blood test	A decrease in the number of erythrocytes and hemoglobin indicates tumor expression and bleeding, due to which iron deficiency anemia is noted
Blood chemistry	In case of insufficient nutrition and diets, hypoalbuminemia may be noted in the test results
Gregersen reaction	The study allows you to reveal occult blood in the feces, it is necessary to exclude bleeding in the lower gastrointestinal tract

If the information obtained during these studies is insufficient to make a diagnosis, the patient is referred for magnetic resonance imaging or computed tomography.

Differential diagnosis

In the course of diagnostics, neoplasias are differentiated with diverticula, functional pathologies of the esophagus, malignant neoplasms and inflammatory diseases. In case of pain behind the sternum, bronchopulmonary pathology and ischemic heart disease are excluded.

During the differential diagnosis, in addition to consulting a gastroenterologist, patients are examined by a pulmonologist and a cardiologist.

Treatment of polyps of the esophagus

If single or multiple hyperplastic formations, not accompanied by clinical manifestations, are recorded accidentally during the endoscopy of the upper gastrointestinal tract, the doctor may suggest dynamic observation of the patient. Along with it, therapy is carried out with the basis of pathology, nutritional correction and control esophagoscopy every six months or a year.

One of the methods of removing the growths of the esophagus is ligation

Polyps are removed promptly, there are no conservative methods of treating the disease.

Indications for surgery:

• intensive growth of formations (more than 1.5 times per year);
• adenomatous outgrowths;
• polyps larger than 0.5 cm;
• pronounced clinical manifestations;
• erosion and inflammation against the background of polyposis;
• increased bleeding.

For removal of esophageal tumors, endoscopic polypectomy, clipping or ligation may be chosen. During endoscopic polypectomy, excision is performed under the control of an endoscope.

Clipping and ligation are also performed endoscopically. Operations involve the application of a clip after capturing the neoplasia and the surrounding mucous membrane. These techniques are less invasive and are associated with a lower risk of perforation or postoperative bleeding.

Possible complications, prevention

The long course of the pathology is associated with an increased risk of manifestations and erosion due to the constant maceration of the formations with the food consumed. It should be borne in mind that a threat to the patient's life is a possible massive bleeding from the esophageal vessels.

With repeated non-intensive blood loss, iron deficiency hyporegenerative anemia occurs, accompanied by dizziness, general weakness, blanching of the skin and mucous membranes, and the flickering of flies before the eyes.

In the later stages of the disease, due to the impossibility of adequate enteral nutrition, cachexia may develop in many patients.

Specific measures for the prevention of the disease have not been developed. In order to prevent polyposis, it is recommended to timely diagnose and carry out therapy for pathologies of the esophagus, chew food well, avoid eating rough food and limit alcohol consumption.

Video

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Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, specialty "General Medicine".

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