Hyperplastic polyp of the stomach and intestines: symptoms, diagnosis, treatment
The content of the article:
-
Histological types of polyps
- Adenomatous formations
- Hyperplastic formations
- Juvenile formations
- The reasons
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Intestinal hyperplastic polyp
- Symptoms
- Diagnostics
- Treatment of hyperplastic intestinal polyps
-
Hyperplastic polyp of the stomach
- Symptoms
- Diagnostics
- Treatment
- Video
A hyperplastic polyp is one of the histological types of benign growths that form from the cells of the mucous membrane of an organ. It differs from other species not only in its structure, but also in the minimum probability of degeneration into a malignant form.
A hyperplastic polyp is a benign formation and can form on the mucous membranes of the cavity organs
A polyp is any benign neoplasm that protrudes above the surface of the mucous membrane of the cavity organ. The place of its localization is different: it can form throughout the gastrointestinal tract (GIT), in the endometrium, vagina, sinuses, bladder, urethra, etc.
The causes of hyperplastic polyps (HP) are not fully understood. Among the widespread theories of the prevailing etiological factor, there are: prolonged mechanical damage, chronic inflammatory processes in the mucous membrane of the organ, hereditary predisposition, dyshormonal states, etc.
The danger of a timely undiagnosed and untreated neoplasm lies in the possibility of malignancy (degeneration of a benign form into a malignant one) and the development of other complications (bleeding, infection, intense pain, etc.).
Histological types of polyps
Pathological growths are divided into several types:
- glandular (adenomatous);
- hyperplastic;
- juvenile.
Separately, hereditary polyposis syndromes are distinguished (Lynch syndrome, Gardner syndrome, Peitz-Jeghers syndrome, juvenile polyposis, etc.)
Adenomatous formations
Adenoma, or adenomatous polyp in relation to malignancy, is the most dangerous, since this type is prone to malignant transformation.
Adenomas, according to their histological structure, are divided into:
- glandular;
- glandular villous;
- villous.
It is the villous adenomas that can degenerate into a malignant form. This species often affects the rectal mucosa. A tumor can be detected by digital examination.
Some large villous adenomas, containing goblet epithelial cells, can secrete up to three liters of mucus per day.
Hyperplastic formations
Often, hyperplastic growths are found in the large intestine. They are not prone to malignancy, their size rarely exceeds 0.5 cm. These neoplasms can be single or multiple, the latter are found more often.
Neoplasms can have a different structure.
The risk of developing pathology increases with age, i.e., growths are mainly found in persons over 40 years old.
According to the histological classification, there are several types of hyperplastic polyps:
- microvesicular HP (MVHP);
- HP containing goblet cells (GCHP);
- Low Mucin HP (MPHP).
Juvenile formations
Juvenile polyps are most often found in children aged 4–5 years, but there are known cases of their detection in adults. The place of localization is the rectum and sigmoid colon. Their size rarely reaches 2 cm.
There are two most common theories of juvenile polyp formation. The first of them speaks of an inflammatory nature, the second - of a violation during the laying of organs during the embryonic development of the fetus.
The main symptom is the appearance of intestinal bleeding.
The reasons
The etiology of HP development is not fully understood. There are three most common theories:
| Cause | Characteristic |
| Chronic Irritant Exposure Theory | For example, infectious agents leading to an inflammatory process. They tried to prove this theory experimentally in 1938, adding carcinogenic substances to the food of laboratory animals. After 7-10 months, stomach polyps were detected, and then carcinomas were found |
| Theory of impaired regenerative function | It speaks of a failure of the regenerative (restorative) abilities of the inner shell of the organ. As a result of this disorder, excessive cell proliferation and the formation of a towering growth occur. |
| The theory of embryonic error | One of the theories explaining the presence of juvenile polyps |
Several factors have been identified that increase the risk of neoplasms, including:
- hereditary predisposition;
- unbalanced nutrition (constipation is a factor contributing to trauma to the intestinal mucosa);
- hypodynamia (decreased physical activity);
- damage to the mucous layer (due to chronic inflammatory processes, mechanical trauma);
- diseases of the gastrointestinal tract (diverticulosis, gastritis, colitis, hereditary diseases);
- alcohol intake, overeating, stress, smoking, etc.
Intestinal hyperplastic polyp
The disease is asymptomatic for a long time, especially with a small size of the neoplasm. Often, a hyperplastic colon polyp is found during a colonoscopy for another pathology.
Symptoms
The only thing that can disturb the patient during this period is discomfort in the abdomen.
In case of malnutrition or the integrity of the growth, the following symptoms are often observed:
- bloody discharge that appears simultaneously with or after stool;
- admixture of mucus in the stool;
- abdominal pain syndrome;
- violation of the stool (constipation, diarrhea or their alternation);
- anemic syndrome (increasing anemia due to chronic blood loss).
Diagnostics
Due to the fact that possible symptoms are nonspecific and do not exclude other intestinal diseases (colitis, hemorrhoids, oncological process, etc.), it is necessary to be examined by a proctologist followed by additional studies.
After collecting complaints, anamnesis, for differential diagnosis, the doctor should conduct a digital examination of the rectum. This method will allow detecting pathological formations of the lower rectum, as well as additionally examining the prostate gland.
Colonoscopy is performed to identify growths in the colon
To clarify the diagnosis, the following may be prescribed:
- sigmoidoscopy: indicated in cases where a neoplasm could not be detected with a digital examination. A special optical device, a sigmoidoscope, allows visualizing the inner layer of the rectum at a distance of 25 cm from the anus;
- colonoscopy: it is necessary to detect neoplasms with localization in any part of the colon above the rectum. A colonoscope is a plastic optical device that allows you to examine the inner lining of the large intestine along its entire length;
- irrigoscopy or magnetic resonance imaging (MRI): used to visualize the pathological formation of this part of the digestive system. Irrigoscopy consists in the introduction of a contrast agent into the large intestine through the anus. After filling the necessary segment of the intestine, X-ray images are taken, which show the location of the formation.
If there are dubious symptoms, a doctor may prescribe a laboratory test - feces for occult blood.
Treatment of hyperplastic intestinal polyps
Hyperplastic formations, especially those accompanied by severe symptoms, are recommended to be treated surgically.
This type of neoplasm almost never transforms into malignant forms, however, it can cause anemia, intestinal disorders and inflammatory bowel processes.
The method of removing the intestinal polyp is determined by the doctor individually
Low-lying HP of the rectum can be removed surgically (with a scalpel), using a laser, electrical pulses, or radio waves; high-lying - removed during colonoscopy using the same physical methods or direct access (through the anterior abdominal wall).
Hyperplastic polyp of the stomach
Hyperplastic polyp of the stomach is one of the most common types of neoplasms of this organ (70-80%). The probability of its malignancy does not exceed 1%.
Like a similar neoplasm of any other localization, this type remains unnoticed for a long time, since it is not accompanied by any symptoms.
Symptoms
The following symptoms can indirectly indicate the presence of HP in the stomach:
- dyspeptic symptoms (nausea, heartburn, heaviness in the stomach, excessive flatulence in the intestines, vomiting, unstable stools);
- decreased appetite, weight loss;
- gastric bleeding (vomiting of coffee grounds, melena);
- anemic syndrome;
- cramping pain in the stomach;
- bad breath.
Diagnostics
For differential diagnosis, additional research methods are used:
- fibrogastroduodenoscopy (FGDS): visualizes the mucous membrane of the esophagus, stomach, duodenum, allows you to take a piece of tissue for its further cytological and histological examination;
- contrast radiography: the patient drinks barium, after which x-rays are taken. The method allows you to identify neoplasms in the wall of the stomach;
- ultrasound procedure;
- study of feces for occult blood.
Treatment
If HP was discovered by chance during a preventive examination of the patient and he does not bother him, the doctor may recommend a wait-and-see tactic, including the treatment of gastritis, peptic ulcer disease, and normalization of the digestive system.
Removal of neoplasms is usually done by endoscopic polypectomy
In most cases, especially if the presence of a pathological neoplasm is accompanied by severe symptoms and brings discomfort to the patient, surgical treatment is recommended, usually minimally invasive endoscopic polypectomy.
During endoscopic polypectomy, an endoscope is inserted into the stomach through the oral cavity, then a special electric loop captures the neoplasm, an electrical impulse is applied and the polyp is removed. Very rarely, abdominal surgery is performed with access through the anterior abdominal wall.
Prevention of polyproduction has not been developed, it is recommended to timely detect and treat diseases of the gastrointestinal tract, eat a balanced diet, eliminate bad habits and minimize stress.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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