Stomach polyps - the good-quality opukholevidny outgrowths of ferruterous structure proceeding from a mucous membrane of a stomach. Polyps of a stomach develop asymptomatically, however at achievement of the big sizes can provoke gastric bleedings, skhvatkoobrazny belly-aches, difficulty of evacuation of food from a stomach; the malignization of polyps is possible. The basis of diagnostics is made by the fibrogastroscopy and an endoscopic biopsy, stomach roentgenoscopy. Tactics concerning polyps of a stomach can be waiting (dynamic observation and control) or active surgical (removal of polyps during endoscopy or band operation).
Stomach polyps – the tumoral epitelialny educations having good-quality character, appearing on an internal wall of a stomach. This very widespread disease in gastroenterology which often is not proving clinically and which is found at the carried-out fibrogastroscopy concerning other pathology. As a rule, polyps of a stomach are characteristic of patients of middle age (40-50 years), but can occur also at more young people and children. More often (more than twice) polyps of a stomach develop at men. In the majority of observations polyps of a stomach settle down in privratnikovy department of a stomach, is more rare – in a stomach body. Single polyps are found in 47% of cases, multiple — in 52%; approximately at 1-2% of patients it is observed diffusion stomach polyposes.
Reasons and classification of polyps of a stomach
The factors promoting emergence of polyps of a stomach: the age is more senior than 40 years; a helikobakterny infection (polyps often develop against the background of gastritises); genetic predisposition (it is characteristic of an adenomatozny polyp – diseases at which polyps curl mainly in a large intestine, but can be found also in other departments of a digestive tract).
Polyps of a stomach are divided by morphological features on adenomatozny and hyper plastic.
Hyper plastic polyps meet practically by 16 times more often, represent growth of cages of an epithelium of a stomach and are not a true tumor. Owing to the morphological structure hyper plastic polyps almost never ozlokachestvlyatsya.
Adenomatozny polyps are formed of ferruterous cages and represent benign tumors of a stomach with high risk of regeneration in stomach cancer (especially it concerns large education, more than two centimeters in size).
Adenomatozny polyps (stomach adenoma) are in turn subdivided on histologic structure into tubulyarny, papillary and papillotubulyarny tumors (depending on prevalence in tumoral fabric of tubular ferruterous, or sosochkovy structures). Besides morphological features polyps are classified by quantity (single and multiple) and by the size.
Symptoms of polyps of a stomach
Small and young polyps, as a rule, are not shown clinically, or the symptomatology of gastritis against the background of which polyps develop is noted.
Educations large can will be complicated by gastric bleeding (and then blood in Calais – a tar-like chair, or vomiting with blood is found). The big sizes of a polyp can become the reason of difficulty of passability of a stomach. Polyps on a leg can leave through the gatekeeper in a duodenum and be jammed, causing the sharp skhvatkoobrazny pains under a breast irradiating on all stomach.
Polyps can promote development of the following complications: formation of ulcers and internal bleeding, difficulty of evacuation of food from a stomach in a duodenum up to gastric impassability, infringement of a polyp by the gatekeeper (for polyps on a long thin leg), an ozlokachestvleniye (for adenomatozny polyps).
Diagnostics of polyps of a stomach
Most often polyps find at an endoscopic or radiological research on a gastritis occasion. Patients do not note specific symptomatology, as a rule, polyps are followed by a chronic inflammation mucous a stomach therefore to the forefront there are displays of gastritis.
The most informative technique of diagnostics is gastroscopy – the endoscopic research allowing to examine in details mucous a stomach, to reveal educations, to estimate their size and to take a bioptat for the histologic analysis. The radiological research of a stomach with contrast substance allows to outline a relief of walls of a stomach and to reveal existence of polyps.
Among measures of laboratory diagnostics there are no specific ways for identification of polyps of a stomach, but at suspicion on development of bleeding from a polyp can conduct a research a calla on the hidden blood. At frequent bleedings in the general blood test can note symptoms of anemia. For detection of a helikobakterny infection conduct the PTsR-research and identification of antibodies by the IFA method.
Treatment of polyps of a stomach
It is necessary to observe recommendations and appointments of the gastroenterologist. Depending on the sizes, quantity, morphological features of polyps, the doctor defines medical actions, but anyway an optimum measure of treatment is removal of polyps. Small polyps can be removed at endoscopy. The large polyps and educations having the wide basis demand more serious surgical intervention.
At hyper plastic polyps of the small size the doctor can sometimes offer waiting tactics – dietary food and dispensary observation with regular inspection (a fibrogastroskopichesky research) of a stomach not less than one-two times a year. The doctor notes dynamics of growth of polyps, the nature of change of their surface (formation of roughnesses, erosion, ulcerations, bleeding), formation of new growths. Sharp acceleration of growth and change of a surface of a polyp can be signs of its ozlokachestvleniye.
In case of development of complications the question about surgical is raised or, at an opportunity, endoscopic removal of a polyp. After removal of a polyp patients also have to undergo regular inspection regarding probability of repeated emergence of polyps.
Patients after endoscopic removal of polyps (an elektroekstsiziya or electrothermic coagulation) need to make control endoscopy in 10-12 weeks for specification of completeness of cleaning of walls of a stomach of polyps. Carry sometimes out a doudaleniye of the remains of a polyp. Final healing of defects mucous, the polyps formed as a result of endoscopic removal, happens from two to eight weeks in time.
It is worth remembering: at regular endoscopic control mucous a stomach with frequent biopsies growth of a polyp can accelerate. Also endoscopy promotes spread of a malignancy inclined to metastasis.
The resection of a stomach is carried out in case of large polyps, multiple, often recidivous polyps, the educations complicated by massive bleeding, a necrosis, jamming, impassability of a stomach, an ozlokachestvleniya (malignization) of a polyp. There is no specific medicamentous therapy of polyps of a stomach, but as this disease often proceeds against the background of gastritis, medicines are appointed according to the principles of treatment of this disease.
Prevention of polyps of a stomach
The modern medicine does not allocate specific measures for prevention of polyps of a stomach. Preventive measures have to be generally directed to the prevention of developing of gastritis (or timely and its adequate treatment) as chronic gastritis is the major factor promoting emergence and development of polyps of a stomach.
For the prevention of diseases of a stomach of the main measures are: a balanced diet with observance of the mode, restriction of smoking and alcohol intake, control over the accepted medicines (the careful use of gastrotoksichny medicines, in particular, anesthetics and nonsteroid resolvents, febrifugal from group).
Patients at whom stomach polyps are revealed need to adhere to dietary food with an exception of the products irritating mucous a stomach (sharp, salty, sour, fried, smoked), and also the food promoting strengthening of secretion of hydrochloric acid. It is desirable to refuse alcohol and smoking completely: alcohol has the direct damaging effect on mucous that can lead to an erozirovaniye and an ulceration of a polyp. Smoking also negatively influences a condition of a wall of a stomach, reducing its protective properties and promoting increase in production of hydrochloric acid.
Medicines of group of nonsteroid resolvents are contraindicated to patients with polyps of a stomach.
The forecast at stomach polyps
During removal of polyps the forecast is favorable. Only, the probability of repeated emergence is high, but regular dispensary observation allows to reveal a recurrence quickly and to carry out removal of new educations at an early stage by low-invasive methods. After removal of polyps restoration of working capacity happens, as a rule, in full. The long course of a disease can lead to stomach cancer.