1. Gastric Polyps: Protons, Spirochetes and hyperplasia
Damian Paton-Gay
Jan 2007

2. The Plan…. A quick look at the epidemiology and major types of polyps
Do PPI’s cause polyps?
Does H. pylori infection cause polyps?
What do gastric polyps have to do with colonic adenomas and carcinomas?

3. Epidemiology A few large epidemiological studies
Incidence 1-3% of gastroscopies

4. Frequency and Types of Polyps
Fundic Gland Polyps
~50%
Hyperplastic Polyps
28% (some texts report up to 78%)
Adenomas
10%
Heterotopic tissue
Polyps associated with
Add up to ~1%

5. Fundic Gland Polyps
Often multiple 2-3 mm sessile lesions in body and fundus
“Focal increase in glandular elements”
Sporadic in general population
53% incidence in FAP
Almost invariably benign
3 case reports of gastric ca in a fundic gland polyp in a pt with FAP

6. Hyperplastic Polyps
Usually solitary <1.5 cm sessile lesions in body
Described as “shinier” and softer than other polyps
May have an umbilicated center
Higher risk of harbouring dysplasia than fundic gland polyps
These have been associated with H. pylori (more later)

7. Hyperplastic Polyps
Risk of developing adenocarcinoma in a hyperplastic polyp is considered ~2%
Based on a study of 477 hyperplastic polyps in 1990
Daibo M et al. Malignant Transformation of Gastric Hyperplastic Polyps. Am J Gastroenterol Mar;85(3):327-8

8. Adenomas Usually solitary and sessile polyps Most often antral
Often quite large (10+ cm in diameter)
Very similar to colonic polyps….
Can be tubular, tubulovillous or villous
Premalignant lesions
Incidence of carinoma is between 3 and 11%

9. Adenomas continued As with colonic polyps
Risk of Ca ^’s with polyp size and histologic type
Also - the presence of a gastric adenoma increases the risk of carcinoma elsewhere in the stomach