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Current Management of Benign Epithelial Gastric Polyps

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Opinion statement

Purpose of review Benign epithelial gastric polyps, although typically asymptomatic, are identified incidentally on upper endoscopy in up to 23% of patients. These include fundic gland, hyperplastic, and adenomatous polyps. Their appropriate characterization is critical as some have malignant potential, may be indicative of a gastric mucosal field defect, or may be related to an underlying polyposis syndrome. This review will discuss the current management of benign epithelial gastric polyps.

Recent findings Association of gastric polyps with proton pump inhibitor use, Helicobacter pylori infection, risk of malignant transformation, and association with polyposis syndromes have been the focus of recent literature.

Summary All symptomatic polyps, polyps larger than 1 cm in size, and polyps later found to contain dysplasia or cancer should be completely removed. Additionally, random biopsies from the intervening non-polypoid mucosa should be obtained. Finally, identification of multiple polyps of fundic gland type and/or concomitant dysplasia should raise suspicion for an underlying polyposis syndrome and prompt appropriate workup. Surveillance is generally only indicated if there is confirmed dysplasia and/or carcinoma within the polyp itself or if preneoplastic changes are identified in the non-polypoid gastric mucosa.

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Acknowledgements

Min Cui, MD, PhD

Department of Pathology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY.

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Authors and Affiliations

  1. The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA

    Antonio R. Cheesman MD, David A. Greenwald MD & Shailja C. Shah MD

  2. Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University, 2215 Garland Avenue, 1025-B Medical Research Building IV, Vanderbilt University Medical Center, Nashville, TN, 37232, USA

    Shailja C. Shah MD

Authors
  1. Antonio R. Cheesman MD
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  2. David A. Greenwald MD
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  3. Shailja C. Shah MD
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Antonio R. Cheesman: manuscript writing, edition, and revisions.

David A. Greenwald: manuscript edition and revisions.

Shailja C. Shah: manuscript writing, edition and revisions, article guarantor.

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Correspondence to Shailja C. Shah MD.

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Antonio R. Cheesman declares that he has no conflict of interest. David A. Greenwald declares that he has no conflict of interest. Shailja C. Shah declares that she has no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Stomach

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Cheesman, A.R., Greenwald, D.A. & Shah, S.C. Current Management of Benign Epithelial Gastric Polyps. Curr Treat Options Gastro 15, 676–690 (2017). https://doi.org/10.1007/s11938-017-0159-6

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