Should gastric polyps be removed immediately upon gastroscopy examination?

Gastric polyps discovered during gastroscopy usually do not need to be immediately removed. Whether they need to be treated requires a comprehensive evaluation based on the size, shape, and pathological type of the polyps. The main treatment methods for gastric polyps include endoscopic resection, regular follow-up observation, and medication therapy.

1. Endoscopic resection is recommended for adenomatous polyps with a diameter exceeding 10 millimeters or accompanied by atypical hyperplasia. This type of polyp may develop into gastric cancer, commonly found in the antrum of the stomach. Endoscopic mucosal resection or endoscopic submucosal dissection can completely remove the lesion. After surgery, it is necessary to fast for 6-8 hours and avoid spicy and stimulating foods for one month.

2. Follow up observation

Inflammatory or proliferative polyps below 5mm may not be treated temporarily, and it is recommended to have a follow-up gastroscopy at 6-12 months. This type of polyp is often associated with chronic gastritis, manifested as local bulging of the gastric mucosa with a smooth surface. During the follow-up period, it is necessary to control helicobacter pylori infection and avoid long-term use of nonsteroidal anti-inflammatory drugs.

3. Drug therapy

Gastric polyps associated with Helicobacter pylori positivity require eradication treatment. Commonly used quadruple therapy includes omeprazole enteric coated capsules, amoxicillin capsules, clarithromycin tablets, and bismuth potassium citrate granules. Partial proliferative polyps can self resolve after infection control, and during treatment, alcohol should be quit and meals should be taken separately.

4. Pathological evaluation

All excised polyps must undergo pathological examination, with a focus on confirming the presence of intestinal metaplasia or high-grade intraepithelial neoplasia. Gastric fundus gland polyps are usually benign, while adenomatous polyps with severe dysplasia require additional endoscopic ultrasound examination to evaluate the depth of infiltration.

5. Lifestyle Intervention

Smoking cessation and alcohol restriction can reduce the probability of polyp recurrence, and daily salt intake should be less than 5 grams. Preserved foods containing nitrite may irritate the gastric mucosa. It is recommended to increase the intake of fresh vegetables and fruits. Even asymptomatic individuals aged 40 and above should undergo gastroscopy screening every 3-5 years.

Within one week after surgery, the main diet should be a liquid diet, gradually transitioning to a low fiber soft diet. Avoid bleeding caused by overheated food and coarse and hard food materials. Drink some yam millet porridge to protect gastric mucosa. Daily monitoring of bleeding symptoms such as black stool and vomiting blood is necessary, and severe abdominal pain requires immediate medical attention. Maintaining a regular daily routine can help restore gastrointestinal function, and it is recommended to engage in light activities such as walking 30 minutes after meals.