Summary about Disease
Fundic gland polyps (FGPs) are small growths that develop in the lining of the stomach, specifically in the fundus (upper part) of the stomach. They are generally benign (non-cancerous) and often discovered during upper endoscopy procedures performed for other reasons. There are different types of FGPs, with the most common being sporadic FGPs and those associated with Familial Adenomatous Polyposis (FAP) or Proton Pump Inhibitor (PPI) use.
Symptoms
Most individuals with fundic gland polyps do not experience any symptoms. They are usually found incidentally during an upper endoscopy. Rarely, large polyps may cause vague upper abdominal discomfort.
Causes
The causes vary depending on the type of FGP:
Sporadic FGPs: The exact cause is unknown, but they are not associated with FAP or PPI use.
FAP-associated FGPs: These are caused by a genetic mutation in the APC gene, leading to numerous polyps throughout the gastrointestinal tract, including FGPs in the stomach.
PPI-associated FGPs: Prolonged use of proton pump inhibitors (PPIs) can sometimes lead to the development of FGPs. It is believed that elevated gastrin levels from PPI use are the cause.
Medicine Used
There is no specific medicine to treat fundic gland polyps directly, but the underlying cause if present should be addressed.
PPI-associated FGPs: If the polyps are thought to be related to PPI use, discontinuing or reducing the PPI dose may be recommended.
FAP-associated FGPs: Patients with FAP require regular endoscopic surveillance and polyp removal.
In some cases, large or symptomatic polyps may be surgically removed.
Is Communicable
Fundic gland polyps are not communicable. They are not caused by an infectious agent and cannot be spread from person to person.
Precautions
There are no specific precautions to prevent sporadic FGPs, as the cause is unknown. However, if FGPs are associated with long-term PPI use, it is important to discuss the risks and benefits of PPI therapy with your doctor and consider alternative treatments if appropriate. Individuals with FAP should undergo regular screening for polyps.
How long does an outbreak last?
Fundic gland polyps are not considered an "outbreak." They are growths that develop over time. They may persist indefinitely if untreated or if the underlying cause (such as PPI use) is not addressed.
How is it diagnosed?
Fundic gland polyps are typically diagnosed during an upper endoscopy (esophagogastroduodenoscopy or EGD). During this procedure, a thin, flexible tube with a camera is inserted into the esophagus, stomach, and duodenum. The doctor can visualize the polyps and take a biopsy (tissue sample) for examination under a microscope to confirm the diagnosis and rule out other conditions.
Timeline of Symptoms
Most people with fundic gland polyps have no symptoms, so there isn't a symptom timeline to describe. In rare cases, very large polyps may cause mild upper abdominal discomfort that gradually increases over time.
Important Considerations
Although FGPs are generally benign, they can be associated with FAP, a hereditary condition that significantly increases the risk of colorectal cancer. Therefore, it is important to rule out FAP, especially if multiple FGPs are present.
If FGPs are found during an endoscopy, the pathologist will examine the biopsy to determine the type of polyp and look for any signs of dysplasia (precancerous changes).
Surveillance endoscopy may be recommended, especially for individuals with FAP or those with large or dysplastic polyps.
Patients with PPI-associated FGPs should discuss the continued need for PPI therapy with their doctor.