Gastric Polyps in North India: Prevalence, Pattern and Beyond

Abstract

Background The prevalence and histopathological type of gastric polyp vary between populations. In the recent past aggressive treatment of Helicobacter pylori (H. pylori) and the excessive use of proton pump inhibitors (PPIs) have altered the prevalence of specific types of gastric polyp. This study was designed to evaluate the prevalence and histopathology of gastric polyps. Methods the medical record of patients who underwent esophagogastroduodenoscopy in 3 centers in Northern India from 2011-2019 were reviewed. Results the prevalence of gastric polyps was 5%, of which 900 (50%) were fundic gland polyps (FGP), 757 (42.05%) hyperplastic polyps (Hpp), and 143 (7.90%) others. 46.49% of the polyp group (cases) and 45.15% of controls had H. pylori gastritis (HPG); 30.59% of the cases and 23.27% of controls had chronic inactive gastropathy (CIG); 1.34% of the cases and 25.63% of controls had reactive gastritis (RG); and 9.05% of the cases and 1.39% of controls had intestinal metaplasia (IM). Portal hypertensive gastropathy (PHTG) was seen in 0.50% of the cases and 4.54% of the controls. Conclusions As a result of anti - H. pylori treatment and the excessive use of PPIs, FGP are now more common, even in Northern India, than Hpp (a new trend). HPG, CIG and IM were more frequent in the cases whereas RG and PHTG were more frequent in the controls. The difference was significant (P<0.001). These results are interesting and provide new perspective to look for pathogenesis of gastric polyps.