A Comparative Study of Patients With Multiple Gastric Hyperplastic Polyps and Patients With 1-2 Polyps

Introduction: Gastric hyperplastic polyps arise from the hyperproliferation of the gastric mucosa in response to irritation, i.e. chemical gastropathy and H. pylori infection. Most patients develop 1-2 polyps; however, some may develop multiple polyps at the same time. Risk factors that lead to developing multiple polyps have not been identified. We aimed to examine the clinical characteristics of patients with multiple polyps, and compare them to those with 1-2 polyps in order to identify potential risk factors. Methods: Records of patients with gastric hyperplastic polyps between 1/2006-1/2015 were reviewed. Demographic data, comorbidities, medical, social, surgical history, EGD, and histological findings were collected. Patients were divided into two groups: multiple hyperplastic polyps (MP) and non-multiple hyperplastic polyps (NMP). MP group was defined as having 3 or more polyps found during the same EGD exam; and NMP group was defined as having 1 or 2 polyps. Inclusion criteria were patients with histologically confirmed gastric hyperplastic polyps. Exclusion criteria were patients < 18 years of age, and those with obscure diagnosis. Results: A total of 100 patients with gastric hyperplastic polyps were identified. Of those, 26% were diagnosed with multiple polyps (18 F,mean age 62.6±14.3 year), and 74% were diagnosed with nonmultiple polyps (48 F,mean age 62.7± 12.2 years). Gender, age, race, BMI, NSAID, PPI use, alcohol consumption, and comorbidities were not statistically significant between the two groups. Anemia was more prevalent in the MP group with mean hemoglobin of 10.80±3.50 compared to 12.08±1.83 in the NMP group (p= 0.038). The recurrence of polyps following their removal occurred in 26.9% of patients in the MP group compared to 9.5% in the NMP group (p= 0.0273). The most common location of polyps in both groups was the antrum followed by the gastric body. The rates of chemical gastritis, H.pylori infection, chronic gastritis, and intestinal metaplasia were similar in both groups. Dysplasia and adenocarcinoma occurred in 4% and 0% respectively in the MP group vs. 2.7% and 1.4% in the NMP group (p=0.72). Conclusion: In our study, the incidence of multiple hyperplastic polyps was 26%. Except for the risk of developing anemia and recurrence of polyps, which was higher in the multiple hyperplastic polyps group, there were no specific characteristics that identified this group of patients from patients fewer polyps.