Polyp (from the Greek "polypus": poly - a lot, a pus - a leg) - proliferation on a thin stalk or on a broad base, consists of epithelial cells and hangs or protrudes into the lumen of the organ.
If the formation is multiple - we are talking about polyposis. Overgrowth is benign, but not offensive, as it can lead to serious complications.
General information about polyps of the esophagus
According to the literature, the size of the polyps of the esophagus varies from a few millimeters to 30 cm.
This is a rare pathology, determined in middle-aged men. Favorite location - the upper third of the esophagus or closer to the cardia, although it can develop in other places. If the polyp on the long leg is in the upper part of the esophagus, it can fall into the throat. When localized near the cardia, infringement can occur.
Esophageal polyps in their structure are divided into:
• hyperplastic - consist of epithelial cells of the mucous membrane of the esophagus;
• adenomatous - consist of glandular epithelium.
1. Hyperplastic polyps rarely malignant, proceed benignly. Despite the low risk of malignancy, they must be removed immediately after detection.
2. Adenomatous polyps more dangerous, the risk of developing cancer is high.
Esophageal polyp - causes
Why does the esophagus polyp occur - the reasons for this are still unknown. Predisposing factors are the presence of certain diseases. These include:
• chronic esophagitis;
• GERD - gastroesophageal reflux disease.
Play a role:
• condition of the wall of the esophagus - microtrauma of the mucosa after ingestion of rough food, some medications;
• genetic predisposition;
• excessive alcohol consumption;
• chronic stress;
• bad ecology.
Esophageal polyp - signs and diagnosis
In the presence of a polyp in the esophagus, signs characteristic of this pathology are absent. Therefore, it is impossible to independently determine the existing growth. It is diagnosed as a find during examinations of the stomach:
• EFGDS - esophagogastroduodenoscopy;
• contrast fluoroscopy.
1. When examining the esophagus with an esophagoscope, a round or oval bright red formation is found. When you touch the tool, bleeding occurs.
2. When conducting a contrast fluoroscopy, a polyp less than 1 cm in size looks like a compacted fold of the mucous membrane.
If the dimensions are more than 1 cm, a defect in the filling of a rounded shape with clear contours is determined.
The absence of signs in the esophagus polyp by which it would be possible to guess its existence are explained by its small size. The functions of the esophagus are not violated, the general condition remains satisfactory. In addition to its small size, it is characterized by slow growth. Therefore, for a long time, it may exist asymptomatically. Periodic dysphagia, a violation of swallowing, should alert. But with a decrease in spasm, the swallowing process is restored, since the polyp cannot completely block the lumen of the esophagus - its size does not allow it.
The polyp is constantly irritated by ingested food, moves under its influence. As a result, the leg of the polyp is stretched, and it gradually grows. There is a further difficulty with swallowing food, slowing its passage through the esophagus and even delaying it.
When the formation reaches a huge size, with the existing polyp of the esophagus, the signs of the tumor appear in a vivid clinical picture. A large polyp can fall down, blocking food from entering the stomach, or rise up and enter the oral cavity, causing:
• difficulty swallowing food;
• pain when swallowing;
• nausea and vomiting after eating;
• discomfort behind the sternum;
• difficulty breathing associated with compression of the trachea ;;
• sharp emaciation.
With a long-existing polyp, there is constant irritation with its rough food. Over time, it becomes covered by erosion and may ulcerate. This leads to bleeding. If there is a slight loss of blood daily, which a person may not be aware of, anemia gradually develops. There is weakness, shortness of breath, palpitations.
Esophageal polyp localization
The clinical picture also depends on the localization of education.
When the polyp is located in the lower third of the esophagus, it can hang in the stomach. This is a dangerous condition, because infringement may develop in the event of a polyp falling on a long leg into the pylorus of the stomach. There is a sharp pain in the epigastric region, accompanied by nausea and vomiting.
In the case of a polyp on a long leg in the throat and even in the larynx, sudden death from asphyxiation can occur.
In the presence of polyposis, the possibility of malignant growths is not excluded. It is believed that each neoplasm that has appeared in the body again can potentially malign. The greatest likelihood of such a transformation in large polyps on a thick stalk.
Esophageal polyp - treatment
If a polyp of the esophagus is detected only surgical treatment. It must be deleted, there are no other ways.
Indications for immediate surgery:
• progressive growth;
• bleeding;
• high risk of malignancy.
Removal of the polyp is carried out depending on its location, size and type.
1. The polyp on the long leg is removed using an esophagoscope.. Then electrocoagulation of the legs and blood vessels is performed to prevent further bleeding. All manipulation lasts several minutes. The wound surface and organ functions are restored in a few days.
2. If formation on a thick stalk is detected, technically it will not be possible to remove it with a fiberscope. In addition, there is a high probability of malignancy in such outgrowths (especially if it is a hyperplastic polyp) during such manipulations. If there is a wide base in the esophagus polyp, the treatment should be prompt.
The operation is performed by an open method. depending on the esophagus, where a polyp is detected. Most often, an incision is made on the neck, because typical localization is the upper third of the esophagus. The neoplasm is cut off, the incision site is sutured. The removed tissue is sent for histological examination. If malignancy has not occurred, the drug determines the picture of a simple polyp with elements of inflammation in the connective tissue and edema.
3. According to statistics large formations are rarely malignant. If this happens, the esophagus is removed.
4. If polyposis is detected in the lower part of the esophagus and in the stomach and if it is impossible to remove it using the fibroscopic method, abdominal surgery is performed abdominally. Such surgical interventions are always done with great care and caution, because any detected neoplasm is considered a potential cancer. To this end, during medical manipulations, they try to avoid seeding of surrounding tissues of the removed tissue.
Removing the growth in the shortest possible time after its discovery makes it possible to prevent the need for extensive operations in the future. Relapses after treatment are rare.
Esophageal polyp - prevention
In terms of treatment, the diet is ineffective. With a polyp of the esophagus, prevention includes primarily following a diet. Dietary nutrition is prescribed to prevent the formation of new ones and reduce trauma to existing polyps of the esophagus, as well as after surgery.
The goals that are pursued in the appointment of a diet:
• reduction of injuries of the esophagus from taking coarse dry food;
• speedy epithelization of damage to the epithelium of the esophagus mucosa;
• normalization of the evacuation function of the esophagus;
• prevention of GERD.
To implement these tasks, you must:
• steaming and chopping to a puree consistency;
• frequent fractional intake in small portions (at least 5 times a day);
• adherence to meals;
• in the absence of contraindications - the use of up to 1.5 liters of fluid per day.
Products not recommended
With an esophageal polyp, prophylaxis also includes the exclusion of any traumatic mucosal products. Not recommended:
• alcohol;
• carbonated drinks;
• seasonings and spices (for the prevention of GERD);
• strong coffee;
• any canned food;
• vegetables that contain coarse fiber (legumes, radishes, asparagus);
• stale bread and crackers;
• stiff unroasted or unroasted meat;
• bony fish.
To avoid malignancy, it must be remembered that even a minor microscopic neoplasm must undergo urgent removal. Otherwise, an extensive traumatic operation is not ruled out in the future. Surgical intervention precludes further progression of the alleged tumor into the trachea and lungs. Even after treatment, the risk of malignancy is not excluded. Therefore, it is necessary to regularly be observed by a gastroenterologist.
The prognosis is all the more favorable the earlier the operation.
At the first signs of malaise, you need to see a doctor and follow his recommendations. Only in this way will it be possible to avoid dangerous consequences, maintain health and a high quality of life.
