Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for evaluation of gastric polyposis noted on recent EGD. History of PPI use noted. No symptoms of dyspepsia, hematemesis, or melena. Family history positive/negative for FAP or Lynch syndrome. Evaluation to differentiate between sporadic fundic gland polyps (FGPs) and FAP-associated polyposis.
Clinical Examination Findings
Abdominal exam: Soft, non-tender, non-distended. No palpable masses or organomegaly. Bowel sounds present. EGD findings: Multiple sessile, smooth, dome-shaped polyps observed in the gastric fundus and body. Biopsy performed to assess for dysplasia or adenomatous changes.
Treatment Protocol
If sporadic: Consider PPI discontinuation if clinically appropriate; surveillance EGD as indicated. If FAP-associated: Spigelman staging for duodenal polyposis; referral to genetics for FAP screening; regular endoscopic surveillance of gastric and duodenal mucosa; surgical consultation if high-grade dysplasia or significant polyp burden is present.