Gastric Polyps Found on Endoscopy: What Happens Next

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Gastric polyps are small growths on the lining of the stomach, and most are found by chance during an upper endoscopy done for some other reason, such as heartburn, indigestion, or anemia. Most gastric polyps are not cancer and never become cancer. A few types do carry risk, and the type is what decides whether anything else needs to happen: no follow-up at all, treatment for H. pylori, removal of the polyp, or a repeat endoscopy. This page explains what the main types of stomach polyps are and how the 2026 American Gastroenterological Association guidance approaches each one, for adults in Arlington, Annandale, and the rest of Northern Virginia who have just read the word "polyp" on an endoscopy report.

This article is general education, not medical advice. Your own results, and what they mean for you, are a conversation with the gastroenterologist who performed your procedure.

What gastric polyps are

A polyp is any growth that rises above the surrounding lining. In the stomach, the term covers several quite different things. The AGA Clinical Practice Update on management of gastric polyps, published in Clinical Gastroenterology and Hepatology in February 2026, describes them as raised lesions of the stomach lining that can arise from several different processes, including overgrowth of normal lining, true precancerous growths, and changes in the stomach's acid-producing glands.

The AGA document is an expert review rather than a formal guideline. Its practice advice comes from the published research and expert opinion, and because the authors did not perform systematic reviews, the statements do not carry formal ratings of evidence quality. It is the most recent document from a US gastroenterology society on this topic and the main source for this page. The AGA summarizes its 14 practice advice statements on its website.

A widely cited 2013 review in Gastroenterology & Hepatology, "Gastric polyps: a review of clinical, endoscopic, and histopathologic features and management decisions", adds descriptive background used below. It reports that gastric polyps are found in about 6% of upper endoscopies and that more than 90% cause no symptoms. Larger polyps can occasionally bleed, cause anemia, block the outlet of the stomach, or cause abdominal pain. Where that older review and the 2026 AGA update differ, this page follows the AGA.

How gastric polyps are found

Because most stomach polyps cause no symptoms, they are rarely the reason for the procedure. They usually turn up during an upper endoscopy (EGD), in which a thin, flexible camera is passed through the mouth to look at the esophagus, stomach, and the first part of the small intestine.

The AGA advises that endoscopists look at more than the polyp itself. It calls a systematic examination of the polyps and the surrounding stomach lining essential, because the lining around a polyp often explains why the polyp formed. The update names three background conditions in particular: H. pylori gastritis, autoimmune gastritis, and gastric intestinal metaplasia, a change in the lining that is linked to stomach cancer risk. It also advises a complete inspection with high-definition imaging and enhanced imaging techniques, with photographs of the polyps and of any abnormal lining.

The AGA also reminds clinicians that more than one type of gastric polyp can be present in the same person, and that different types tend to sit in characteristic parts of the stomach and have characteristic sizes and appearances. Appearance alone is not the final word, though. The type is confirmed by a pathologist looking at tissue under a microscope.

The main types of gastric polyps

The AGA lists the main types as fundic gland polyps, hyperplastic polyps, hamartomatous polyps, gastric adenomas (including pyloric gland and oxyntic gland adenomas), and gastric neuroendocrine tumors. The first three below account for most of what people are told after an endoscopy.

Fundic gland polyps

Fundic gland polyps are the most common type of gastric polyp. The 2013 review reports that they made up 47% of gastric polyps in one large series. They are usually small, smooth, and found in the upper part of the stomach, and they occur in three settings: on their own (sporadic), in people taking proton pump inhibitors, and in people with an inherited condition called familial adenomatous polyposis.

Sporadic fundic gland polyps carry very little risk. The 2013 review puts the chance of cancer in them at less than 1% and notes that surveillance endoscopy is not recommended for sporadic fundic gland polyps without dysplasia, meaning without precancerous changes on biopsy.

Hyperplastic polyps

Hyperplastic polyps are the second most common type. They are an overgrowth of the stomach lining in response to inflammation, and the 2013 review describes a strong association with chronic gastritis, H. pylori infection, pernicious anemia, and chemical irritation of the lining. The polyp itself has little cancer potential, but the review notes it can sit alongside a higher risk of cancer elsewhere in the inflamed stomach, which is one reason the surrounding lining gets biopsied.

The name can confuse people who have had a colonoscopy. Hyperplastic polyps in the colon are usually considered harmless, but the 2013 review stresses that gastric hyperplastic polyps have their own clinical significance despite the similar name. Our page on colon polyps covers the colon side.

Gastric adenomas

Gastric adenomas are true precancerous growths, the stomach's counterpart to adenomatous polyps in the colon. They are much less common than the first two types in the United States: the 2013 review reports that they account for 6% to 10% of gastric polyps in Western populations. They are often found with atrophic gastritis and intestinal metaplasia in the surrounding lining. Because of their cancer potential, the review describes complete removal as the standard approach.

Less common types

Gastric neuroendocrine tumors can look like polyps. The most common form, according to the 2013 review, develops in people with autoimmune gastritis and generally has an excellent outlook. Hamartomatous polyps are linked to several rare inherited polyposis syndromes. These types are uncommon, and when one is found, your gastroenterologist will explain what it means for you specifically.

Gastric polyps and proton pump inhibitors

People who take a proton pump inhibitor (PPI), such as omeprazole, for reflux or ulcers are often surprised to learn that their stomach polyps may be linked to the medication. The prescription omeprazole label on DailyMed states that PPI use is associated with an increased risk of fundic gland polyps, a risk that increases with long-term use, especially beyond one year. It adds that most people who developed them had no symptoms and that the polyps were found incidentally during an endoscopy.

The 2026 AGA update addresses the obvious next question directly. Its sixth statement says that people who take PPIs for valid reasons do not need to stop them because fundic gland polyps related to the medication have been found. In other words, the polyps on their own are not a reason to stop a medication that is treating something real.

That does not make every PPI prescription permanent. The label advises using the shortest duration of PPI therapy appropriate to the condition being treated, and whether you still need yours is a fair question to ask. Our page on long-term PPI use walks through the AGA's separate guidance on when stepping down makes sense. Please do not stop a PPI on your own, especially if it was prescribed for Barrett's esophagus, a bleeding ulcer, or severe reflux.

Gastric polyps and H. pylori

H. pylori is a common stomach bacterium that can inflame the stomach lining for years without symptoms. The AGA's fifth statement is one of its clearest: everyone with adenomatous or hyperplastic gastric polyps should be tested for H. pylori and treated if the test is positive.

Treatment can matter for the polyps themselves. The 2013 review reports that when H. pylori is the cause, about 80% of hyperplastic polyps regress after the infection is cleared. Clearing the infection also matters beyond the polyps, because long-standing H. pylori infection is the leading risk factor for stomach cancer. Our page on peptic ulcers and H. pylori explains testing and treatment, and our gastritis page covers inflammation of the stomach lining more broadly.

Biopsy or removal of gastric polyps

During the endoscopy, your gastroenterologist decides whether to take small tissue samples (biopsies) from a polyp, remove it, sample the surrounding lining, or some combination. The AGA notes that removal can be done with standard tools such as a wire snare or biopsy forceps, with a technique called endoscopic mucosal resection, or, for some lesions, with a more involved technique called endoscopic submucosal dissection. Which approach fits depends on the type, size, and location of the polyp, and some techniques may be done at a later, separate procedure.

When there are many polyps of different sizes, the AGA advises removing the largest ones when possible and sampling or removing the smaller ones. It also advises targeted biopsies of any suspicious surrounding lining, such as areas that look like intestinal metaplasia or atrophic gastritis, following existing biopsy protocols.

Results come from the pathology laboratory, not from the procedure room, so the type of polyp is often not known on the day of the endoscopy. If you went home without a clear answer, that is normal. The final pathology report is what tells your gastroenterologist which follow-up, if any, you need.

Follow-up after gastric polyps

The AGA's twelfth statement sets the principle: surveillance plans should be built on the type of polyp found and on the condition of the surrounding stomach lining. There is no single schedule for everyone with gastric polyps.

For polyps that show dysplasia, the AGA gives specific timing:

• Low-grade dysplasia, completely removed: a surveillance endoscopy in 1 year.
• High-grade dysplasia, completely removed: a surveillance endoscopy in 6 months.
• Low-grade dysplasia, biopsied only or not completely removed: a follow-up endoscopy within 6 months.
• High-grade dysplasia, biopsied only or not completely removed: a follow-up endoscopy within 3 months.

The AGA also advises surveillance endoscopy when biopsies of the lining next to a polyp confirm gastric intestinal metaplasia or atrophic gastritis, because in that case the background lining, not just the polyp, carries the risk. At the other end of the range, a small sporadic fundic gland polyp with no dysplasia usually needs no follow-up endoscopy at all, according to the 2013 review.

Your gastroenterologist sets your schedule from your own pathology report, your history, and your family history, so it may differ from these general figures.

When gastric polyps point to an inherited condition

Occasionally, stomach polyps are a clue to an inherited polyposis syndrome. The 2013 review describes fundic gland polyps as exceptionally common in people with familial adenomatous polyposis, a genetic condition better known for causing large numbers of colon polyps, and notes that dysplasia found in what looks like a sporadic fundic gland polyp should raise suspicion for it. It describes colon evaluation for people under 40 who have numerous fundic gland polyps, especially when they are not taking a PPI or when biopsies show dysplasia.

If many polyps are found at a young age, or if relatives have had polyposis or early colon or stomach cancer, tell your gastroenterologist. Our page on family history and colon cancer screening explains how inherited syndromes change screening, and our stomach cancer page covers who may be at higher risk.

Questions to ask about gastric polyps

A follow-up visit, or a call once pathology is back, is a good time to ask:

• What type of gastric polyp did I have, and was there any dysplasia?
• Was the polyp removed completely, or only biopsied?
• What did the biopsies of the surrounding stomach lining show?
• Was I tested for H. pylori, and do I need treatment?
• Could my PPI be related, and do I still need it at this dose?
• Do I need another endoscopy, and when?
• Does anything in my family history change the plan?

Symptoms that should not wait

Most gastric polyps cause no symptoms, so new symptoms deserve their own attention. Contact your doctor promptly for black or tarry stools, vomiting blood or material that looks like coffee grounds, new fatigue or shortness of breath that could signal anemia, trouble swallowing, persistent vomiting, or weight loss you cannot explain. Our pages on black stools and upper GI bleeding and iron deficiency anemia explain more. Heavy bleeding, fainting, or vomiting large amounts of blood is an emergency: call 911 or go to an emergency department.

Care for gastric polyps in Northern Virginia with GC of NoVA

Gastroenterology Center of Northern Virginia cares for adults across Arlington, Annandale, and the surrounding communities. Our five gastroenterologists perform upper endoscopy, review pathology results with patients, test for and treat H. pylori, and set follow-up plans based on the type of gastric polyp found and the condition of the stomach lining. Our page on upper endoscopy cost covers insurance questions, and our page on your first gastroenterologist visit explains what to bring.

We see patients at our Arlington office at 1715 N George Mason Drive, adjacent to VHC Health, and our Annandale office at 3299 Woodburn Road in the Woodburn Medical complex. To schedule a visit, call Arlington at (703) 522-7476 or Annandale at (703) 560-6106, or learn more at gcofnova.com.

This article is for general education and is not medical advice. Talk with a qualified gastroenterologist about your symptoms, diagnosis, and treatment options.