Helicobacter pylori and gastrointestinal polyps

Abstract

Polyps of the gastrointestinal tract are mucosal elevations that may have a mechanical, developmental, inflammatory, or neoplastic pathogenesis. Therefore, it is not surprising that there is no specific relationship between gastrointestinal polyps and H. pylori infection. In the stomach, inflammatory and proliferative responses, irrespective of their etiology, seem to favor the development of inflammatory polyps. Intact oxyntic glands, unaffected by inflammatory changes, seem to be more vulnerable to focal dilatations induced by proton pump inhibitors, hence the strong negative association of these nonneoplastic, noninflammatory polyps with H. pylori gastritis. Gastric adenomas, precursors of adenocarcinoma, are likely related to H. pylori infection by the same mechanisms that link this infection to gastric cancer. In the colon, the indisputable association of H. pylori gastritis with both hyperplastic and neoplastic polyps remains largely unexplained.