Esophageal polyps are growths that develop on the inner lining of the esophagus, the muscular tube connecting the throat to the stomach. These growths are generally benign and not considered life-threatening. While they can occur in individuals of any age, they are observed more frequently in adults, particularly those over 60 years old.
Causes and Associated Conditions
Chronic inflammation is a primary factor driving the formation of many esophageal polyps. Conditions such as gastroesophageal reflux disease (GERD), where stomach acid frequently flows back into the esophagus, commonly lead to esophagitis, an inflammation of the esophageal lining. This persistent irritation can trigger the development of inflammatory polyps and hyperplastic polyps, which represent a regenerative response by the mucosal tissue to ongoing injury.
Certain medications can induce esophagitis, and infections or sites of previous surgical procedures or polypectomies may also contribute to polyp formation. Other less common types include fibrovascular polyps, which are rare benign tumors often found in the upper esophagus, and squamous papillomas, sometimes linked to inflammation or human papillomavirus (HPV).
Symptoms and Potential Complications
Many esophageal polyps are small and do not cause any noticeable symptoms, often being discovered incidentally during medical examinations for other conditions. However, if a polyp grows to a larger size, it can begin to interfere with normal esophageal function. Patients might experience dysphagia, which is difficulty swallowing, or a persistent sensation of something being stuck in the throat. Rarely, a large polyp can also cause chest pain or discomfort.
The potential for most esophageal polyps to become malignant is very low. A biopsy is routinely performed to confirm the polyp’s specific type and rule out any malignant changes. Other rare complications can include bleeding, particularly if the polyp becomes ulcerated, or, in very rare instances with extremely large polyps like fibrovascular ones, obstruction or even asphyxiation if they are regurgitated into the airway.
Diagnosis and Treatment Options
The primary method for identifying esophageal polyps is an upper endoscopy, also known as an esophagogastroduodenoscopy (EGD). During this procedure, a thin, flexible tube equipped with a camera and a light is gently guided down the throat into the esophagus, allowing the doctor to visually inspect the lining and locate any growths.
If a polyp is identified, the standard approach is often an endoscopic polypectomy, which involves removing the polyp during the same endoscopic procedure. Specialized tools passed through the endoscope are used to safely excise the growth. The removed tissue is then sent to a laboratory for a biopsy, which provides a detailed microscopic analysis to confirm its benign nature and classify its specific type. Depending on the polyp’s characteristics and the presence of underlying conditions such as GERD, follow-up care may be recommended to monitor the esophageal health and manage any contributing factors.