Endocrine Abstracts

We examined gastroenterocolonic tract condition at 92 patients with active acromegaly (male 30, female 66, age 26–78 y.o., most of the patients 45–59 y.o.). Gastroduodenoscopy (n=92) and colonoscopy (n=74) were performed. Median GH levels were 22.7 (12.5; 51) mMe/l, median IGF1 levels – 640 (507; 800) ng/ml.

Esophagitis was diagnosed at 22 (23.9%) patients, incompetence of cardia – 33 (35.8%) patients. There was one case of gastric cancer (operated before). Helicobacter pylori was found at 78% of patients (predominantly 2–3 degree). Gastroduodenitis was found in all patients (100%), additionally chronical or acute stomach erosions were revealed at 20 (21.7%) patients. Stomach polyps were found at 28 (30.4%) patients (hyperplastic polyps n=5). Polyps localized predominantly at distal parts of the stomach (mostly antrum), size up to 5 mm 14 cases, 6–10 mm – 11 cases, >10 mm – three cases. Duodenal ulcer was found at six patients, duodenal erisions – in seven cases. Duodenal polyps were found at 2 other patients (hyperplastic polyp n=1).

Colonic pathology were found in 64 patients (86.5%), including sigmoiditis (n=13, 17.6%), colitis (n=7, 9.5%), colonic diverticula (n=22, 30%), dolichocolon (n=21, 28.4%). Colonic polyps were found in 39 (52.7%) cases and consisted of hyperplastic polyps (n=26, 35.1%) and adenomatous polyps (n=13, 17.6%), including 7 (9.5%) cases of joint presence of hyperplastic and adenomatous polyps, and adenocarcinoma (n=1, 1.4%). Polyps were single in 20 cases (27%), 2–8 polyps in 8 (10.8%) cases, and >8 polyps in 12 (16.2%). Polyps were in size up to 5 mm in two cases, 6–10 mm in 20 cases, 11–15 mm in 14 cases, and >15 mm in three cases.

We did not found association of stomach and colonic polyps in any case. Median GH levels were higher at patients with stomach polyps comparing with colonic polyps (33 (12.5;58) vs 18.8 (12.5;40) mMe/l) however the difference was not statistically significant. Median IGF1 levels were similar in both groups (655 (507; 812) vs 600 (500; 710) ng/ml respectively).

Thus, gastro/colonic pathology is common among acromegalic patients. Stomach polyps like colonic polyps are also associated with acromegaly.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.