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Colon Polyps

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Introduction

The colon or the large intestine is a part of the digestive system. The large intestine is a hollow tube and is the last bit in the digestive system. It is here that the body forms and stores the stool. Colon polyps are overgrowth in the large intestine. It is also called colorectal polyps. Often, these polyps are harmless and diagnosed only during tests conducted to determine colon cancer (polyps, in a few cases, progress to cancer).

Description

A colon polyp is a small clump of cells formed in the lining of the large intestine. There are two types of colon polyps: neoplastic and non-neoplastic. Non-neoplastic polyps include hyperplastic polyp, inflammatory polyp, and hamartomatous polyps. The non-neoplastic variety does not become cancerous, but the neoplastic type has adenomas and serrated polyps. The bigger the polyp, the higher the risk of cancer.

Regular screening tests such as colonoscopy show polyps. If they are diagnosed early, they can be removed safely and completely.

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What are the Causes of Colon Polyps?

Gene mutation is considered a cause of colon polyp. In normal cases, the healthy cells grow and divide in order. There could be a gene mutation in some individuals, and normal cells can divide and form new normal cells in places where it may not be necessary. This unregulated growth is called a polyp. This can develop anywhere along the length of the large intestine.

As mentioned, colon polyps are of two types: neoplastic and non-neoplastic. Inflammatory polyps are seen in case of ulcerative colitis or Crohn’s disease. Polyps themselves are not a threat, but Crohn’s disease increases the overall risk of colon cancer.

What are the Risk factors of Colon Polyps?

Pain in the upper abdomen is the most common symptom of bile duct stones. Other signs and symptoms that a person may experience are as follows:

  • Age : People above the age of 50 are at risk.
  • Inflammatory conditions such as ulcerative colitis or Crohn’s disease: These factors result in a predisposition to developing colon polyps and, maybe, colon cancer at a later stage.
  • Family history : If a person has a genetic predisposition (if someone in the family has had this condition before), they are at a higher risk.
  • ● Tobacco and alcohol abuse.
  • ● Obesity and lack of exercise.
  • ● Race: African-Americans are at a greater risk..
  • ● Uncontrolled type 2 diabetes.
  • ● Certain hereditary disorders can also cause colon polyp such as :
    • Lynch syndrome : It is also called non-polyposis colorectal cancer, which tends to develop a few colon polyps, and the chances of these turning malignant are high. It is also associated with tumours of the stomach, intestine, urinary tract, and ovaries.
    • Familial adenomatous polyposis : A rare genetic disorder where the patient develops a few hundred to thousands of polyps along the intestinal lining. If this condition is not treated promptly, it progresses to cancer.
    • Gardner syndrome : Along with polyps, the patient also develops tumours in the skin, abdomen, and bones.
    • Mutation in MYH genes : This causes adenomatous polyps and colon cancer at a young age.
    • Peutz-Jeghers syndrome : Freckles are seen all over the body including, lips, gums, and feet. It also causes the growth of non-cancerous polyps that can later become cancerous.
    • Serrated polyposis syndrome : This causes multiple serrated polyps.

What are the Symptoms of Colon Polyps?

Colon polyps do not cause any signs or symptoms by themselves, and they are diagnosed only during routine tests or accidentally when testing for other conditions. However, some patients might experience the following symptoms:

  • ● Rectal bleeding.
  • Blood in stools : Stools may appear reddish or black.
  • Constipation or diarrhea : Constipation or diarrhea that lasts for more than a week.
  • Pain : Due to obstruction in the intestine, there may be cramps in the abdomen.
  • Iron deficiency anemia : Due to polyps, there may be chronic bleeding without a change in stool color. In the long run, this can cause iron deficiency anemia, and the patient may feel breathless and tired.

How are They Diagnosed ?

  • Colonoscopy : A thin, flexible tube is passed through the anus with a camera attached at the tip allowing the doctor to study the rectum and colon. If a polyp is present, the doctor immediately excises and sends it for analysis.
  • Sigmoidoscopy : It is similar to colonoscopy, but the tissue cannot be removed for further analysis as seen in colonoscopy.
  • CT colonography : It is also called virtual colonoscopy, where a CT scan gets the doctor 2D and 3D images of the colon.
  • Barium enema : Liquid barium is injected through the rectum, and a special x-ray captures images of the colon. This makes the colon appear white and makes it easier to identify the polyp.
  • A stool test : This is done to check if there is any microscopic bleeding.

How are They Treated?

Polyps are generally removed during a colonoscopy and are further sent for biopsy to check for malignancy. If polyps cannot be removed during a colonoscopy, they are removed through laparoscopic surgery. Laparoscopic surgery is a minimally invasive procedure where polyps are removed and sent for biopsy. Generally, surgery is not necessary in the case of colon polyps.

What are the Risks Involved in Surgery?

Polypectomy risks include:

  • ● Perforation or rectal bleeding.
  • ● Severe pain or bloating.
  • ● Infection at the surgical site.
  • ● Vomiting.

What are the Prevention Measures?

  • ● A fiber-rich diet eases the movement of the food through the colon and can prevent the formation of polyps.
  • ● Increase the intake of vitamin D and calcium.
  • ● Reduce the intake of red meat, high-fat foods, and processed foods.

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FAQ's

Are Polyps Almost always PreCancerous?

No. Polyps are generally harmless if not associated with any other underlying conditions.

How Long Does it take to Heal After Polypectomy?

Recovery is relatively quick and usually not associated with any major complications. A few minor side effects include bloating, gassiness, and cramping, which subside in a couple of days. Full recovery can take up to 2 weeks.

Is it Necessary to Surgically Remove Polyps if they are Non-Symptomatic?

Even if Polyps are non-symptomatic and non-cancerous, the risk of colon cancer increases if a polyp grows. Thus, it is always removed if discovered during a colonoscopy.

Can Polyps Recur After Removal?

Polyps, once removed, usually do not grow again. However, they may show up at another location if the patient has a predisposition that caused the polyp in the first place.

Can Polyps Resolve Themselves?

Sometimes, Polyps go away on their own. But if present, removing them is important.

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