Intestinal Polyps - Symptoms and Treatment

The presence of one or more polyps is a common diagnosis during colonoscopy which always tends to raise questions by patients and their families.

After all, what does an intestinal polyp mean? Is polyp cancer? Do you need surgery to remove the polyp?

Before explaining the polyps in detail, we will quickly clarify three points:
  • Polyps are very common and occur in more than 30% of the adult population.
  • Not all polyps have the potential to turn into cancer, and for those that can turn around it takes many years to undergo this transformation.
  • Currently it is possible to remove polyps completely and safely.

Intestinal polyps
Intestinal polyps

What is an intestinal polyp?

Polyps are a small protuberance growing in wells coated with mucous membranes. The large intestine (colon) is the main point which arises from polyps. Intestinal polyp is a benign neoplasm that occurs by an abnormal growth of cells of the intestinal mucosa. Roughly speaking, we can say that they are a kind of wart in a colon.

The vast majority of polyps are benign and will continue to be so for the rest of life. However, depending on the type of polyp (explained below) there is a risk of transformation to cancer.

Risk factors for the development of intestinal polyps

Risk factors
Risk factors
  • Age over 40
  • Inflammatory bowel disease
  • Family history
  • Smoking
  • Sedentary way of life
  • Obesity
  • Diet high in saturated fat
  • Diet low in fruits, vegetables, fiber and calcium
  • Excess alcohol

What are the types of polyps? Which polyps can turn into cancer?

There are several types of polyps, however, two of them represent the vast majority:
  • Hyperplastic - polyps of small size, usually located in the terminal portion of the colon (rectum and sigmoid colon). They do not have the potential to turn into cancer
  • Adenomas - polyps that are at risk of turning into cancer. But less than 5% of adenomas eventually turn into a malignant lesion

On average, an adenoma takes at least seven years to turn into cancer. It is important to know that most colon cancers arise from a polyp, however, there are very few polyps that can turn into cancer.

Symptoms of intestinal polyps

Most polyps are small in size and ultimately cause no symptoms. Usually only they are detected when performing screening tests for colon cancer. Larger polyps can cause intestinal obstruction by preventing the progression of stool or have bruises by the passage of hard stools, so you can bleed.

Diagnosis of intestinal polyps

Diagnosis of polyps
Diagnosis of polyps
Currently the test of choice for the diagnosis of polyps / colon cancer screening is colonoscopy, an examination performed with an endoscope through anus. A colonoscopy is an examination, which allows the visualization of polyps as well as their withdrawal.

Only the naked eye cannot distinguish an adenoma from a hyperplastic polyp. Therefore, the removal of any polyps diagnosed histologically (microscopically) is indicated.

The adenomas are divided into three groups according to the evaluation:
  • Tubular adenoma
  • Villous adenoma
  • Tubulo-villous adenoma

The size of adenomatous polyps (greater than 1 cm) and a large quantity of a villous component (more than 25%) are the main risk factors for transformation into cancer.

Screening for colon cancer is recommended for all people over 50 years. People with a family history of first-degree relative with colon cancer before 60 should begin screening at the age of 40.

Treatment of intestinal polyps

Polyps removal
The most effective way to prevent colon cancer is early adenomatous polyps identification and removing them before they turn into a malignant lesion.

As mentioned above, the polyps can be removed by colonoscopy immediately after their identification. The removal of polyps does not hurt and usually does not cause bleeding.

Rarely, the polyp is too large for removal and it cannot be done through the colonoscope. In these cases, surgery is usually necessary for the extraction of the lesion.

The removal of polyps is safe, with the complication rate of less than 1 per 1000 procedures. The greatest risk is the colon perforation and bleeding. To minimize the risk of complications, the patient so as not to facilitate bleedings should not take drugs such as aspirin, anti-inflammatory or anticoagulants such as heparin or warfarin.

Polyposis syndromes

There are some rare diseases, genetic diseases, which manifest themselves with dozens of polyps in the digestive tract, even in youth, associated with other symptoms in various body parts. Among these syndromes can be mentioned:
  • Lynch
  • Gardner
  • Turcot
  • Cronkhite-Canada
  • Peutz-Jeghers
  • Cowden

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