Introduction
Colon polyps are small groups of cells that form on the surface of the colon. Most colon polyps are harmless. But some colon polyps can turn into colon cancer, which can be fatal.
What Are the Types of Polyps?
There are two main types of polyps - neoplastic and non-neoplastic.
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Non-neoplastic polyps are unlikely to develop into cancer. Non-neoplastic polyps include hyperplastic polyps and inflammatory polyps.
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Neoplastic polyps include adenomas. Most colon polyps are adenomas. These polyps can turn cancerous if left untreated or unnoticed for a long time. Larger the polyp size, the greater the risk of cancerous transformation.
Polyps may have a flat or raised appearance. Adenomas are subdivided based on their growth patterns:
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Tubular.
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Sessile.
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Serrated.
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Villous.
What Are the Symptoms of Colon Polyps?
Most colon polyps are asymptomatic and are usually diagnosed during the examination of the colon.
A Few symptoms of colon polyps include:
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Rectal Bleeding: Rectal bleeding is a sign of colon polyps and colon cancer.
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Stool Color Change: The Stool may appear as black or red streaks in the stool because of blood.
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Pain: Abdominal cramping and pain can occur because of a large colon polyp obstructing the bowel.
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Change in Bowel Habits: Constipation or diarrhea lasting longer than a week can indicate colon polyps or colon cancer.
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Iron Deficiency Anemia: Bleeding from polyps can result in iron deficiency anemia causing shortness of breath and tiredness.
What Are the Causes of Colon Polyps?
Colon polyps can develop anywhere in the large intestine. Mutations in specific genes cause irregular growth of cells in the colon resulting in polyps.
What Are the Risk Factors?
Factors that increase the risk of colon polyps include:
- Age: 50 years or old are at increased risk.
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Intestinal Diseases: Inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease increase the risk of colon cancer.
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Family History: There is an increased risk of colon polyps in patients with a close family history of colon polyps or cancer.
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Smoking and Alcohol: Excess alcohol use combined with smoking can increase the risk of colon polyps.
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Obesity: Overweight, excess fat intake, and lack of exercise can increase the risk.
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Race: Black Americans are at increased risk of developing colon cancer.
Some of the genetic conditions that can cause colon polyps to include:
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Lynch Syndrome: People with Lynch syndrome develop few colon polyps, but those polyps have the tendency to turn malignant quickly. Lynch syndrome is the most common form of inherited colon cancer.
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Familial Adenomatous Polyposis (FAP): This is a rare disorder that causes hundreds or thousands of polyps in the lining of the colon. If they are untreated, they can turn into colon cancer.
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Gardner’s Syndrome: This syndrome is a variant of familial adenomatous polyposis, and polyps develop in the colon and small intestine.
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Peutz-Jeghers Syndrome: This is a condition in which freckles develop all over the body and noncancerous polyps develop in the intestines, which may turn cancerous.
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Serrated Polyposis Syndrome: Multiple serrated adenomatous polyps develop in the upper part of the colon.
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MYH Associated Polyposis: A problem with the MYH gene causes colon polyps.
How Can We Diagnose Colon Polyps?
A screening test helps in detecting colon polyps before they turn cancerous. These screening tests also detect colon cancer in its early stages.
Screening methods are:
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Colonoscopy: It is the most reliable test for colon polyps and colon cancer. If polyps are found, they are removed immediately, or tissue samples are taken for examination.
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Computed Tomography (CT) Colonography: It is also known as virtual colonoscopy. This test uses a computed tomography scan to view the colon. This test is minimally invasive.
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Flexible Sigmoidoscopy: A thin tube with a light and a camera is inserted through the rectum to view the sigmoid colon and rectum. This test does not show the entire colon, and some polyps and cancer growths may be missed during this test.
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Stool Tests: This test is used to identify the presence of blood in the stool.
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Barium Enema: Liquid barium is injected into the rectum, and x-rays are taken to view the images of the colon.
How Can We Prevent Colon Polyps?
Regular screening can prevent the risk of colon polyps and colon cancer.
Some lifestyle modifications also prevent colon polyps, including:
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Healthy Diet: Add more fruits, vegetables, and grains and reduce fat. Exercise regularly and maintain healthy body weight. Avoid smoking and limit alcohol consumption.
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Calcium and Vitamin D: Calcium and vitamin D consumption has preventive benefits against colon cancer.
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High-Risk People: Genetic counseling is advised for people with a family history of colon polyps.
What Is the Treatment?
The treatment involves the removal of all the polyps present.
The removal options are:
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Removal With a Forceps or Wire Loop (Polypectomy): Small polyps are removed with forceps. If a polyp is too large, a liquid is injected under the polyp to lift and isolate the polyp from the nearby tissues so that it can be removed easily.
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Laparoscopy: Polyps that are too large are removed with a minimally invasive surgical procedure called laparoscopy, in which an instrument called a laparoscope is inserted into the abdomen.
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Colon and Rectum Removal: In the presence of a rare inherited condition, surgery is done to remove the entire colon and rectum to prevent life-threatening cancer.
What Is Follow-up Care?
Adenomatous or serrated polyps are at increased risk of developing cancer. The risk depends upon the number of polyps, size, and characteristics of the polyps removed. Regular follow-up screening tests for polyps should be done.
Colonoscopy is recommended:
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In five to ten years, if one or two small adenomas were present.
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In three to five years, if three or four adenomas are present.
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In three years, if adenomas are larger than 10 millimeters or five to ten adenomas were present.
Conclusion
Colon polyps are small growths on the lining of the large intestine of the digestive tract. Most polyps are harmless, but some can convert into cancer growth over a period of time. The treatment involves the surgical removal of all the polyps present.
