Introduction:
Colorectal or colon polyps are small clumps of cells that grow on the colon or rectum lining. In most cases, colon polyps are harmless, but sometimes they might develop into colon cancer. If colon cancer develops due to colorectal polyps being found in a later stage, it could be fatal. Colorectal polyps can be formed in any individual. However, people in their 50s are more prone to develop it; even people who are overweight, smoker, or have a family history of colon polyps may develop colorectal polyps. Generally, colorectal polyps do not present any symptoms. Thus regular screening is important to look for polyps formation. Colorectal polyps detected in the initial stages can be easily removed. Regular screening for polyps is the best way to prevent the chances of colon cancer.
What Are the Causes of Colorectal Polyps?
The cause of polyps formation is the uncontrolled growth of healthy cells in the colon or rectum. Healthy cells grow when there is a need for cells in the lining of the colon or rectum and stop when it is sufficient. However, in cases of mutation in some genes, these healthy cells keep growing even if they are not needed and form polyps in the colon and rectal linings.
The polyps are divided into two main categories. Namely neoplastic and non-neoplastic polyps.
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Non-Neoplastic Polyps: They include inflammatory polyps, hyperplastic polyps, and hamartomatous polyps. These non-neoplastic polyps do not become cancerous.
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Neoplastic Polyps: These include adenomas and serrated types of polyps. These polyps can become cancerous if they are given enough time to grow. Most neoplastic polyps are adenomas. The larger the size of the polyp, the greater the chance it will develop into cancer.
What Are the Symptoms Seen in Colorectal Polyps?
In most cases, the colorectal polyps are asymptomatic, but in some cases, they may have some of the following symptoms:
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Rectal Bleeding: Blood coming out of the rectum can be a sign seen in cases of colorectal polyps as well as in some other conditions, such as cancer, hemorrhoids, or minor tears of the anus.
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Changes in Bowel Habits: Diarrhea or constipation lasting for more than a week may indicate the presence of larger polyps in the colon or cancer.
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Changes in Stool Color: The presence of blood in the stool can give it a red streak or black stool appearance. However, change in the color of the stool can also be due to dietary changes, certain food-containing colors, or medications.
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Pain: A large colon polyp can obstruct the bowel and lead to cramping and abdominal pain.
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Iron Deficiency Anemia: Polyps may bleed slowly over time without traces of blood in the stool. This chronic bleeding can reduce the iron in the body, which is important for the red blood cells to carry hemoglobin. This leads to iron deficiency anemia which makes the person weak and tired.
What Are the Risk Factors Which Can Lead To Colorectal Polyps?
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Age of the Person: Colon polyps are more common in people over 50.
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Presence of Inflammatory Intestinal Conditions: Conditions such as Crohn’s disease or ulcerative colitis may increase the chances of polyps formation and cancer development in the colon or rectum.
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Family History: In some cases of colorectal polyps, the origin is hereditary, as the colon polyps might be present in the parents or siblings of an individual. So it is important to take a thorough history of cases of colorectal polyps.
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Excess Alcohol Abuse and Smoking: People who are alcohol abusers and consume three or more alcoholic drinks daily are considered at risk of developing colon polyps. Even people who are regular smokers, along with consuming alcohol, are considered at risk.
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Lack of Exercise and Obesity: People who are not physically fit and lack physical activities can develop colorectal polyps.
What Are the Hereditary Conditions Which Can Cause Colorectal Polyps?
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Gardner’s Syndrome: It is a variant of familial adenomatous polyposis which causes polyps formation in the entire colon and the small intestine. In this condition, the person also develops non-cancerous tumors in other body parts, such as the abdomen, bones, and skin.
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Familial Adenomatous Polyposis: It is a rare disorder that leads to the development of hundreds and thousands of polyps in the colon's lining starting from the teenage stage. In such cases, the chances of developing colon cancer are almost 100 %.
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Lynch Syndrome: It is also known as hereditary non-polyposis colorectal cancer. People suffering from Lynch syndrome develop very few polyps which can easily turn malignant.
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Peutz-Jeghers Syndrome: It is a genetic condition that starts with the development of freckles all over the body, including the lips, feet, and gums. After this, non-cancerous polyps are formed in the entire intestines; these polyps may eventually become cancerous lesions.
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MUTYH- Associated Polyposis (MAP): This condition is similar to familial adenomatous polyposis and is caused by a mutation of the MYH gene. People suffering from MUTYH-associated polyposis develop many adenomatous polyps and colon cancer at a very young age.
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Serrated Polyposis Syndrome: It is a condition that can lead to multiple serrated adenomatous polyps in the upper right region of the colon. These polyps also have the potential to develop into cancers.
How to Make the Diagnosis of Colorectal Polyps?
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Colonoscopy: It is a diagnostic test done to locate the polyps in the colon and rectum with the help of an endoscope.
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Virtual Colonoscopy: It is a method that uses a computed tomography scan along with a colonoscopy to see the colon and rectum.
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Flexible Sigmoidoscopy: A thin, flexible tube with a camera is used to examine the rectum and the last third of the colon (sigmoid).
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Stool Tests: These tests are done when there are traces of blood in the stool.
What Is the Treatment for Colorectal Polyps?
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Polypectomy: Removal of the polyps with the help of a wire loop and the forceps. If the polyps are too large to remove by this method, then a liquid is inserted below the polyp to lift it, and then it is removed.
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Minimally Invasive Procedure With Laparoscopy: In cases of larger polyps, a minimally invasive surgical method is used in which small incisions are made, and the polyps are removed by inserting a laparoscope into the abdomen.
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Total Proctocolectomy: This method removes the colon and rectum and the polyps. This method is used in familial adenomatous polyposis, as there are hundreds of polyps in the colon and rectum.
Conclusion:
Colorectal polyps are small cellular growths in a person's colon and rectum. These polyps are formed due to several underlying causes such as older age, obesity, alcohol abuse, family history of polyps, and some genetic conditions such as familial adenomatous polyposis, Gardner’s syndrome, and many more. These polyps can potentially develop and turn into cancerous lesions if they grow and are left untreated. The treatment of colorectal polyps can be performed by polypectomy, laparoscope, or by total proctocolectomy.
