Understanding Polyps and Their Treatment
What Is a Colon Polyp?
Polyps are benign growths on the lining of the bowel. They can occur in several locations in the gastrointestinal tract but are most common in the colon. They vary in size from less than a quarter of an inch to several inches in diameter. They look like small bumps growing from the lining of the bowel and protruding into the bowel cavity. They sometimes grow on a “stalk” and look like mushrooms. Some polyps can also be flat. Many patients have several polyps scattered in different parts of the colon. Some polyps can contain small areas of cancer, although the vast majority of polyps do not.
What Are Known Risks for Developing Polyps?
The most significant risk factor for developing polyps is a family history. Patients with a personal history of polyps or colon cancer are at risk of developing new polyps. Also, there are some rare polyp or cancer syndromes that run in families and increase the risk of polyps occurring at younger ages.
There are two common types: hyperplastic polyp and adenoma. The hyperplastic polyp is not at risk for cancer. The adenoma, however, is thought to be the precursor for almost all colon cancers, although most adenomas never become cancers. Histology examination of tissue under a microscope is the best way to differentiate between hyperplastic and adenomatous polyps.
Although it’s impossible to tell which adenomatous polyps will become cancers, larger polyps are more likely to become cancers and some of the largest ones (those larger than 1 inch) can already contain small areas of cancer. Your doctor cannot be sure of the tissue type by the polyp’s appearance; doctors generally recommend removing all polyps found during a colonoscopy.
How Are Polyps Found?
Most polyps cause no symptoms. Larger ones can cause blood in the stools, but even they are usually asymptomatic. Therefore, the best way to detect polyps is by screening individuals with no symptoms. Several other screening techniques are available: testing stool specimens for traces of blood, performing sigmoidoscopy to look into the lower third of the colon, or using a radiology test such as a barium enema or CT colonography. If one of these tests finds or suspects polyps, your doctor will generally recommend a colonoscopy to remove them.
Colonoscopy is the most accurate way to detect polyps; many experts now recommend colonoscopy as a screening method so that any polyps found or suspected can be removed during the same procedure.
How Are Polyps Removed?
Most polyps found during colonoscopy can be removed entirely during the procedure. Various removal techniques are available; most involve removing them with a wire loop biopsy forceps or burning the polyp base with an electric current. This is called polyp resection. The bowel’s lining is not sensitive to cutting or burning, and polyp resection does not cause discomfort.
Resected polyps are then examined under a microscope by a pathologist to determine the tissue type and to detect any cancer.
What Are the Risks of Polyp Removal?
Polyp removal, polypectomy, during colonoscopy is a routine outpatient procedure.
Possible complications, which are uncommon, include bleeding from the polypectomy site and perforation of the colon. Bleeding from the polypectomy site can be immediate or delayed for several days; persistent bleeding can almost always be stopped by treatment during colonoscopy.
How Often Do I Need Colonoscopy if I Have Polyps Removed?
Your doctor will decide when your next colonoscopy is necessary. The timing depends on several factors, including the number and size of polyps removed, the polyps’ tissue type and the quality of the colon cleansing for your previous procedure.
The quality of cleansing affects your doctor’s ability to see the surface of the colon.
If the polyps were small and the entire colon was well seen during your colonoscopy, doctors generally recommend a repeat colonoscopy in three to five years. If your repeat colonoscopy doesn’t show any indication of polyps, you might not need another colonoscopy for ten years.
*IMPORTANT REMINDER: The preceding information is intended only to provide general information and not as a definitive basis for diagnosis or treatment in any particular case. It is very important that you consult your doctor about your specific condition.