Colon polyps are a cluster of cells that grows in the last part of the digestive tract called the colon. Polyps are usually benign, but can some develop into cancer. The colon is located at the end of the digestive tract and has the job of reabsorbing water from the digested matter and making solid waste. DNA normally controls how the cells grow and reproduce. In colon polyps, the DNA of these cells has a mutation that allows them to grow and reproduce at higher rate than normal. Instead of dying like a normal cell would, these cells live longer. Polyps come in two main shapes: sessile (large and flat) or pedunculated (stalk with a ball at the end). The cell growth in polyps comes in three types: adenomatous (most polyps, most likely to become cancerous), hyperplastic (less common, rarely turn into cancer), and inflammatory (found usually in Crohns disease or ulcerative colitis). Most of the time, you will not have any symptoms of colon polyps so doctors recommend screening for polyps. Screening with colonoscopy at regular intervals can be done to remove polyps and prevent them from becoming cancer. Risk factors for having colon polyps include eating a diet high in fat and low in fiber, being over 50 years old, having a family member with colon polyps or colon cancer, having inflammatory bowel disease (Crohns disease or ulcerative colitis), smoking cigarettes, drinking alcohol, being sedentary (a couch potato), and being overweight. Certain inherited gene mutations can put you at an increased risk for colon polyps and colon cancer including familial adenomatous polyposis (FAP), Gardner’s Syndrome, MYH-associated polyposis (MAP), Lynch syndrome (hereditary nonpolyposis colorectal cancer or HNPCC) and Peutz-Jehgers syndrome.
No symptoms, bleeding from the rectum, blood on the stool, constipation, diarrhea, pain, inability to have a bowel movement
If you are having symptoms, your doctor will talk to you about your history and do a physical exam. Because polyps do not usually cause symptoms, your doctor will recommend screening. Screening for polyps can be done with stool tests to look for blood which need to be done regularly. The disadvantage of stool testing for blood is that it may not test positive if they are not currently bleeding. Another screening method is colonoscopy or flexible sigmoidoscopy at the age of fifty if not earlier. A colonoscopy involves going into a doctor’s office, being made sleepy with medication through an IV, then the doctor will place a thin tube with a camera on the end (a scope) into the rectum and into the colon. The doctor will be able to look at the image on a television during the procedure and will be able to remove most polyps with very small instruments at that time. A flexible sigmoidoscopy is the same test but only looks at the first part of the colon. Another method to look at the colon involves placing a dye in the colon called barium then taking a picture with an x-ray machine. This procedure is good to visualize polyps, but cannot remove the polyps like colonoscopy. Computerized tomography (CT) can also be used to look at the colon for polyps but, again, polyps cannot be removed if found.
Whenever possible, the treatment of colon polyps is to remove them from the colon. Even though some types are unlikely to become cancer, it is impossible to tell what type of polyps you have until they are removed and looked at under a microscope. The majority of polyps can be removed during colonoscopy or sigmoidoscopy with a tiny tool called a snare which is inserted through the scope. The snare is a loop that surrounds the polyp and closes down to cut it off. Bleeding is prevented by cauterizing (lightly burning) the stalk of the polyp. For polyps that cannot be removed during colonoscopy, surgery will likely be necessary. The surgery is generally laproscopic, meaning that it is done by making a few small incisions in the abdomen through which small tools and a camera are placed to perform the surgery. If you are at high risk for getting colon cancer (such as people with genes leading to cancer), your doctor or gastroenterologist may recommend surgical removal of the colon. You can decrease your risk of getting colon cancer by getting adequate calcium, eating a healthy diet with plenty of fruits and vegetables, eating a good amount of whole grains, decreasing the amount of fat in your diet, staying away from alcohol, quitting smoking, being physically active and maintaining a good body weight. You should discuss your treatment options with your doctor or gastroenterologist.
