Colon polyps: removal, causes and diagnosis

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• Symptoms of colon polyps
• Risk factors
• Diagnosis of neoplasms
• Treatment
• Popular questions

Colon polyps

- these are benign formations, which are usually asymptomatic and are most often found in patients complaining of discomfort, intestinal dysfunction, pain in the anus, pathological discharge from the anus, which also occurs in other diseases (hemorrhoids, paraproctitis, anal fissure , colitis, rectal cancer, etc.).

The prevalence of formations increases with age and ranges from 25 to 35% among the population over 50 years of age.

The clinical significance of this pathology is due to the fact that from 70 to 95% of colorectal cancer cases develop in the “polyps-cancer” sequence Source: Vladimirova A.A. The use of aquascopy in the diagnosis of colorectal polyps / A.A. Vladimirova [and others] // Bulletin of the All-Russian Scientific Center of the Siberian Branch of the Russian Academy of Medical Sciences. - 2006. - No. 6 (52). — P. 32-35. .

What is a polyp?

A polyp is a small, benign growth that sometimes appears on the inside of the colon or rectum (anus). Some people may only have one polyp, but it is also quite common for people to have two or more polyps at the same time. A colonic polyp may have a “leg” and a “head” and resemble a fungus growing from the inner lining of the intestine. There are other types of polyps that have a flatter shape, like a “growth” on the inner surface of the intestine. Most often, polyps form in the left half of the colon - the descending colon and the sigmoid colon. But polyps can also be in other parts of the intestine.

A little anatomy, causes of growth and classification

Polyps in the sigmoid colon occur due to inflammatory processes in the intestines.

Polyps are benign neoplasms. They are formed in hollow organs - the intestines, uterus, nasal passages.

In the sigmoid colon, polyps form from cells lining the inner lumen of the intestine. The shape of the new growth is varied - spherical, mushroom-shaped, resembling a bunch of grapes. The polyp is attached to the wall of the organ on a thin stalk. Causes of sigmoid colon polyposis:

• chronic inflammatory processes in the intestines;
• violation of the microflora of the gastrointestinal tract;
• genetic causes - in 35% of patients, polyposis of various organs was observed in close relatives;
• male representatives are in the high-risk area. This pathology is diagnosed 3 times more often in men than in women;
• physical inactivity and, as a result, congestion in the gastrointestinal tract, defecation disorders and inflammatory processes;
• failure to adhere to the principles of healthy eating. The diet is poor in plant foods and coarse fiber. This impairs intestinal motility.

Thus, polyps are an unpleasant consequence of various gastrointestinal diseases and an unhealthy lifestyle. Types of polypous growths in the sigmoid colon:

1. Hyperplastic - light, small in size - no more than 0.5 cm - plaques. The likelihood of degeneration into a malignant tumor is extremely low.
2. Adenomatous - sizes range from 1 to 5 cm. The risk of degeneration is extremely high. This type is a precancerous formation. Due to their large size, they can provoke intestinal obstruction or bleeding.
3. Diffuse – multiple lesions of the mucous membrane. They arise due to a genetic predisposition to polyposis and, as a consequence, Peutz-Jeghers pathology, Cowden, Lynch, Gardner, and Turko syndromes.

Briefly about the gastrointestinal tract

The colon and rectum (anus) are parts of the gastrointestinal tract. The gastrointestinal tract begins at the level of the mouth and ends in the anal canal. When we eat or drink, food and liquid from the mouth travel through the esophagus to the stomach. The stomach processes food and pushes it into the small intestine. The length of the small intestine is several meters and it is in it that the main processes of digestion and absorption of nutrients occur. Undigested food, water and waste then enter the colon. The largest part of the large intestine is called the colon, and is about 150 centimeters long. It is divided into 4 sections: the ascending colon, the transverse colon, the descending colon and the sigmoid colon. The colon primarily absorbs water and some salts. The colon continues into the rectum, its length is from 15 to 20 centimeters. The rectum accumulates feces (stool) before it is emptied.

Symptoms of the disease

Discomfort in the anus may be a sign of polyps.

Polyposis of the sigmoid colon in the initial stages is asymptomatic. The patient can learn about the presence of pathology during a routine examination of other organs.

Multiple growths can cause some discomfort, but the first specific symptoms occur when the tumor reaches a size of more than 3 cm. Symptoms of sigmoid colon polyposis:

• pain, attacks of itching when trying to sit down or change body position;
• blood in stool after bowel movement. Some types of polyps can cause heavy bleeding;
• presence of mucus in feces;
• attacks of diarrhea alternate with delayed bowel movements. There may be a false urge to defecate;
• various signs of dyspepsia - nausea, vomiting, increased gas formation;
• large polyps may fall out of the anus;
• in severe cases - obstruction, fever, general weakness.

Types of colon polyps

Typically, colonic polyps are divided into three types: hyperplastic polyps, adenomatous polyps (adenomas), and polyps in polyposis syndromes.

It is quite difficult to determine the degree of risk of an adenoma degenerating into cancer. Clinical studies have been conducted that have shown that if a patient has a single polyp adenoma measuring 1 cm, then the risk of its degeneration into colon cancer within 10 years is 1 in 12, and within 20 years – 1 in 4. Also described and predisposing factors for the degeneration of an adenoma into a tumor, for example, the larger the adenoma, the higher the risk. There are also different subtypes of adenomas, some of which have a much higher risk of developing into cancer than others.

Further we will talk only about hyperplastic and adenomatous polyps, which are most often found in adults.

How are polyps diagnosed (identified)?

Most often, colon polyps are discovered during this study. Colonoscopy is a diagnostic method in which the doctor examines the entire colon from the inside. A colonoscope is a thin flexible telescope tube. The thickness of a colonoscope is approximately equal to a finger. It enters through the anus and further into all parts of the colon until it reaches the cecum (the junction of the small and large intestines). A colonoscope has fiber optic channels that transmit light to a camera at the end of the machine. This allows the doctor to examine your intestine from the inside.

Sometimes other testing methods are used to diagnose colon polyps, such as barium enema (a special X-ray test with contrast), sigmoidoscopy (similar to colonoscopy, but uses a shorter telescope), and sigmoidoscopy.

When performing sigmoidoscopy, it is possible to examine the lowest section of the colon - the rectum and the beginning of the sigmoid colon, that is, the final 15-20 centimeters of the colon.

During sigmoidoscopy, the lower third of the colon is examined. Both studies are performed on an outpatient basis and do not require lengthy preparation.

In contrast, a colonoscopy allows you to examine the entire colon. To conduct the study, preliminary preparation of the intestine (cleaning the intestine of feces) is required.

Although stool occult blood testing is an important test for diagnosing various colon diseases, a negative result on this test does NOT guarantee the absence of polyps. If at least one polyp is detected, a complete examination of the colon is required, since in 30% of cases polyps are multiple.

As mentioned earlier, the vast majority of polyps do not manifest themselves in any way. Therefore, in a large number of people who have polyps, they will never be diagnosed (not detected). The above diagnostic methods may be prescribed if you have any characteristic symptoms or if there are other reasons. For example, if a stool test for occult blood is positive, a colonoscopy should be ordered to accurately examine the colon.

Benefits of treatment at GMS Hospital

At GMS Hospital, rectal polyps are treated using advanced minimally invasive techniques. The choice of surgical intervention method depends on the shape, type, size and location of the tumor. The main advantages of treating colon polyps in our clinic:

• operations are performed by experienced doctors of the highest category;
• the whole procedure takes 20-30 minutes;
• a histological analysis of the removed polyp is immediately performed;
• the use of endoscopic technologies allows you to avoid hospitalization;
• absence of surgical complications;
• rapid recovery after intervention.

Our specialists remove polyps using special electrosurgical equipment. The operation is performed quickly, safely and painlessly, and the removed tissue is immediately sent for histological analysis. The use of minimally invasive technologies ensures rapid wound healing and a speedy return to the usual rhythm of life.

How are colon polyps treated?

If you have a colon polyp or polyps, you will most likely be asked to have them removed, even if the presence of the polyps is not associated with any symptoms. This is done in order to prevent the risk of malignant degeneration of polyps into a cancerous tumor in the future.

Most colon polyps can be removed during a colonoscopy. The colonoscope has a channel through which special long instruments are inserted into the intestinal lumen, with the help of which the polyp is removed. This may be a forceps-like instrument that grasps and lifts the polyp from the intestinal wall, usually used to remove very small polyps. There are other instruments, at the end of which there is a wire electrosurgical loop, with the help of which the polyp is “cut off” from the intestinal wall and at the same time the vessels are cauterized to prevent bleeding.

Typically, the polyp removal procedure is painless and can be performed on an outpatient basis. Patients may also be offered a colonoscopy with the removal of polyps in a state of medicated sleep (“under sedation”, “under anesthesia”), in which case the risk of pain during the procedure is reduced to zero.

Sometimes, multiple procedures may be required to remove large polyps. If the size and location of the polyps do not allow their endoscopic removal, surgical intervention is required.

After the polyp is removed, it is sent for histological examination (examination under a microscope). This is done to make sure that the polyp has been completely removed, to determine the type of polyp, whether it is benign (not cancerous) or whether there are signs of malignant degeneration.

Risk factors

Risk factors and mechanisms of colon polyps are being actively studied. Among the environmental factors, the nature of nutrition is significant, with a predominance of refined foods in the diet, which contribute to constipation and prolonged stasis of intestinal contents. Dysbacteriosis of the colon has some influence on the occurrence of polyps, reflecting a violation of local and decreased general immunity, contributing to changes in the differentiation and regeneration of mucosal cells. The role of concomitant diseases of the biliary system and impaired production of bile acids, which have a mutagenic effect on the mucous membrane, is also noted as a risk factor. Active chronic inflammation and mucosal dysplasia play a certain role in the occurrence of polyps.

Colonoscopy with removal of polyps (endoscopic polypectomy) is possible:

• free of charge within the framework of compulsory health insurance, that is, under the compulsory medical insurance policy, if there is a referral from a medical institution or a territorial health authority;
• free of charge as part of high-tech medical care, if a previously performed biopsy confirms the malignant degeneration of the polyp;
• on a contractual basis at the request of the patient.

Diagnostic colonoscopy, as well as removal of polyps during colonoscopy, can be performed with intravenous sedation (pain relief).

Preventive actions

Healthy eating will become an effective preventive measure.

This disease does not select the patient’s gender or age. But by following the rules of prevention, you can avoid this pathology. Doctors recommend:

1. Adjust your diet. You should not get carried away with diets, it is enough to adhere to the principles of healthy eating.
2. Quitting smoking, eating spicy foods, and drinking alcohol in large quantities. This will have a beneficial effect on all body systems.
3. Maintaining a drinking diet.
4. Watch your weight.
5. When the first signs of pathology appear - blood or mucus in the stool - do not delay, but consult a doctor. This disease is treated by proctologists, coloproctologists, and gastroenterologists.
6. According to indications, carry out the necessary operational measures.

A polyp is a benign neoplasm, but under certain conditions it can degenerate into malignant tumors. Don't delay your visit to the doctor. It’s easy to lose health, but it’s not always possible to restore it.