Bowel polyps, also known as colon polyps, are small growths that are found on the inner lining of the colon (large intestines) or rectum. They range in size, from several millimeters up to 10cm. (3) Moreover, some people may have just a single polyp while others have several. Anyone can develop colon polyps. You’re at higher risk if you’re 50 or older, are overweight or a smoker, or have a personal or family history of colon polyps or colon cancer.
Colon polyps often don’t cause symptoms. It’s important to have regular screening tests, such as a colonoscopy, because colon polyps found in the early stages can usually be removed safely and completely. The best prevention for colon cancer is regular screening for and removal of polyps.
Bowel polyps are small growths on the inner lining of the large intestine (colon) or rectum.
- Bowel polyps are very common, affecting around 1 in 4 people aged 50 or over.
- They’re slightly more common in men.
- Some people develop just 1 polyp, while others may have a few.
Types of bowel polyps
There are different types of bowel polyps each with unique characteristics in terms of size, location, and shape. They are grouped into two main categories, hyperplastic and adenomatous (adenoma) polyps.
Nearly 90% of bowel polyps are hyperplastic polyps and are usually harmless. (6) Typically they range from 1 to 5mm in dimension and are most commonly found in the left colon especially the rectum. (7)
Adenomatous polyps appear different from hyperplastic polyps based on how they grow. They have four main growth patterns, including tubular, villous, sessile and serrated.
Symptoms of bowel polyps
- Rectal bleeding. This can be a sign of colon polyps or cancer or other conditions, such as hemorrhoids or minor tears of the anus.
- Change in stool color. Blood can show up as red streaks in your stool or make stool appear black. A change in color may also be caused by certain foods, medications or dietary supplements.
- Change in bowel habits. Constipation or diarrhea that lasts longer than a week may indicate the presence of a larger colon polyp or cancer. However, a number of other conditions also can cause changes in bowel habits.
- Pain. A large colon polyp can partially obstruct your bowel, leading to crampy abdominal pain.
- Iron deficiency anemia. Bleeding from polyps can occur slowly over time, without visible blood in your stool. Chronic bleeding robs your body of the iron needed to produce the substance that allows red blood cells to carry oxygen to your body (hemoglobin). The result is iron deficiency anemia, which can make you feel tired and short of breath.
Causes of bowel polyps
Healthy cells grow and divide in an orderly way. Mutations in certain genes can cause cells to continue dividing even when new cells aren’t needed. In the colon and rectum, this unregulated growth can cause polyps to form. Polyps can develop anywhere in your large intestine.
In normal circumstances, immature cells on the lining of the colon and other body parts are signaled to multiply, mature then die in a consistent and timely manner.
If there is genetic mutation such as in bowel polyps, the cells divide at a faster rate, do not mature and do not die as programmed. What results is an accumulation of immature, abnormal cells that form protrusions from the lining of the large intestines.
There are two main categories of polyps, nonneoplastic and neoplastic. Nonneoplastic polyps include hyperplastic polyps, inflammatory polyps and hamartomatous polyps. Nonneoplastic polyps typically do not become cancerous.
Bowel polyps do not usually cause any symptoms, so most people with polyps will not know they have them.
They’re often picked up during screening for bowel cancer.
But some larger polyps can cause:
• a small amount of slime (mucus) or blood in your poo (rectal bleeding)
• diarrhoea or constipation
• pain in your tummy (abdominal pain)
Factors that may contribute to the formation of colon polyps or cancer include:
• Age. Most people with colon polyps are 50 or older.
• Having inflammatory intestinal conditions, such as ulcerative colitis or Crohn’s disease of the colon. Although the polyps themselves are not a significant threat, having ulcerative colitis or Crohn’s disease of the colon increases your overall risk of colon cancer.
• Family history. You’re more likely to develop colon polyps or cancer if you have a parent, sibling or child with them. If many family members have them, your risk is even greater. In some people, this connection isn’t hereditary.
• Smoking and excess alcohol use. An analysis of eight studies showed an increased risk of developing colon polyps for people who consumed three or more alcoholic drinks per day. Alcohol intake combined with smoking also appears to increase the risk.
• Obesity, lack of exercise and fat intake. Studies show that all of these factors can increase your risk of developing polyps. On the other hand, including more fiber in your diet and exercising regularly can reduce your risk.
• Race. Black Americans have a higher risk of developing colon cancer.
Diagnosing bowel polyps
Most bowel polyps are diagnosed through a colonoscopy, a procedure that detects changes in all parts of the colon and rectum. The doctor uses a colonoscope, a tube with a camera and light attached to it. The tiny camera sends images to an external monitor, allowing the doctor to visualize the colon and get tissue samples for examination.
CT colonography is less invasive and uses low dose radiation to view the interior sections of the colon. Just like an X-ray, images are generated for the doctor to review. The bowel cleansing regimen is the same as that of colonoscopy.
Treatments for bowel polyps
There are several methods for treating polyps. The most common procedure involves physically removing the polyp using a wire loop. This happens during a procedure called a colonoscopy. During a colonoscopy a flexible tube called a colonoscope is passed through your bottom and up into your bowel.
The colonoscope has a wire attached to it through which an electric current is passed. The wire is used to either burn off (cauterise) or cut off (snare) the polyp. Both methods are painless.
The most common treatment is the removal of the polyps (polypectomy) during colonoscopy. The doctor uses a wire loop to either pull tight and cut off the polyp or to cauterize (burn off). Both of these procedures are painless and can be done on an outpatient basis.
When necessary, the doctor may use a laparoscope that is inserted through the abdominal wall through small abdominal incisions. The instrument has a camera that allows the health care provider to visualize the polyps then resect them.
Surgery is rare, but it may be recommended when the polyps are too large, too many or cannot be reached during colonoscopy. Most of the operations done are laparotomy, where the surgeon makes a single large abdominal incision to remove the polyps.
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