Polyps are abnormal growths rising from the lining of the
large intestine (colon) and protruding into the intestinal
canal (lumen). Some polyps are flat; others have a stalk.
Polyps
are one of the most common conditions affecting the colon
and rectum, occurring in 15-20 percent of the adult population.
Although most polyps are benign, the relationship of certain
polyps to cancer is well established.
What are the symptoms of Polyps?
Most polyps produce no symptoms and often are found incidentally
during endoscopy or x-ray of the bowel. Some polyps, however,
can produce bleeding, mucous discharge, alteration in bowel
function, or in rare cases, abdominal pain.
How are Polyps diagnosed?
Polyps are diagnosed either by looking at the colon lining
directly (colonoscopy) or by x-ray study (barium enema).
There are three types of colorectal endoscopy: (1) rigid
sigmoidoscopy, (2) flexible sigmoidoscopy and (3) colonoscopy.
Rigid sigmoidoscopy permits examination of the lower six
to eight inches of the large intestine. In flexible sigmoidoscopy,
the lower one-fourth to one-third of the colon is examined.
Neither rigid nor flexible sigmoidoscopy requires medication
and can be performed in the doctor's office.
Colonoscopy uses a longer flexible instrument and usually
permits inspection of the entire colon. Bowel preparation
is required, and sedation is often used.
The colon can also be indirectly examined using the barium
enema x-ray technique. This examination uses a barium solution
to coat the colon lining. X-rays are taken, and unsuspected
polyps are frequently found.
Although checking the stool for microscopic blood is an
important test for colon and rectal disorders, a negative
test does NOT rule out the presence of polyps. The discovery
of one polyp necessitates a complete colon inspection, since
at least 30 percent of these patients will have additional
polyps.
Do Polyps need to be treated?
Since there is no fool-proof way of predicting whether or
not a polyp is or will become malignant, total removal of
all polyps is advised. The vast majority of polyps can be
removed by snaring them with a wire loop passed through
the instrument. Small polyps can be destroyed simply by
touching them with a coagulating electrical current.
Most colon examinations using the flexible colonoscope,
including polyp removal, can be performed on an outpatient
basis with minimal discomfort. Large polyps may require
more than one treatment for complete removal. Some polyps
cannot be removed by instruments because of their size or
position; surgery is then required.
Can Polyps recur?
Once a polyp is completely removed, its recurrence is very
unusual. However, the same factors that caused the polyp
to form are still present. New polyps will develop in at
least 30 percent of people who have previously had polyps.
Patients should have regular exams by a physician specially
trained to treat diseases of the colon and rectum.
