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Polyps of the Colon and Rectum

What are colon polyps?


Colon polyps are abnormal growths of tissue that arise from the lining of the colon. Presence of the polyps is usually not known unless there is bleeding or an examination of the colon is conducted. If colon polyps are present for several years, they can lead to the development of colon cancer.

The following points should be considered:
• Colon Polyps are common (People over 50 are more likely to get colon cancer than younger people)
• Genetic factors may also play a part in colon polyps
• Most colon polyps are harmless and not all polyps develop into cancer
• Colon polyps usually can be removed safely

TYPES OF COLON POLYPS


There are four types of colonic polyps: adenomatous, hyperplastic, harmartomatous and inflammatory. But the most common types of polyps are two hyperplastic and adenomatous polyps.

Adenomatous Polyps


Adenomas (adenomatous polyps) are the most common type of colon polyps, Two-thirds of colon polyps are adenomas. Most of these polyps do not develop into cancer, although adenomas have the potential to develop into colorectal cancer. In general, the larger the adenoma, the more likely it is to eventually become a cancer. As a result, large polyps are usually biopsied or removed completely to allow for microscopic examination.

Hyperplastic polyps


Hyperplastic polyps are usually less than 10 mm in size found in the colon. Hyperplastic polyps have no potential to develop into cancer and are not worrisome.

Hamartomatous polyps


Hamartomatous polyps are often found by chance in the small intestine and small bowel. The disease caused by hamatomatous polyps is Peutz-Jegher or Juvenile Polyposis Syndrome.

Inflammatory polyps


Inflammatory polyps are growths which occur with chronic inflammation. These are seen usually in chronic ulcerative colitis where patients may have dozens of inflammatory polyps. These are not precancerous. Sometimes, because of bleeding, inflammatory polyps require removal.

What are the symptoms of colon polyps?


The majority are not associated with any symptoms. Some colon polyps can cause bleeding, mucous discharge, and changes in bowel habits.

How are colon polyps diagnosed?


Colon Polyps are diagnosed by either viewing the lining of the colon directly (colonoscopy) or by x-ray study (barium enema). Colonoscopy uses a flexible endoscope to visualize the polyp and sedation is often used. The colon can also be examined by using the barium enema x-ray. Colonoscopy is preferred by most as it allows your doctor to remove polyps at the time of the procedure. Since polyps occur in 15-20% of Americans, a screening colonoscopy is recommended for all people 50 years of age and at age 40 for those with a family history of polyps or colon cancer.

How are colon polyps treated?


Small polyps can be removed at the time of colonoscopy. Larger polyps may require surgery. A laparoscopic surgical approach is ideal for large polyps requiring treatment.

References: Blumberg D, Opelka FG, Hicks TC, Timmcke AE, Beck DE. Significance of a Normal Surveillance Colonoscopy in Patients with a History of Adenomatous Polyps. Dis Colon Rectum, 2000; 43:1084-1092

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