Critical facts on colorectal polyps

What goes on in our colon is likely not on our radar. If nothing is out of the ordinary, we assume everything is fine. Yet polyps, an abnormal growth on the inner surface of the large intestine (colon), is one of the most common colorectal conditions affecting between 15% to 40% of the adult population. They are also more common in men and older adults.

Polyps can occur anywhere in the large intestine including the rectum. However, the primary area most polyps are found are in the left colon, sigmoid colon, or rectum. Most polyps begin as benign (noncancerous) growths.  The majority of polyps are benign but some may turn into cancer over time. Because the relationship of polyps leading to cancer in the colorectal area is well established, this is why screening for polyps during a colonoscopy, is an important tool for finding these growths and removing them when found.

What causes colorectal polyps?

It is not completely understood what causes colorectal polyps. Some research suggests that certain factors such as age and family history can increase a person’s risk for developing polyps.

Who should be tested for colorectal polyps?

Everyone should discuss with their doctor of what age to begin testing for colorectal polyps. Anyone age 50 or older should be tested but screening at a younger age may be recommended if a person has symptoms or if they have a family history, such as a parent or sibling diagnosed with polyps or colorectal cancer.

If a polyp is found during a colonoscopy, total removal of the polyp is advised. The vast majority of polyps are removed by snaring them with a wire loop passed through a device or small polyps can be destroyed by touching them with a coagulating electrical current.  Most colorectal polyps can be removed on an outpatient basis with minimal discomfort.

What are the risk factors for colorectal polyps?

Anyone can develop polyps in the colorectal area but there are individuals who will have a greater chance of developing them if they:

·      Are over the age of 50

·      Have someone in their family who has had polyps or colorectal cancer

·      Have had polyps before

·      Have inflammatory bowel disease such as ulcerative colitis or Crohn’s disease

·      Are obese

·      Drink alcohol

·      Don’t exercise

·      Smoke cigarettes or use chewing tobacco

·      Had uterine or ovarian cancer before age 50

What are the symptoms?

The majority of people with colorectal polyps do not have symptoms. The main way doctors discover them is when a colonoscopy is performed. If a colon polyp does cause symptoms, they may manifest themselves if a person:

·      Has bleeding from their rectum – they may notice blood on their underwear or on toilet paper after having a bowel movement.

·      Has blood in their stool. Blood can make stool look black or can show up as red streaks in the stool.

·      Feels tired because they have anemia and not enough iron in their body. Bleeding from colorectal polyps can lead to anemia due to blood loss and a lack of iron.

·      Any changes in bowel habits such as constipation or diarrhea that lasts more than a week.

·      Has mucus drainage from the anus.

Anyone who is experiencing any of the above symptoms needs to contact their doctor right away.

How are colorectal polyps diagnosed?

There are several ways polyps can be diagnosed.   A colonoscopy has been the main way of finding polyps.  This procedure uses a long, flexible instrument which allows inspection of the entire colon. Bowel preparation is required before the procedure and sedation is used.  If a polyp is found during the procedure, they most likely will be removed right away.

Flexible sigmoidoscopy is a procedure that uses a flexible, narrow tube with a light and tiny camera on one end to look inside the rectum and lower colon. Flexible sigmoidoscopy can show irritated or swollen tissue, ulcers, polyps, and cancer.

Virtual colonoscopy is another method for finding polyps. A thin, flexible tube in inserted into the rectum and inflates it with air. X-rays are taken and computers create pictures of the large intestine to be viewed on a screen. This scan takes less time than a colonoscopy but bowel preparation is still required. If the scan finds polyps, a person will then need a colonoscopy to remove the polyp.

There is also a stool test a person can do.  A stool sample is sent to a laboratory to be inspected for signs of cancer, such as blood found within the stool. 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.

How can polyps be prevented?

Even though there is no sure way of preventing polyps, there are several things one can do to lower their risk.  Research suggests that making the following changes may have health benefits lowering the risk of developing polyps:

·      Eat more fruits and vegetables and less fatty foods

·      Do not smoke or use chewing tobacco

·      Avoid alcohol

·      Exercise most days of the week

·      If overweight, lose weight

·      Eat more foods with calcium such as milk, cheese, yogurt, and broccoli

·      Cut back on or avoid processed meat such as bacon, sausage, hot dogs, and lunch meats

Can polyps come back?

If a polyp is removed completely, it is unusual for it to return in the same place.  The same factors that caused it to grow to begin with, can still cause polyp growth in a different location in the colon or rectum.  New polyps will develop in at least 30 percent of people who have previously had polyps.