What are colonic Polyps?

Colon polyps are growths that develop on the inner lining of the colon or large intestine. These growths can vary in size and shape, and some can develop into colon cancer over time.

Colon polyps are quite common, and they are usually benign or non-cancerous. However, some types of colon polyps, such as adenomatous polyps, have a higher risk of turning into cancer if they are not removed.

The exact cause of colon polyps is not known, but there are several risk factors that can increase the likelihood of developing them. These include age (polyps are more common in people over 50), a family history of colon polyps or colon cancer, a personal history of inflammatory bowel disease, a high-fat, low-fiber diet, and smoking.

Most people with colon polyps do not experience any symptoms. However, some people may experience rectal bleeding, changes in bowel habits, abdominal pain, or unexplained weight loss. These symptoms may indicate that the polyps have become cancerous, and it is important to seek medical attention if you experience any of them.

What are the types of Colonic Polyps?

There are several types of colonic polyps, but the most common types are adenomatous, hyperplastic, and serrated polyps.

Here’s a brief overview of each type:

1. Adenomatous polyps: These are the most common type of colonic polyps, and they have the highest risk of turning into colon cancer. Adenomatous polyps can be further classified as tubular, tubulovillous, or villous based on their appearance under the microscope. The larger and more complex the adenomatous polyp, the greater the risk of developing colon cancer.
2. Hyperplastic polyps: These are the most common non-cancerous type of colonic polyps. Hyperplastic polyps are typically small and do not have a high risk of turning into cancer. However, large hyperplastic polyps or those located in certain areas of the colon may be removed during a colonoscopy to be certain that they are not pre-cancerous.
3. Serrated polyps: Serrated polyps are a less common type of colonic polyp, but they have a higher risk of turning into colon cancer compared to hyperplastic polyps. They are classified as either traditional serrated adenomas or sessile serrated adenomas. They are typically located in the right colon and may be more difficult to detect during a colonoscopy.

There are other less common types of colonic polyps, such as juvenile polyps, inflammatory polyps, and hamartomatous polyps, but these types are less likely to turn into colon cancer.

It’s important to note that most colonic polyps are non-cancerous, but the risk of developing colon cancer increases as the size and number of polyps grow.

 

How can Colonic Polyps be detected?

Colonic polyps can be detected through various methods, including:

1. Colonoscopy: This is the most common and effective method of detecting colonic polyps. During a colonoscopy, a long, flexible tube equipped with a camera is inserted into the rectum to examine the entire colon. If polyps are found, they can be removed during the procedure.
2. Computed tomography (CT) colonography: Also known as virtual colonoscopy, this is a non-invasive imaging test that uses a CT scanner to create images of the colon. If polyps are found, a follow-up colonoscopy is typically recommended to remove them.
3. Flexible sigmoidoscopy: This is a similar procedure to a colonoscopy, but it only examines the lower part of the colon. It is less invasive than a colonoscopy, but it may miss polyps located higher up in the colon.
4. Fecal occult blood test (FOBT): This is a simple test that checks for the presence of blood in the stool, which may indicate the presence of colonic polyps or colon cancer. However, this test is not as reliable as colonoscopy for detecting polyps, as it may miss small or non-bleeding polyps.

Stool DNA test: This is a newer test that checks for DNA changes in the stool that may be associated with colon cancer or polyps. This test is less invasive than a colonoscopy, but it may not detect all types of polyps.

If colonic polyps are detected during any of these tests, a follow-up colonoscopy is typically recommended to remove them. Regular screening for colonic polyps is important, particularly for people over the age of 50 or those with a family history of colon cancer or polyps. Early detection and removal of polyps can prevent them from turning into cancer.

How are Colonic Polyps treated?

Colonic polyps can be treated by removing them during a colonoscopy. The removal of polyps is a straightforward procedure, and most people do not experience any complications.

There are two main methods for removing colonic polyps:

1. Snare polypectomy: This is the most common method for removing polyps. A wire loop, known as a snare, is passed through the colonoscope, and positioned around the base of the polyp. The snare is then tightened, cutting the polyp from the colon wall.
2. Endoscopic mucosal resection (EMR): This method is used for larger or more complex polyps. A special solution is injected beneath the polyp to lift it away from the colon wall. A snare is then used to remove the lifted polyp.
3. Large Polyps which have evidence of high grade dysplasia may need surgical removal. This is usually achieved by removing that segment of the colon which is then sent for further evaluation. Surgery can be carried out via the laparoscopic, robotic or open method depending on various factors.

After the polyps are removed, they are typically sent to a laboratory for analysis to determine if they are cancerous or pre-cancerous. If the polyps are cancerous, further treatment may be necessary, such as surgery or chemotherapy.

It is important to note that not all polyps need to be removed. Small, non-cancerous polyps, such as hyperplastic polyps, may not require treatment. Your doctor will determine the best course of action based on the size, location, and type of polyp, as well as your personal medical history and risk factors.

Is family history an important factor when it comes to colonic polyps?

Yes, family history is an important factor when it comes to colonic polyps. People with a family history of colon polyps or colon cancer have an increased risk of developing polyps themselves.

If a first-degree relative (parent, sibling, or child) has had polyps or colon cancer, your risk of developing them is two to three times higher than the general population. If multiple relatives have had polyps or colon cancer, or if the condition developed at a young age, your risk is even higher.

In some cases, genetic mutations can increase the risk of developing colon polyps and cancer. For example, people with a hereditary condition called familial adenomatous polyposis (FAP) have a nearly 100% risk of developing colon cancer by the age of 40 if the condition is not treated. Other genetic conditions, such as Lynch syndrome, can also increase the risk of colon cancer.

If you have a family history of colon polyps or cancer, it is important to discuss your risk with your doctor. They may recommend more frequent screening, such as starting colonoscopies at an earlier age or having them more frequently than the recommended intervals. Other measures, such as a healthy diet, regular exercise, and avoiding smoking and excessive alcohol consumption, can also help reduce your risk.

 

Get in touch with us for any further queries.

Our team of experienced Medical and Surgical Gastroenterologists will guide you about the most appropriate investigations and treatment for colonic polyps. Do get in touch with us if you have a family history of polyps or colonic cancers.

Early detection and treatment is a curative modality in these instances.

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