Colon Polyps

What is a polyp?

A polyp is a small tissue growth from the lining of the bowel. It can be finger like (pedunculated) or flat (sessile).

What are the type of colonic polyps?

There are many types of colonic polyps some are rare but the two most common ones are adenomas and hyperplastic polyps.

Colonic adenoma polyps are very common affecting about 20% of the population. They are more common with increasing age. The majority of adenomas do not cause symptoms but they are very important because they change into cancer over a period of 5-10 years. There is a good evidence that nearly all colon cancers start as a colonic adenoma before changing into cancer.

Hyperplastic polyps. These are small pale elevations in the lining of the bowel. These polyps do not change into cancer however, certain types particularly when large and in big numbers can harbour adenoma that changes into cancer.

What are the symptoms of colonic polyps?

Most patients will not have any symptoms and they are picked up during a screening colonoscopy. Some patients may have bleeding or pass mucus from the back passage. Colonic polyps often cause tiny blood loss in stool that can show up on stool test (facecal occult blood test). 

How colonic polyps are diagnosed?

Colonoscopy is the best test because it is accurate and the polyps can be removed or sampled during the same procedure. Other tests include Barium enema or CT colonography can be used. If these two test showed polyps then a colonoscopy will need to be performed to confrim the findings and remove or sample the polyps.

What is the treatment of colonic polyps?

Polyps are removed (polypectomy) during colonoscopy using diathermy (electric heat) with a snare (special wire looped around the polyp) or a with hot biopsy forceps. The polyp is sent for examination by a pathologist to assess it nature. Further treatment and follow-up colonoscopy (suviellance) depends on the type, size, number, completeness of resection and other factors.

Occasionally I mark the colon at the site of the polyp with special ink. This to facilitate identifying the area of the polyp during subsequent surgery if needed.

How to prevent colon polyps?

Colon polyps are most common in developed countries and diet and lifestyle are almost certainly to blame. Though there is no clear single dietary cause for polyps and large studies are still being conducted patients will have no harm from increasing fibre in their diet. Aspirin may reduce the formation of polyps but this is still controversial.