Colorectal Polyps

Recommend to others!


Colorectal polyps are growths that develop in the colon or at the level of the rectum. Their cause is still unknown. Most colorectal polyps are benign. One type of colorectal polyps may be the precursor of colorectal cancer. Therefore, regular screening is very important in people over 50 years or those with an increased risk of colorectal cancer.


Colorectal polyps are usually asymptomatic, symptoms appearing only when they are larger than 1 cm or when they are cancerous. The most common symptom is rectorrhagia (elimination of red blood in the stool). Sometimes bleeding can not be immediately noticed, it is hidden, and can be discovered only with the help of a screening test of a stool, called fecal occult blood test. Colorectal polyps do not usually cause pain or changes in the bowel transit, unless they are large and clog a part of the colon. These symptoms are rare because polyps are discovered and removed before they become large enough so as to produce symptoms. Once the cancer appears, other symptoms may also occur, such as changes in the bowel transit or significant weight loss.


The only way to find colorectal polyps, except when they are large and cause pain and bleeding, is to perform one or more investigations of the colon mucosa. More tests can be used in order to determine colorectal polyps. Two of them, rectosigmoidoscopy with a flexible tube and colonoscopy, can also be used to collect tissue biopsy (tissue samples) or to remove polyps. All tests are used for the screening of colorectal polyps or colorectal cancer and they are followed by other tests after the polyps were removed.
These tests are:
- Fecal occult blood tests. These are done in order to discover microscopic amounts of blood in the stool. It is a simple test to perform, it has a low cost and it is used for diagnosing colorectal polyps or colorectal cancer. Studies have shown that this test decreased the number of deaths from colorectal cancer. By itself, this test can not determine the accurate diagnosis of colorectal polyps or colorectal cancer and a negative test does not rule out the presence of a colorectal cancer. If it is positive (blood in the stool), a colonoscopy must be performed in order to identify the reason for bleeding and to remove the eventual polyps.
- Sigmoidoscopy with a flexible tube. This allows the doctor to observe the surface of the colon located in the lower third. During a sigmoidoscopy, tissue samples from the growths can be collected (biopsy pieces), and sometimes precancerous or cancerous growths can be removed. Although a sigmoidoscopy does not see the entire colon, a study showed that this test combined with a test fecal occult blood test, can detect 76% of the advanced forms of polyps and cancers.
- Colonoscopy. This screening method allows the doctor to inspect the entire colon for polyps or cancerous forms. During colonoscopy, samples are taken from any growths that are present (biopsy) and sometimes even from the precancerous or cancerous tissue, which can be removed this way. A colonoscopy is recommended every 10 years, beginning with the age of 50 years in people who have a medium risk of developing colorectal cancer and in cases when another screening test is positive for colorectal polyps or cancer. Colonoscopy is recommended beginning with the age of 40 years, if there is a family history of colorectal cancer in first degree relatives aged up to 60 years; every 5 years after the removal of one or more polyps; every 1-2 years to people of 20-25 years who have a history of transmission of a familial colorectal cancer syndrome.
- Double-contrast barium enema (barium enema). This examination is a radiographic method of examining the colon. This double-contrast barium enema can be used to screen for colorectal cancer because it detects all the polyps throughout the colon. It can more accurately detect the large polyps or cancer than the fecal occult blood test combined with flexible sigmoidoscopy. Barium enema is not as accurate as colonoscopy. Barium enema detects 83% of precancerous polyps (adenomatous) larger than 1 cm, compared with a 95% diagnosis made by colonoscopy. Barium enema can not visualize small polyps, they can be taken for pieces of stool and does not allow to take samples of biopsy or the removal of polyps. Researches are made in order to find other methods of detecting colorectal cancer, including genetic testing or virtual colonoscopy, which is a noninvasive screening method that uses computed tomography (CT) to visualize the colon.


Screening for colorectal cancer
The screening performed with only one test or more tests combined, decreases the risk of complications and death from colorectal cancer. Groups of experts recommend a routine screening for colorectal cancer to all people over 50 years who have a medium risk of colorectal cancer. These people do not have a family history of colorectal cancer or polyps, did not have colorectal polyps or cancer and do not have symptoms of colorectal cancer.
Screening test options:
- Fecal occult blood test
- Flexible sigmoidoscopy every 5 years
- Fecal occult blood test combined with sigmoidoscopy with flexible tube every 5 years
- Double-contrast barium enema every 5 years
- Colonoscopy every 10 years.
If there is an increased risk of developing colorectal cancer, screening begins earlier or it is done more often. If there is family history of colorectal cancer, investigations begin at the age 40 years or at an age 10 years less than the nearest family member with this disease. If there is a family history of inheritance of this disease (familial colonic polyposis syndrome), screening tests start at puberty or at the age of 21 years, depending on the existing syndrome. The decision about when screening should be done is made together with the doctor. The decisions depend on the age, family history, associated diseases and other benefits after the screening.


Treatment – Overview
Colorectal polyps are usually removed during a screening examination through sigmoidoscopy with a flexible tube or colonoscopy. The collected sample (biopsy) is examined in order to determine if it is a noncancerous or precancerous (adenomatous) form.
Initial treatment


Studies about the diet high in fiber
Most doctors have found that a hypolipidemic diet ( low fat consumption) and high in fiber helps to prevent colorectal polyps and colorectal cancer. Two major studies have found that such a diet does not lower the risk of the recurrence of the diseases. It is assumed that these studies have not observed the groups for the study for a long enough time in order to see the benefits of such a diet. More research is needed. Meanwhile, a diet low in fat and high in fiber, may have other beneficial effects on health, such as the prevention of cardiovascular diseases.



Speak Your Mind


Current day month ye@r *