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Colon Polyps

What is Colon Polyps?

Colon polyps are a gradual overgrowth of the colonic mucosa, which have chances of becoming malignant. They are present all over the large intestine and are considered as a predisposition to colon cancer. They usually aggravate with age. Asymptomatic when colon polyps are isolated, they can cause occult colonic bleeding in certain cases. Colon polyps develop in the epithelial cells that line the colon and are considered as benign neoplasms.

Causes

  • Genetics – An autosomal disorder FAP (Familial Adenomatous Polyposis), which truncates mutations of the adenomatous polyposis coli gene (APC gene), HNPCC and Cowden disease are all associated with the development of colon polyps.

  • Environment – Colon polyps are manifested in geographically distinct populace.

  • Diet – Consumption of antioxidants, fat, alcohol and dietary fibre can lead to colon polyps.

Signs and Symptoms

  • Occult blood in stool

  • Abdominal pain

  • Diarrhoea or constipation

  • Weight loss

  • Fatigue and weakness

  • Pale skin

  • Fainting and lightheadedness

  • Black stools

Types of colon polyps

  • Polyposis Syndromes – Genetics and heredity are contributing factors to this syndrome. Conditions such as FAP, colorectal cancer or Lynch syndrome, hereditary nonpolyposis, etc. are some examples of polyposis syndrome.

  • Hyperplastic Polyps – 90% of the benign protrusions are hyperplastic polyps. They measure < 0.5 cm in diameter and occur mostly in the rectosigmoid region in adults.

  • Adenomas – Adenomas constitute about 10% of all polyps and are of three types: villous, tubulovillous and tubular. They measure > 1 cm in diameter and can potentially develop into cancer.

Diagnosis

  • Physical examination includes digital rectal exam, in which distal polyps are detected.

  • Stool occult blood test is done to detect polyps > 10 mm.

  • Stool DNA study assesses the mutant or colon tumour cells.

  • Genetic blood samples testing will help identify the hereditary cause of colon polyps.

  • Endoscopic colonoscopy evaluates the colon.

  • Virtual colonoscopy comprises of CT scans or MRI to detect large polyps. Optical colonoscopy is conducted for the removal of the colonic polyps that have been detected.

  • Air contrast barium enema is done to detect polyps > 1 cm in diameter.

  • Flexible sigmoidoscopy is done to ascertain the cause of rectal bleeding, scanning the rectum and sigmoid.

  • Capsule endoscopy examines the gastrointestinal tract.

  • Bowel cleansing is accomplished prior to most of the procedures.

Treatment and medication

Medical treatment is usually with NSAIDs to decrease the size of the polyps. Calcium and Folate supplements are prescribed to minimize the risk of recurrence of the polyps.

After thorough patient examination, Dr. Deepak recommends surgical intervention especially for the pedunculated polyp and intestinal polyps associated with FAP.

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