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Colonic polyp is referred to excessive growth of the mucosal tissue within the large intestinal (colon) lumen. Although, in most cases, there's no definitive cause, but are commonly associated with diseases like inflammatory bowel disease and rarely with hereditary conditions like Familial Adenomatous Polyposis, Puetz-Jeghers syndrome, Lynch syndrome and many more.
There are two types of Colon polyp, one that is Non-Cancerous (Hyperplastic / Inflammatory / Hemartomas / Lymphoid), wherein the risk of turning or progressing into cancer is unlikely. However, the second type is Cancerous (Adenomatous), these carry a high risk of turning into cancer if left untreated. These polyps in the colon are known to occur in any age group. If the growth is found in children, they are termed Juvenile polyp. However, it is seen commonly among people aged >50 years and is found in both male and female. They are often asymptomatic and are picked up on a CT scan abdomen during evaluation for other cause. Hence, it is essential to perform regular screening. In most cases, people get themselves tested when there is blood in stools, unexplained abdominal pain, patient with anaemia, vague complaints like weight loss, generalised weakness due to chronic negligible blood loss.
Although there is no particular cause for Colon polyp, however, there are certain risk factors such as being overweight, family history of polyps or colon cancer, uncontrolled type 2 diabetes, having a hereditary disorder such as Lynch syndrome, inflammatory condition which affects the colon and the most important poor lifestyle that may trigger the growth.
Careless and poor lifestyle may contribute to the disease, especially people who consume a high-fat diet, drink alcohol and smoke frequently and live a sedentary lifestyle. A colon polyp is preventable if people follow and maintain a healthy diet. Doctors and dieticians recommend food that contains high Vit D and calcium such as milk, egg, fish, broccoli etc. and reduces the intake of processed food, red meat, and fatty food.
It's usually diagnosed by doing a simple procedure called colonoscopy. This method helps in examining the entire length of the colon, and aids in exact localisation, number of polyps, size and appearance of the polyps in real-time. The procedure also helps the doctor to remove the polyp at once and is sent for biopsy to understand the type of polyp. It is based on the type; doctors structure the treatment method for the patient.
Other than colonoscopy there are a few more screening methods such as Sigmoidoscopy, Barium enema, CT colonography and stool test.
Polyps can cause recurrent bleeds causing anaemia. People with larger polyps in their intestines can cause recurrent pain abdomen and sometimes intestinal obstruction. However, the most dreaded and fatal complication happens when it turns into cancer over a period of time. Hence, it is essential to remove the polyp immediately after the detection of cancerous cells in the colon.
Polyps are best treated with the complete removal of the polyp from the colon, and that procedure is known as 'Polypectomy'. This can be safely done by the endoscopic approach, least time consuming, requiring a limited period of observation post-procedure and carries very minimal risk of bleeding.
In certain conditions like Familial Adenomatous Polyposis patients have hundreds to thousands of polyps. In those select patients, the whole colon may have to be removed surgically.
In most cases colon polyp found in people are benign, however, the doctor recommends getting it removed as certain types are malignant. Any patient with blood in stools needs to meet their doctor for evaluation so that polyps are not missed. If polyps aren't treated at the right time, they can turn into cancer.
(Authored by Dr Adarsh CK, Chief Consultant Gastroenterologist and Hepatologist at BGS Gleneagles Global Hospital, Bangalore)