What are Colorectal Polyps?
Colorectal polyps are small growths that develop on the inner lining of the colon (large intestine) or rectum. They are very common, especially in adults over 50 years old. Many polyps are benign (non-cancerous) and may remain silent without causing symptoms. However, certain types can turn cancerous over time.
Types of Colorectal Polyps:
- Adenomatous polyps (Adenomas):
- These are the most common precancerous polyps.
- About 70% of polyps removed during colonoscopy are adenomas.
- Although only a small percentage turn cancerous, most colorectal cancers arise from adenomatous polyps through a process called the adenoma-carcinoma sequence.
- Hyperplastic polyps:
- Normally small and found in the rectum or sigmoid colon.
- These are usually mild with a very low risk of progressing to cancer.
- Sessile serrated adenomas (SSAs) and traditional serrated adenomas (TSAs):
- Less common but can become cancerous, particularly if they are large.
- SSAs are often seen on the right side of the colon and can be hard to detect due to their flat shape.
- Inflammatory polyps:
- Typically seen in patients with inflammatory bowel disease (IBD), such as ulcerative colitis.
- They are not cancerous but indicate ongoing inflammation in the colon.
- Hamartomatous polyps:
- Usually associated with genetic syndromes like Peutz-Jeghers syndrome.
- Although they are mostly harmless, people with these syndromes have a higher cancer risk.
What Causes Colorectal Polyps?
Polyps form due to the abnormal growth of cells lining the colon. Risk factors include:
- Age over 50 years
- Family history of polyps or colorectal cancer
- Genetic syndromes (e.g., familial adenomatous polyposis, Lynch syndrome)
- Inflammatory bowel diseases
- Sedentary lifestyle
- Obesity
- Smoking and excessive alcohol intake
- A diet high in red meat and lower in fiber
What Are the Symptoms of Colorectal Polyps?
Most polyps remain asymptomatic and are discovered during routine colonoscopy. However, larger polyps can cause:
- Rectal bleeding
- Blood in stool (black or red)
- Change in bowel habits (diarrhea or constipation)
- Abdominal pain (rare)
- Iron deficiency anemia due to chronic blood loss
If you notice any of these symptoms, consult a colorectal specialist in Pune promptly for evaluation.
Do All Polyps Turn into Cancer?
The good news is – not all polyps turn cancerous. However, adenomatous polyps and sessile serrated adenomas carry a risk of malignancy if they remain undetected or are not removed. The likelihood of cancer increases with:
- Larger size (>1 cm)
- Presence of villous features in adenomas
- High-grade dysplasia
- Multiple polyps were found during screening
This is why regular screening and timely removal of polyps are crucial preventive methods against colorectal cancer.
How Are Colorectal Polyps Diagnosed?
The gold standard for diagnosis is colonoscopy, where a flexible tube with a camera visualizes the whole colon and rectum. During colonoscopy, if polyps are found, they are usually removed (polypectomy) and sent for histopathology to determine their type. Other diagnostic tools include:
- Flexible sigmoidoscopy: studies the lower part of the colon.
- Stool tests: such as fecal occult blood test (FOBT) or FIT test to detect hidden blood.
- CT colonography (Virtual colonoscopy): utilizes CT scans to look for polyps and cancers.
Treatment of Colorectal Polyps:
The primary treatment is polypectomy, where the polyp is removed endoscopically. Large polyps or those with cancerous changes may require surgical resection of part of the colon. After removal, follow-up colonoscopies are scheduled based on the type, size, and number of polyps found.
Can Polyps be Prevented?
While you cannot completely prevent polyps, certain lifestyle measures can significantly lower the risk:
- Eat a diet rich in fruits, vegetables, and fiber
- Reduce consumption of red and processed meats
- Exercise regularly
- Maintain a healthy weight
- Avoid smoking and limit alcohol intake
- Undergo a screening colonoscopy as advised, specifically if you are above 50 years or have a family history
Should You Be Worried About Colorectal Polyps?
Finding out you have colorectal polyps can be worrying. However, early detection and removal prevent them from turning cancerous. Routine screening plays a crucial role. Patients with risk factors or family history must be particularly vigilant.
Remember:
- Most polyps are benign
- Some have cancerous potential
- Removal during colonoscopy is a preventive measure
- Regular follow-up is key
When to See a Doctor:
Consult a colorectal surgeon in Pune if you experience:
- Rectal bleeding
- Change in bowel routines lasting more than a few days
- Unexplained abdominal pain
- Iron deficiency anemia
As a colorectal surgeon and gastroenterologist in Pune, Dr. Jankar emphasizes that screening saves lives. Colorectal cancer is one of the leading cancers worldwide, and it almost always starts as a small polyp. Early removal is a simple, effective way to lower cancer risk.
Conclusion:
If you have been diagnosed with colorectal polyps, do not panic. Talk to your specialist to understand the type of polyp, associated risks, and follow-up plans. Regular colonoscopies, a healthy lifestyle, and awareness can protect you from serious complications in the future. Book your screening today — prevention starts now.