Colorectal Polyps: Causes, Symptoms, Diagnosis, Treatment, and Prevention
Colorectal polyps are abnormal growths of tissue that form on the inner lining of the colon or rectum, which are parts of the large intestine. Although most of them are not cancerous, some of them can turn into colorectal cancer over time, which is why it is important to identify and treat colorectal polyps before they become harmful.
Causes and Risk Factors
Many factors may contribute to the development of colorectal polyps, but the exact cause is unknown. The following factors may increase the risk:
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Age: The risk of colorectal polyps increases with age, especially after 50 years old.
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Family history: Having a close relative who had colorectal polyps or cancer may increase the risk of inheriting a genetic condition that causes polyps to form.
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Lifestyle: Being overweight or obese, smoking, eating a high-fat or low-fiber diet, and drinking alcohol may increase the risk of colorectal polyps.
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Medical conditions: Having inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, or type 2 diabetes that is not well-controlled may increase the risk of colorectal polyps.
Types and Symptoms
Polyps of the colon can be classified as either non-neoplastic or neoplastic. Usually, nonneoplastic polyps are harmless and do not cause cancer. Neoplastic polyps are more likely to cause cancer, including adenomas and serrated polyps. Based on their shape and growth pattern, adenomas can be further classified into tubular, villous, or sessile serrated adenomas. The larger and more irregular the polyp, the greater the risk of cancer.
Most colorectal polyps do not cause any symptoms and are often found during routine screening tests. However, some possible signs and symptoms of colorectal polyps include:
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Change in bowel habits, such as constipation or diarrhea that lasts longer than a week
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Change in stool color, such as blood in the stool, black or red streaks, or pale stools
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Abdominal pain, cramps, or bloating
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Rectal bleeding or pain
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Iron deficiency anemia, which can cause fatigue, weakness, or shortness of breath
Diagnosis and Treatment
The best way to diagnose colorectal polyps is by performing a colonoscopy, which is a procedure that uses a flexible tube with a camera and a light to examine the entire colon and rectum. As part of a colonoscopy, the doctor can also remove any polyps found. The polyps are then sent to a laboratory for further examination. The sigmoidoscopy, which examines only the lower part of the colon, and stool tests, which check for blood or DNA changes in the stool, can also help detect colorectal polyps.
In order to prevent colorectal polyps from becoming cancerous, polypectomy is the most effective treatment. It involves removing polyps during a colonoscopy or sigmoidoscopy. Depending on the type, size, number, and location of the polyps, the doctor may use different methods to remove them, including snaring, burning, and cutting. It is possible to require surgery to remove some polyps, especially if they are large or difficult to reach.
Prevention and Follow-up
Especially for people at higher risk of developing colorectal polyps, regular screening tests are the best way to prevent them. In addition to detecting colorectal cancer at an early stage, screening tests can help find and remove polyps before they become cancerous. According to the individual's age, family history, and medical history, screening tests may be recommended at various frequency and types. Some general guidelines include:
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People with average risk should start screening at age 50 and repeat every 10 years with a colonoscopy or every year with a stool test.
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People with high risk should start screening at a younger age and repeat more often, depending on the type and severity of their risk factors. They may also need additional tests, such as genetic testing or endoscopic ultrasound.
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People who have had colorectal polyps or cancer should follow the advice of their doctor regarding the appropriate screening schedule and surveillance plan.
Other ways to prevent colorectal polyps and cancer include:
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Eating a healthy diet that is rich in fruits, vegetables, whole grains, and fiber, and low in fat, red meat, and processed meat
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Maintaining a healthy weight and avoiding obesity
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Quitting smoking and limiting alcohol consumption
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Exercising regularly and staying physically active
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Taking aspirin or other anti-inflammatory drugs, if prescribed by the doctor, as they may reduce the risk of colorectal polyps and cancer
The majority of colon polyps are harmless, but over time, they may become cancerous. It is therefore important to have regular screening tests and to remove any polyps found. It is possible to prevent colorectal cancer and improve quality of life by doing so.
