What are colon polyps?

The large intestine, also called the colon, is part of the digestive system.  It is a long, hollow tube at the end of the digestive tract where the body makes and stores stool.  A polyp is extra tissue that grows inside the body.  Colon polyps grow in the large intestine.

Digestive tract

Colon

Are polyps dangerous?

Most polyps are not dangerous. Most are benign, which means they are not cancer. But over time, some types of polyps can turn into cancer. Usually, polyps that are smaller than a pea aren't harmful. But larger polyps could someday become cancer or may already be cancer. To be safe, doctors remove all polyps and test them.

There are basically 4 types of polyps that commonly occur within the colon:

• Inflammatory - Most often found in patients with ulcerative colitis or Crohn's disease. Often called "pseudopolyps" (false polyps), they are not true polyps, but just a reaction to chronic inflammation of the colon wall. They are not the type that turns to cancer. They are usually biopsied to verify type.
• Hyperplastic - A common type of polyp which is usually very small and found in the rectum. They are considered to be low risk for cancer.
• Tubular adenoma or adenomatous polyp - This is the most common type of polyp and the one referred to most often when a doctor speaks of colon polyps. About 70% of polyps removed are of this type. Adenomas carry a definite cancer risk which rises as the polyp grows larger. Adenomatous polyps usually cause no symptoms, but if detected early they can be removed during colonoscopy before any cancer cells form. The good news is that polyps grow slowly and may take years to turn into cancer. Patients with a history of adenomatous polyps must be periodically reexamined.
• Villous adenoma or tubulovillous adenoma- About 15% of polyps removed are of this type. This is a much more serious type of polyp that has a very high cancer risk as it grows larger. Often they are larger and sessile and not on a stem making removal more difficult. Smaller ones can be removed in piecemeal fashion - sometimes over several colonoscopies. Larger sessile villous adenomas may require surgery for complete removal. Follow up depends on size and completeness of removal.

Who gets polyps?

Anyone can get polyps, but certain people are more likely than others. You may have a greater chance of getting polyps if

• you're over 50. The older you get, the more likely you are to develop polyps.
• you've had polyps before.
• someone in your family has had polyps.
• someone in your family has had cancer of the large intestine.

Find out if someone in your family has had polyps. You may also be more likely to get polyps if you

• eat a lot of fatty foods
• smoke
• drink alcohol
• don't exercise
• weigh too much

What are the symptoms?

Most small polyps don't cause symptoms. Often, people don't know they have one until the doctor finds it during a regular checkup or while testing them for something else. But some people do have symptoms like these:

• bleeding from the anus. You might notice blood on your underwear or on toilet paper after you've had a bowel movement.
• constipation or diarrhea that lasts more than a week.
• blood in the stool. Blood can make stool look black, or it can show up as red streaks in the stool.

If you have any of these symptoms, see a doctor to find out what the problem is.

How does the doctor test for polyps?

The doctor can use the following tests to check for polyps:

• Sigmoidoscopy. With this test, the doctor can see inside your large intestine. The doctor puts a thin flexible tube into your rectum. The device is called a sigmoidoscope, and it has a light and a tiny video camera in it. The doctor uses the sigmoidoscope to look at the last third of your large intestine.
• Colonoscopy. This test is like sigmoidoscopy, but the doctor looks at all of the large intestine. It usually requires sedation.

Who should get tested for polyps?

Talk to your doctor about getting tested for polyps if

• you have symptoms
• you're 50 years old or older
• someone in your family has had polyps or colon cancer

How are polyps treated?

The doctor will remove the polyp. Sometimes, the doctor takes it out during sigmoidoscopy or colonoscopy. Or the doctor may decide to operate through the abdomen. The polyp is then tested for cancer.  If you've had polyps, the doctor may want you to get tested regularly in the future.

How can I prevent polyps?

Doctors don't know of any one sure way to prevent polyps. But you might be able to lower your risk of getting them if you

• eat more fruits and vegetables and less fatty food
• don't smoke
• avoid alcohol
• exercise every day
• lose weight if you're overweight

Eating more calcium and folate can also lower your risk of getting polyps. Some foods that are rich in calcium are milk, cheese, and broccoli. Some foods that are rich in folate are chickpeas, kidney beans, and spinach.

Some doctors think that aspirin might help prevent polyps. Studies are under way.

Points to Remember

• A polyp is extra tissue that grows inside the body. Most polyps are not harmful.
• Symptoms may include constipation or diarrhea for more than a week or blood on your underwear, on toilet paper, or in your stool.
• Many polyps do not cause symptoms.
• Doctors remove all polyps and test them for cancer.
• Talk to your doctor about getting tested for polyps if
  • you have any symptoms
  • you're 50 years old or older
  • someone in your family has had polyps or colon cancer

Glossary

Abdomen (AB-duh-men): The area between the chest and the hips. It contains the stomach, small intestine, large intestine, liver, gallbladder, pancreas, and spleen.

Anus (AY-nus): The opening through which stool leaves the body.

Benign (buh-NINE): Not cancerous.

Colonoscopy (koh-luh-NAW-skuh-pee): A test to look inside the entire large intestine. The doctor uses a flexible tube that contains a light and a tiny video camera. This device is called a colonoscope.

Large intestine: A long, hollow tube in your body that makes and stores stool. Also called the colon.

Polyp (PAH-lip): An extra piece of tissue that grows inside the body.

Rectum (REK-tum): The last section of the large intestine, leading to the anus.

Sigmoidoscopy (SIG-moy-DAW-skuh-pee): A test to look inside the lower section of the large intestine. The doctor uses a flexible tube that contains a light and a tiny video camera. The device is called a sigmoidoscope.

Stool: The solid waste that passes through the rectum as a bowel movement.