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Definition

Colon polyps are growths on the lining of the colon or rectum. The colon and the rectum are parts of the large intestine, which is part of the digestive system.

The two most common kinds of polyp are adenomatous polyps and hyperplastic polyps. Adenomatous polyps can become larger over time and may develop into cancer. Hyperplastic polyps do not increase in size and only rarely become cancerous.

Colon Polyp

Causes

The cause of colon polyps is unknown but it may be partly hereditary. Also, there is a genetic condition called polyposis coli that is characterized by the occurrence of thousands of adenomatous polyps throughout the bowel.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors for colon polyps include:

Age: over 50 years
Family members with colon polyps or colon cancer
History of colorectal cancer (or cancer of the large intestine)

Symptoms

Symptoms are often not present and the polyps are only found during an endoscopy or x-ray. If symptoms are present, they can include:

Rectal bleeding
Anemia
Diarrhea, constipation, and/or bloating that lasts over a period of time
Abdominal pain, rarely

Diagnosis

The doctor will ask about your symptoms and medical history and perform a physical exam. Tests may include:

Digital rectal exam—the doctor inserts a gloved finger into the rectum to feel for polyps.
Stool test—a sample of your stool is checked for blood.
Sigmoidoscopy—a thin, lighted, flexible tube is inserted into the rectum to examine the rectal area and the lower colon.
Colonoscopy—a thin, lighted, flexible tube (longer than a flexible sigmoidoscopy tube) is inserted in the anus and used to view the entire colon.
Barium enema and X-ray—a barium fluid is injected into the colon and rectum. Several x-rays are taken; the barium makes your colon show up on x-ray
Biopsy—a sample of tissue is removed for testing to determine whether the polyp is adenomatous or hyperplastic and to check for the presence of cancer cells.

Treatment

Depending on the size of the polyp, it may be removed. Large polyps are at high risk for becoming cancerous and should be removed. Usually, polyps can be removed by colonoscopy. Before a colonoscopy, you will be given laxatives to clean out your bowel and you may be sedated. Then a thin, lighted, flexible tube is passed through the rectum and into the colon. The polyps can be cut out through the tube using a wire.

If the polyps are very large, you may need to have surgery to have them removed. Your doctor may send the tissue from the removed polyps to be tested for cancerous or precancerous cells.

Prevention

It’s not clear how polyps can be prevented. However, the following guidelines can help you stay healthy and may help prevent not only polyps but also colon cancer:

Eat a diet high in fiber with plenty of fruits, vegetables, and whole grains.
Minimize the amount of animal fat in your diet. This occurs in beef and other meat products as well as full-fat dairy products.
Exercise regularly.
Maintain a healthy weight.
Don't smoke.
See your doctor for regular screenings after the age of 50.
More frequent screenings may be warranted if polyps are found

RESOURCES:

American Society of Colon and Rectal Surgeons

http://www.fascrs.org

National Institute of Diabetes and Digestive and Kidney Diseases

http://www.niddk.nih.gov

CANADIAN RESOURCES:

Canadian Digestive Health Foundation

http://www.cdhf.ca/aboutcdhf.htm

The Canadian Association of Gastroenterology (CAG)

http://www.cag-acg.org/default.aspx

References:

American Society of Colon and Rectal Surgeons website. Available at: http://www.fascrs.org. Accessed October 11, 2005.

Beers MH, Berkow R. The Merck Manual of Diagnosis and Therapy. 17th ed. Hoboken, NJ: John Wiley & Sons; 1999.

Kasper DL, Braunwald E, Fauci AS, et al. Harrison's Principles of Internal Medicine. 16th ed. New York, NY: The McGraw-Hill Companies; 2005.

Mayo Foundation for Medical Education and Research website. Available at: http://www.mayo.edu/. Accessed October 11, 2005.

What I need to know about colon polyps. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/colonpolyps_ez/. Accessed October 11, 2005.

Last reviewed February 2008 by Daus Mahnke, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Colon Polyps