Intestinal polyps

Alternative names

Colorectal polyps; Polyps - colorectal

Definition

A colorectal polyp is a growth that projects (usually on a stalk) from the lining of the colon or rectum.

Causes, incidence, and risk factors

Polyps of the colon and rectum are usually benign and produce no symptoms, but they may cause painless rectal bleeding. There may be single or multiple polyps and they become more common as people age. Over time, certain types of polyps, called adenomatous polyps, may develop into cancer. Another common type of polyp found in the colon is called a hyperplastic polyp, which is generally not at risk for developing into colon cancer.

Polyps greater than one centimeter have a greater cancer risk associated with them than polyps under one centimeter. Risk factors include advancing age or a family history of colon cancer or polyps.

Polyps may also be associated with some hereditary disorders, including:

• Gardner's syndrome
  
• Peutz-Jeghers syndrome
  
• Juvenile polyposis
  
• Familial adenomatous polyposis
  
• Lynch syndrome (HNPCC)
  

Symptoms

There are usually no symptoms. However, the following symptoms may occur:

• Rectal bleeding
  
• Bloody stools
  
• Fatigue associated with anemia
  
• Abdominal pain (rare)
  

Signs and tests
A rectal examination may reveal a polyp that can be felt by the physician. However, the physical exam is usually normal.

Tests that show polyps:

• Sigmoidoscopy
  
• Colonoscopy
  
• Virtual colonoscopy
  
• Barium enema
  

Treatment

Over time, adenomatous colorectal polyps can develop into cancer and should be removed. In most cases, the polyps may be removed at the same time a colonoscopy is performed. For patients with polyps, follow-up colonoscopy should be performed within 3 to 5 years to see if the polyps have returned.

Rarely, for polyps with a high potential of becoming cancerous, a colectomy (removal of a part of the colon) may be recommended.

Expectations (prognosis)