Polyps in the intestines in adults

Polyps are abnormal growths of tissue in the lining of hollow organs. There are many types of polyps that can grow in multiple locations throughout the body, including the colon, stomach, small intestine, vocal cords, nose, ear, sinuses, bladder, uterus, and cervical canal. But in more detail we will talk about colorectal polyps that affect the colon or only the rectum.

Colorectal polyps are common, especially in adults over age 50, and often do not cause any symptoms. When they first develop, these growths are usually not malignant (cancerous). However, some polyps can become malignant (colon cancer) over time if a doctor does not find and remove them.

Intestinal polyps are small formations on the inner surface of the colon or on the rectal mucosa. They are common, affecting 15-20% of the population of our country, and many do not even know about their existence. Polyps are usually less than 10 mm in size, although they can be as large as 20 to 30 mm or more. There are different forms:

• some are a tiny raised area or bulge known as a base polyp;
• some look like grapes on a stem, and are known as stalk polyps;
• some take the form of many tiny bumps clustered together.

Intestinal polyps are not usually cancerous, although if found they must be removed as some will eventually turn into cancer if left untreated. Some people develop only one polyp, while others have several. They usually occur in people over 50 years of age.

What are polyps in the intestine

The doctor who discovers polyps bases further recommendations based on a number of characteristics of these formations: the number of polyps present, their size, and additional criteria.

It is important to know the type of polyp as some carry very little risk and others are more of a cancer concern. Once polyps develop, your chances of reappearing increase.

Hyperplastic polyps occur when cells in an area of ​​the intestinal mucosa grow too quickly. The risk of them becoming cancerous is low if the affected individual has no more than 100 hyperplastic polyps.

Adenomatous polyps (adenomas) determined by the growth of new cells, and not by the overproduction of typical cells, as in the case of hyperplastic polyps. There are several different types of adenomas:

• villus adenomas are more likely to become cancerous but can be safely removed during a colonoscopy
• Inflammatory polyps are common in people with inflammatory bowel disease, primarily Crohn’s disease or ulcerative (so-called non-specific) colitis. In fact, these are not true polyps. Essentially, these are raised areas of inflamed tissue that do not usually carry a risk of developing colorectal cancer.

polyp forms. Although there are several different types of polyps, they usually come in one of two forms:

• sessile polyps are flat polyps in which unusual cells are grouped in a mound on the intestinal wall. They can sometimes be hard to spot because they don’t stand out very much, but newer high-resolution colonoscopes make it easier to spot.
• polyps on leg – These are raised growths attached to the intestinal wall with long thin legs. They are mushroom-shaped and much easier to spot than sessile polyps. Usually, a doctor can easily remove them during a colonoscopy.

Polyp size. Colorectal polyps can range in size from very small (a few millimeters in diameter) to quite large (a few centimeters in diameter). The larger the polyp, the higher the risk that it will turn into cancer.

Causes of polyps in the intestines in adults

Intestinal polyps occur due to abnormal cell production. The lining of the intestine is constantly being renewed, and a defective gene can lead to more rapid growth of cells in the intestine. There may be a family tendency to develop polyps, and then colon cancer.

There are several types of polyposis formations. Most are benign, but one type, the adenomatous polyp, is associated with changes (called mutations) in the DNA lining of the colon. These mutations can develop into colon cancer. It is known that the larger the polyp, the more likely it contains cancer cells.

Some people are born with a genetic tendency to develop multiple polyps. Inherited conditions, such as familial adenomatous polyposis or Gardner’s syndrome, can cause hundreds of polyps to grow along the intestinal wall. Without surgery to remove the affected area of ​​the intestine, at least one of the polyps becomes malignant. These two conditions are rare.

Polyps are found in about 30% of the adult population 45 years of age or older. Men and women of all nationalities are at risk for polyps. Certain influences increase the risk or frequency of these changes. Factors are related to your diet, lifestyle, advanced age, gender and genetics or hereditary problems. Important lifestyle factors that predispose to colorectal polyps and cancer (increasing the likelihood of developing these conditions) include:

• smoking;
• excessive drinking (drinking too much alcohol);
• refusal to play sports;
• excess weight;
• eating processed foods and too much red meat (instead of a mostly plant-based diet);
• a history of colorectal polyps or colorectal cancer;
• a history of inflammatory bowel disease (if Crohn’s disease or ulcerative colitis is diagnosed) or primary sclerotic cholangitis.

Symptoms of polyps in the intestines in adults

Although the vast majority of polyps are asymptomatic, very large polyps can cause rectal bleeding.

Some larger polyps can cause:

• a small amount of blood in the stool;
• mucus that is formed during bowel movements;
• diarrhea or constipation;
• abdominal pain.

Sometimes, bleeding polyps can cause fatigue and other symptoms of anemia (low red blood cells). Rarely, a large polyp can cause diarrhea or secretion of large amounts of potassium. This can cause severe fatigue and muscle weakness.

Treatment of polyps in the intestines in adults

Colon polyps, some of which can lead to colorectal cancer, are common, so all adults between the ages of 50 and 74 should be screened, even if they don’t have symptoms.

Diagnostics

Recommended screening tests:

Forensic Immunochemical Test (ITC). It involves getting a kit from a medical laboratory, using it at home to collect a stool sample, and then returning it to the lab for testing. Lab technicians will analyze the stool sample for traces of blood. If the result is positive, the doctor will likely perform a colonoscopy to determine the source of the blood in the sample.

Occult blood test. Beforehand, your doctor will instruct you to collect a stool sample at home and bring it to a medical laboratory, where a technician will check the sample for any signs of blood. If it tests positive for blood, then it could be a polyp, but it could also be another condition, such as hemorrhoids, so further testing is usually required.

Colonoscopy. A doctor may use this procedure to look for polyps and to remove polyps. Generally, a doctor will recommend a colonoscopy if a positive TKI test or blood in the stool is detected, but may recommend it based on symptoms or age. During this test, the doctor uses a long, flexible tube with a camera attached to the end to look at the inner lining of the rectum and colon. During this process, doctors can identify and remove any polyps that are found. Larger polyps may require a second colonoscopy to remove them completely. The doctor will send tissue from the removed polyps for examination to determine the type of polyp.

Sigmoidoscopy. A flexible tube is inserted through the rectum to examine the last third of the large intestine (sigmoid colon).

Computed tomography (CT). An x-ray test that uses radiation to create images of the colon.

If any of the recent tests showed abnormalities, a colonoscopy should be performed to check for polyps and remove them.

Modern treatments

There are several treatments for polyps, but the most common procedure involves burning the polyp or removing it during a colonoscopy. The procedure is painless and is performed by cutting the polyp with a flexible wire. Both of the above methods involve passing a flexible instrument called a colonoscope through the anus and up into the intestines. The colonoscope has an electrical current that either cauterizes (burns) or cuts off the polyp.

Rarely, polyps may need to be treated by surgically removing part of the intestine. This is usually only done when the polyp has some cellular changes or is very large.

After a polyp or polyps are removed, they are sent to a specialist lab who will tell your doctor if:

• the polyp is not completely removed;
• there is a risk of re-growth;
• there are any malignant changes in the polyp.

If the polyp has a malignant change, you may need additional treatment (depending on the extent and type of change).

Sometimes, open abdominal surgery is required to remove a very large polyp. For cancerous polyps, surrounding tissue or part of the colon may also be removed.

Prevention of polyps in the intestines in adults at home

The danger of polyps is that most cases of colon cancer arise from these formations. You can reduce your chance of developing malignant polyps in the following ways:

• increase your intake of fruits, vegetables, and whole grains;
• limit your intake of processed red meat;
• daily exercise for at least 30 minutes;
• maintain a healthy weight – excess fat, especially around the waist, changes your metabolism and increases the likelihood of developing colorectal and colon cancer.

In addition, some studies show that certain measures may help reduce the risk of colon cancer.

Multivitamins or vitamin D supplements daily. People who consume more vitamin D have a lower risk of colon cancer compared to people who do not have enough vitamin D.

Aspirin-like drugs. In several studies, people who took aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) on a regular basis reduced their chances of developing adenomatous polyps or colorectal cancer by 40 to 50%. Because of the side effects of these drugs, it is not recommended to take them every day just to prevent colon cancer if your cancer risk is moderate.

To give up smoking. Smoking increases the risk of colon cancer.

Women who take hormones after menopause have a lower risk of colon cancer. However, long-term use of estrogen and progesterone after menopause is not recommended for this purpose.

Popular questions and answers

We asked questions regarding the development of intestinal polyps and their possible consequences Pathologist, Junior Researcher, National Research Center for Pediatric Hematology, Oncology and Immunology named after N.N. Dmitry Rogachev to Dmitry Abramov.