This information is intended only to provide general guidance. It does not provide definitive medical advice. It is important that you consult your doctor about your specific condition.
What is a colon polyp?
Polyps are benign growths involving the lining of the intestine. They can occur anywhere in the gastrointestinal tract but are most common in the colon. They vary in size from less than an eighth of an inch to 2 inches in diameter. They look like small bumps growing from the inside lining of the intestine. They sometimes grow on a stalk and look like mushrooms. Other polyps may be flat. Some polyps can contain small areas of cancer, although the vast majority of polyps do not.
How common are colon polyps? What causes them?
Polyps are very common in adults, who have an increased chance of acquiring them, especially as we get older. While quite rare in 20-year-olds, it is estimated that the average 60-year-old without special risk factors for polyps has a 25% chance of having a polyp. We don't know what causes polyps. Some experts believe a high-fat, low fiber diet can predispose to polyp formation. There may be a genetic risk to develop polyps as well.
What are known risks for developing polyps?
The biggest risk factor for developing polyps is being older than 50 years old. A family history of colon polyps or colon cancer increases the risk of polyps. Also, patients with a personal history of polyps or colon cancer are at risk of developing new polyps. In addition, there are some rare polyp or cancer syndromes that run in families and increase the risk of polyps occurring at younger ages.
Are there different types of polyps?
There are 2 common types: the hyperplastic polyp and the adenoma. The hyperplastic polyp is typically not at risk for developing into cancer. The adenoma, however, is thought to be the precursor (origin) for almost all colon cancers, although most adenomas never become cancers. Histology (examination of tissue under a microscope) is the best way to differentiate between hyperplastic and adenoma polyps. Although it is impossible to tell which adenoma polyps will become cancer, larger polyps are more likely to become cancers, and some of the largest ones (those larger than 1 inch) can already contain small areas of cancer. Because your doctor cannot usually be certain of the tissue type by the polyp’s appearance, doctors generally recommend removing all polyps found during a colonoscopy.
How are polyps found?
Most polyps cause no symptoms. Larger ones can cause blood in the stool, but even they are usually asymptomatic. Therefore, the best way to detect polyps is by screening individuals with no symptoms. Colonoscopy is the most accurate way to detect polyps; therefore many experts now recommend colonoscopy as the primary screening method. This has the added advantage that any polyps found or suspected can be removed during the same procedure. Dr. Albert Harary screens his patients using colonoscopy, which he performs in New York City at Manhattan Endoscopy Center.
Several other screening techniques are available: Testing stool specimens for traces of blood or a gene test for cancer, performing sigmoidoscopy to look at the lower quarter of the colon, or using a radiology test such as CT colography ("virtual colonoscopy"). None is as accurate as colonoscopy. If one of these tests finds or suspects polyps, your doctor will generally recommend colonoscopy to remove them.
When Dr. Harary finds a polyp during colonoscopy, he usually can completely remove it during the procedure. He uses various removal techniques; most involve removing the polyp with a wire loop, biopsy forceps, and/or burning the polyp base with electric current. This is called polyp resection. Because the bowel’s lining is not sensitive to cutting or burning, you will not feel discomfort during the polyp resection. Resected polyps are then examined under the microscope by pathologist to determine the tissue type and to detect any cancer.
What are the risks of polyp removal?
Polyp removal (or polypectomy) during colonoscopy is a routine outpatient procedure. Possible complications, which are uncommon, include bleeding from the polypectomy site and perforation (a hole or tear) of the colon. Bleeding from the polypectomy site can be immediate or delayed for several days (up to 10 days); persistent bleeding can almost always be stopped by treatment during another colonoscopy. Perforations rarely occur and may require surgery to repair.
How often do I need colonoscopy if I have polyps removed?
Your doctor will decide when your next colonoscopy is necessary. The timing depends on several factors, including the number and size of polyps removed, the polyp’s tissue type, and the quality of the colon cleansing for your previous colonoscopy. The quality of cleansing affects your doctor’s ability to see the surface of the colon. If the polyps were small and the entire colon was seen well during your colonoscopy, Dr. Harary usually recommends a repeat colonoscopy in 3-5 years. However, if the polyps were large and flat, your doctor might recommend an interval of only months before a repeat colonoscopy to assure complete polyp removal. Your doctor will discuss these options with you.
To learn more about the treatment and removal of polyps, please contact our New York City office today.