Colon polyps

Colon polyps are abnormal growths that appear on the inner lining of the large intestine (colon). They vary in size and shape and can be either benign (non-cancerous) or potentially malignant (cancerous). While most colon polyps are harmless, some can develop into colorectal cancer over time, which makes early detection and removal vital.

These polyps are commonly found during routine colonoscopies and are often asymptomatic. Understanding the risk factors, signs, and treatment options can help prevent serious complications. Lifestyle changes and regular screening are critical tools in reducing the risk of colon cancer.

Colon polyps are tissue growths that form on the mucosal lining of the colon or rectum. They develop when the body produces extra cells in the lining, often due to mutations or inflammation. Although many polyps are benign, some may evolve into cancer, especially if left undetected.

They are typically classified as:

• Non-neoplastic (non-cancerous): These include hyperplastic polyps and inflammatory polyps.
• Neoplastic (potentially cancerous): These include adenomas and serrated polyps, which have a higher risk of becoming cancerous.
   

India

In India, colon polyps are less commonly diagnosed due to limited routine screening. However, with the growing awareness of colorectal cancer, detection rates are increasing. The prevalence of adenomatous polyps among patients undergoing colonoscopy in India is around 7–10%.

Worldwide

Globally, colon polyps are quite common. In the United States, approximately 20–30% of adults over age 50 have one or more adenomas. The risk increases with age and lifestyle factors like diet and smoking.

1. Adenomatous Polyps (Adenomas): Potentially pre-cancerous and the most common type.
2. Hyperplastic Polyps: Generally benign and less likely to become cancerous.
3. Inflammatory Polyps: Common in people with inflammatory bowel diseases like Crohn’s or ulcerative colitis.
4. Serrated Polyps: May become cancerous depending on their size and location.

• Inflammation: Chronic bowel inflammation can increase the risk.
• Age: Most people over 50 are at higher risk.
• Diet: High-fat, low-fibre diets may contribute.
• Lifestyle Factors: Obesity, smoking, and alcohol use.
• Family History: Hereditary conditions like Familial Adenomatous Polyposis (FAP).

Often, colon polyps present no symptoms and are discovered during screening. However, when symptoms appear, they may include:

• Rectal bleeding
• Blood in stool
• Abdominal pain
• Changes in bowel habits (diarrhoea or constipation)
• Iron deficiency anaemia (in advanced cases)

• Colonoscopy: A camera is used to inspect the entire colon.
• Flexible Sigmoidoscopy: Examines the lower part of the colon.
• Stool Tests: Detect hidden blood or DNA mutations.
• CT Colonography (Virtual Colonoscopy): Uses imaging to detect polyps.
• Biopsy: If polyps are found, a tissue sample is taken for analysis.

The treatment of colon polyps usually involves removing them to prevent progression into cancer. Treatment depends on the size, number, and type of polyps.

Removal Methods

• Polypectomy: During a colonoscopy, the doctor removes polyps using a wire loop or snare.
• Endoscopic Mucosal Resection (EMR): For larger polyps, a special solution is injected beneath the polyp to lift it before removal.
• Surgical Removal: If the polyps are too large or if cancer is suspected, part of the colon may be surgically removed.

Medications

Although medication is not typically the primary treatment, some may be used in specific cases:

• Aspirin and NSAIDs: These have shown potential in reducing the size and number of adenomatous polyps in people with familial adenomatous polyposis. (Asa 50mg Tablet)
• Celecoxib: A COX-2 inhibitor approved for use in certain hereditary conditions like FAP. (Coxib 200mg Tablet)
• Calcium Supplements: May reduce polyp recurrence in some people.(Combcal CCM Tablet)
• Vitamin D: Some studies suggest a protective effect, though more research is needed.

Note: Medications are usually considered in conjunction with regular surveillance and are not replacements for polyp removal.

• Dietary Changes: High-fibre diets, rich in fruits and vegetables, may reduce risk.
• Probiotics: Help maintain gut health, though not proven to prevent polyps.
• Herbal Remedies: Like green tea extract and curcumin are being studied but lack conclusive evidence.

Always consult a doctor before trying alternative treatments.
 

• Age (over 50)
• Family history of colon cancer or polyps
• Genetic conditions like FAP or Lynch syndrome
• Sedentary lifestyle
• Smoking and heavy alcohol use
• Obesity and diabetes

• Bleeding: Especially if polyps are large.
• Intestinal Blockage: Rare but possible.
• Progression to Cancer: Especially with adenomas.
• Complications from Removal: Such as perforation or infection.

• Stay Informed: Know your type of polyp and follow up.
• Monitor Symptoms: Report any changes to your doctor.
• Lifestyle Changes: Adopt a healthy diet and exercise.
• Regular Screenings: Follow your doctor’s recommendations.
• Join Support Groups: For emotional support and shared experiences.

• "All polyps are cancerous." Most are benign.
• "Only old people get polyps." They can occur in younger individuals.
• "Once removed, polyps won’t return." New polyps can develop, hence follow-up is essential.
• "A colonoscopy is painful." It’s usually done under sedation and is well-tolerated.

• Blood in the stool
• Unexplained abdominal pain
• Changes in bowel habits
• Unexplained weight loss
• Family history of colorectal conditions

• What type of polyp do I have?
• Is it benign or pre-cancerous?
• What are my treatment options?
• Do I need follow-up colonoscopies?
• Are there lifestyle changes I should make?
• Should my family members be screened?

• Offer Emotional Support: Encourage routine screenings and treatment.
• Help with Lifestyle Changes: Prepare healthy meals and promote physical activity.
• Stay Informed: Understand the condition to provide better support
• Accompany to Appointments: Emotional and logistical support can be invaluable.

Colon polyps are common and often harmless, but some can lead to colorectal cancer if not detected and treated early. Routine screenings, a healthy lifestyle, and timely medical interventions can significantly reduce the risks. With proper awareness and management, people with colon polyps can lead healthy, full lives.