Colorectal Polyps: Symptoms, Risks, and Treatment Options

Colorectal polyposis

I started experiencing intestinal colic about 6 to 7 years ago.
At the end of last year, I visited a doctor due to stomach discomfort and, after taking medication for a while, I thought I had recovered when the symptoms disappeared.
Recently, in the past two months, I have been experiencing stomach pain again and sought medical attention.
The gastroscopy results were normal, but a colon X-ray revealed a polyp about the size of a pinky finger, along with mild internal hemorrhoids.
The doctor recommended an endoscopic examination to check for any changes in the polyp, but also informed me that the procedure could be quite uncomfortable.
I have been frequently feeling sharp pains in both sides of my abdomen, as well as recurrent stomach pain and intestinal colic.
Please provide me with information regarding colorectal polyps, treatment options, and the likelihood of progression to colorectal cancer.
Thank you!

Wen, 20~29 year old female. Ask Date: 2000/11/22

Dr. Yang Guojun reply Internal Medicine

Polyps can generally be classified into hyperplastic polyps and adenomatous polyps.
Only adenomatous polyps have the potential to undergo malignant transformation, and the risk of cancer development is related to the size of the adenomatous polyps.
It is necessary for your polyps to undergo colonoscopy and removal.
Colonoscopy can be quite uncomfortable, so it is advisable to have the procedure done at a hospital where anesthesia is available, as stated by Dr.
Yang Guojun, a gastroenterologist.

Reply Date: 2000/11/22

More Info

Colorectal polyps are growths on the lining of the colon or rectum, and they can vary in size and type. Understanding the symptoms, risks, and treatment options associated with colorectal polyps is crucial for managing your health effectively.

Symptoms of Colorectal Polyps
Many colorectal polyps do not cause symptoms, which is why regular screening is essential, especially for individuals over the age of 50 or those with risk factors. However, some polyps can lead to symptoms such as:
- Rectal bleeding: This may appear as bright red blood in the stool or on toilet paper.

- Change in bowel habits: This includes diarrhea or constipation that lasts longer than a week.

- Abdominal pain: Some individuals report cramping or pain, particularly if the polyp is large.

- Iron deficiency anemia: This can occur if there is chronic bleeding from the polyp.

Risks Associated with Colorectal Polyps
The primary concern with colorectal polyps is their potential to develop into colorectal cancer over time. The risk of cancer varies based on the type of polyp:
1. Adenomatous polyps: These are the most common type and have the potential to become cancerous. The risk increases with the size and number of adenomatous polyps.

2. Hyperplastic polyps: Generally considered benign and have a low risk of cancer.

3. Sessile serrated adenomas: These can also have a risk of cancer, particularly if they are larger.

Treatment Options
The treatment for colorectal polyps typically involves their removal, especially if there is a concern about their potential to become cancerous. Here are the common approaches:
1. Colonoscopy: This is the most common method for diagnosing and removing polyps. During the procedure, the doctor can visualize the colon and remove polyps using special tools. While it may be uncomfortable, sedation is often used to minimize discomfort.

2. Surgical removal: In cases where polyps are large or if there are multiple polyps, surgical intervention may be necessary. This could involve a partial colectomy, where a section of the colon is removed.

3. Follow-up screenings: After polyp removal, regular follow-up colonoscopies are recommended to monitor for new polyps, especially if you have a history of adenomatous polyps.

Risk of Progression to Colorectal Cancer
The likelihood of a polyp turning into colorectal cancer depends on several factors, including the type of polyp, its size, and the presence of dysplasia (abnormal cells). Generally, adenomatous polyps larger than 1 cm have a higher risk of malignancy. The progression from a polyp to cancer typically takes several years, which is why regular screening is vital for early detection and prevention.

Conclusion
Given your history of abdominal pain and the discovery of a polyp, it is essential to follow your doctor's recommendations for further evaluation through a colonoscopy. While the procedure may seem daunting, it is a critical step in ensuring your health and preventing potential complications, including colorectal cancer. If you have concerns about discomfort during the procedure, discuss them with your healthcare provider, as they can provide options for sedation and pain management.

In summary, while the presence of a polyp can be concerning, with appropriate monitoring and treatment, the risks can be managed effectively. Regular screenings and a proactive approach to your gastrointestinal health are key to preventing serious complications.

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