Small Intestinal Polyps: Concerns and Next Steps After Colonoscopy

During the colonoscopy, a polyp was found in a portion of the small intestine?

Hello, doctor.
Due to irregular bowel movements and soft, unformed stools, I underwent a colonoscopy.
During the procedure today, no abnormalities were found in the colon, but several polyps were discovered in the small intestine.
The doctor mentioned that having polyps is normal, although the quantity is somewhat high, and reassured me that they are benign.
A biopsy was taken, and I will have to wait two weeks for the results.

1.
I would like to ask if there is any possibility that these polyps could be malignant? Is the irregular shape of my stools related to the small intestine?
2.
How might the doctor address this issue? I am really worried and unable to sleep or eat while waiting for the results (I couldn't find much information online about similar cases, which adds to my anxiety).

3.
Since these are polyps, why is a biopsy necessary? What exactly are they testing for?
4.
About a week ago, I experienced pain in the area just to the right of my navel, approximately the length of four fingers.
I visited a clinic and had an ultrasound, where the doctor indicated that the small intestine was slightly enlarged, which could be causing the pain.
They prescribed medication, suggesting it was a bacterial infection.
After taking the medication for a week, the pain has subsided.
Is there any connection between this abdominal pain and the polyps? If there is a connection, why did the pain resolve after taking antibiotics? Thank you.

Nan Hong, 20~29 year old female. Ask Date: 2015/09/28

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello,
1.
Polyps are nodules that protrude from the mucosa, and most polyps smaller than 0.5 cm are benign.
The benefit of biopsy is that it allows us to determine the tissue type, which may include inflammatory glandular hyperplasia, adenomas, dysplastic lesions, or neuroendocrine tumors (carcinoids), among others.
2.
The small intestine is responsible for food digestion and absorption.
When the intestines are inflamed, absorption may be impaired, leading to symptoms such as abdominal pain.
Polyps in the intestines may not always present symptoms, but they can sometimes cause bleeding, anemia, diarrhea, or cramping.
Please continue to follow up with the treatment at the Gastroenterology Department of Taoyuan General Hospital, Ministry of Health and Welfare, Attending Physician Dr.
Lin Ming-Hui.

Reply Date: 2015/09/28

More Info

Hello! Thank you for your questions regarding small intestinal polyps and your recent colonoscopy findings. It's understandable to feel anxious about health issues, especially when it comes to potential abnormalities like polyps. Let’s address your concerns one by one.

1. Possibility of Malignancy: While it's true that polyps can be benign, there is a small risk that some types may develop into cancer over time. The majority of small intestinal polyps are indeed benign, especially if they are small and asymptomatic. The biopsy results will provide more definitive information about the nature of the polyps. The pathologist will look for any dysplastic changes, which are precursors to cancer. If the polyps are classified as hyperplastic or adenomatous without dysplasia, they are generally not considered precancerous.

2. Connection Between Bowel Habits and Small Intestinal Polyps: The irregularity in your bowel movements, such as soft and non-formed stools, can be influenced by various factors, including diet, hydration, and gut motility. While small intestinal polyps can sometimes cause symptoms, they often do not lead to significant changes in bowel habits unless they are large or obstructive. The fact that your colonoscopy showed no abnormalities in the colon is reassuring, but it’s essential to monitor your symptoms and discuss them with your healthcare provider.

3. Next Steps and Management: After the biopsy results are available, your doctor will discuss the findings with you. If the polyps are benign, they may recommend routine surveillance, which could involve follow-up colonoscopies at regular intervals. If there are concerns about the number or type of polyps, your doctor may suggest further evaluation or even removal of the polyps if they are deemed necessary.

4. Why Biopsy is Necessary: The biopsy is crucial because it allows for a microscopic examination of the polyp tissue. This examination helps determine the type of polyp and whether there are any precancerous changes. The results will guide your doctor in making recommendations for follow-up care.

5. Abdominal Pain and Its Relation to Polyps: The abdominal pain you experienced could be related to a variety of factors, including the presence of small intestinal polyps, but it’s also possible that it was due to a transient issue such as a mild infection or inflammation. The fact that the pain resolved after antibiotic treatment suggests that it may have been related to a bacterial infection rather than the polyps themselves. However, it’s essential to keep your healthcare provider informed about any recurring symptoms.

In summary, while the presence of small intestinal polyps can be concerning, most are benign, and the biopsy will provide clarity. It’s essential to maintain open communication with your healthcare provider, follow their recommendations, and report any new or worsening symptoms. Remember, staying informed and proactive about your health is the best approach. If you have further questions or concerns, don’t hesitate to reach out to your doctor for personalized advice. Wishing you good health and peace of mind as you await your biopsy results!

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