Colorectal polyps


Definition

A colorectal polyp is a growth on the lining of the colon or rectum.

Alternative Names

Intestinal polyps; Polyps - colorectal; Adenomatous polyps; Hyperplastic polyps; Villous adenomas; Serrated polyp; Serrated adenoma; Precancerous polyps; Colon cancer - polyps; Bleeding - colorectal polyps

Causes

This EM Should be displayed at the top of the article section "Causes"

Polyps of the colon and rectum are most often benign. This means they are not a cancer and do not spread. You may have one or many polyps. They become more common with age. There are many types of polyps.

Adenomatous polyps are a common type. They are gland-like growths that develop on the mucous membrane that lines the large intestine. They are also called adenomas and are most often one of the following:

When adenomas become cancerous, they are known as adenocarcinomas. Adenocarcinomas are cancers that originate in glandular tissue cells. Adenocarcinoma is the most common type of colorectal cancer.

Other types of polyps are:

Polyps bigger than 1 centimeter (cm) have a higher cancer risk than polyps smaller than 1 centimeter. Risk factors include:

A small number of people with polyps may also be linked to some inherited disorders, including:

Symptoms

Polyps usually do not have symptoms. When present, symptoms may include:

Exams and Tests

The health care provider will perform a physical exam. A large polyp may be felt during a rectal exam.

Most polyps are found with the following tests:

Treatment

Colorectal polyps should be removed because some can develop into cancer. In most cases, the polyps may be removed during a colonoscopy.

For people with adenomatous polyps, new polyps can appear in the future. You should have a repeat colonoscopy usually 1 to 10 years later, depending on:

In rare cases, when polyps are very likely to turn into cancer or too large to remove during colonoscopy, the doctor will recommend a colectomy. This is surgery to remove part of the colon that has the polyps.

Outlook (Prognosis)

Outlook is excellent if the polyps are removed. Polyps that are not removed can develop into cancer over time.

When to Contact a Medical Professional

Call your provider if you have:

Prevention

To reduce your risk of developing polyps:

Your provider can order a colonoscopy or other screening tests:

Taking aspirin, naproxen, ibuprofen, or similar medicines may help reduce the risk for new polyps. Be aware that these medicines can have serious side effects if taken for a long time. Side effects include bleeding in the stomach or colon and heart disease. Talk with your provider before taking these medicines.

References

American Gastroenterological Association. Early detection of colorectal cancer (CRC) and adenomatous polyps clinical decision support tool. Gastroenterology. 2014;147(4):925-926. PMID: 25151575 www.ncbi.nlm.nih.gov/pubmed/25151575.

Itzkowitz SH, Potack J. Colonic polyps and polyposis syndromes. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 126.

Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR; United States Multi-Society Task Force on Colorectal Cancer. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143(3):844-857. PMID: 22763141 www.ncbi.nlm.nih.gov/pubmed/22763141.

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN guidelines): colorectal cancer screening. Version 2.2016. www.nccn.org/professionals/physician_gls/pdf/colorectal_screening.pdf. Accessed February 1, 2017.

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