Remove Colon Polyps Sooner Than You Think

Colorectal Polyp (also commonly known as colonic polyps) is a common gastrointestinal disease, older people will increase the incidence of colon polyps and at higher rates of malignant transformation. Intestinal polyps are caused by genetics, diet, inflammation, infection and decreased immune capacity and other irritating factors. If patients with intestinal polyps dragged for the longer time, your chance of developing into cancer will become higher.

Colorectal cancer ranks second in incidence in Hong Kong and roughly 1 in 21 males and 1 in 34 females will acquire this disease with median age of onset at 68 in males and 69 in females.

A 37-year-old male office worker hasn’t a family medical history of colorectal cancer and no obvious symptoms. However, he eats junk, smokes and drinks alcohol with zero exercise. He underwent a colonoscopy and a 2cm cancerous polyp found. It was instantly removed by endoscopic surgery before turning into colorectal cancer.


From polyp to cancer

Colon polyps present for a significant duration of time (more than 5 years) are at high risk of developing into cancer. Sign and symptoms of colonic polyps relate to its location, size and shape.

In general, smaller colon polyps do not cause significant symptoms, so regular screening is necessary. When a polyp increases in size, common symptoms usually include rectal bleeding, blood in the stool, constipation or diarrhea. Please note the followings:

1) Rectal bleeding

Rectal bleeding is the most common symptom of hemorrhoids or colon polyps. The bright-red blood can be found on the surface of the patient’s stool. This may be due to colon polyps irritating rectal tissue during bowel movements, and causing rectal inflammation and bleeding.

2) Blood in the stool

Similar to rectal bleeding, stool is found in small amounts of reddish brown blood. Patients with blood in the stool appear to have a fecal occult blood test. According to the faecal occult blood test, surgeons will advise whether a colonoscopy is needed.

3) Constipation and diarrhea

Bowel ordinarily generates a rhythmic movement. Your stool is either consistently hard and comes out in pieces or a soft, single piece that passes without much effort. All these changes may be intestinal obstruction due to intestinal polyps. Constipation or diarrhea may also be symptoms of other intestinal diseases or infections. Therefore, it is important to check the severity of the patient’s condition, and the timing and extent of diarrhea or constipation.


Importance of polyps’ removal

Colon polyps are classified into non-adenomatous polyps and adenomatous polyps.

Adenomatous polyps will not be self-eliminated and are not amenable to medication. Polyps with no appropriate treatment will grow and eventually develop into cancer. Non-adenomatous polyps are relatively safe, and sometimes tiny inflammatory polyps can disappear on their own or through anti-inflammatory treatment, but inflammatory polyps can develop into adenomas polyps because of the irritation of inflammation for a long time.

The varied treatment approaches are designed for different specific conditions. As colon polyps has risk of becoming cancer, surgeons usually suggest endoscopic removal, a procedure known as polypectomy. This procedure is safe, effective in preventing polyps to become cancer and is scar-less.


Pay attention to regular colonoscopy

Mr. Yang, in his mid-sixties, had several times of blood in the stool five years ago. He worried about suffering from rectal cancer, and eventually sigmoid colon polyps were found after colonoscopy. Those polyps were resected and confirmed to be benign adenomatous polyps after histological assessment. A regular screening after surgery is essential. Mr. Yang did not turn up in the regular checkups since then. Five years later, he again found symptoms of blood in the stool, and results revealed that polyps recurred and became cancer.

Mr. Yang’s case reflects a fact that some people underestimate the importance of surveillance endoscopy in particularly those high-risk individuals. Due to anxiety or fear, some patients do not want to re-examine after polyps’ removal, resulting in failure to prevent colonic cancer.

For patients with a family medical history of polyps, surgeons will determine the frequency and duration of the patient to re-examine after the first endoscopic surgery. Re-examination is usually done once every three years, if no polyp is found in two consecutive cases, surgeons will extend the detection period. Whenever a small polyp is found, it should be removed promptly and sent for histological assessment. This can reduce the chance of malignant polyps’ formation.