In recent years, colonoscopy found more and more patients with colon polyps, especially some patients remove polyps will still recur, and repeatedly never “root”, but also fear of cancer, causing a greater burden on the patient’s body and mind.
Most intestinal polyps are benign It is reported that 90% of colorectal polyps are medically called adenomas, the incidence of the population is about 15% to 20%, and most of them are benign. However, a small percentage of adenomas can become cancerous, and the malignancy rate is closely related to the size of polyps, with the malignancy rates of less than 1cm, 1~2cm and more than 2cm in diameter being 1%, 10% and 35% respectively. The malignancy rate of choroidal adenomas less than 2cm in diameter is 10%, and that of those larger than 2cm is as high as 53%. This is of particular concern.
Preventable for the cause Most polyps can be cured by endoscopic treatment, but can we prevent recurrent polyps? Before that, we need to understand the causes of colorectal polyps.
1, mechanical stimulation long-term constipation patients, the production of intestinal toxins, or the use of stimulating laxatives to stimulate the intestinal wall can also occur polyps, because the coarse residue in the stool, foreign bodies and other factors can cause damage to the intestinal mucosa or long-term stimulation of intestinal mucosal epithelium, intestinal parasites and other non-inflammatory factors long-term stimulation, resulting in mucosa, glandular epithelium and submucosal tissue limited hyperplasia, the formation of intestinal polyps.
Countermeasures: Keep the bowels open, pay attention to cleanliness and dietary safety, and prevent intestinal parasitic infections.
In addition, there is a close relationship between polyp formation and genetic mutations and hereditary factors in some people. The most common is familial adenomatous polyposis, an autosomal dominant disease, the main pathological changes are the widespread appearance of tens to hundreds of polyps of different sizes in the large intestine, if not treated, can be cancerous, and can be manifested as simultaneous multiple primary bowel cancer. These polyps are difficult to prevent through lifestyle, and those with family history need to strengthen follow-up, raise awareness, early detection and treatment.
2, dietary factors Modern people’s westernized diet, too fine, such as “two high and one low” (high fat, high protein, low dietary fiber) diet structure and less and less exercise, and the development of colorectal polyps have a certain relationship. A greasy diet can increase the concentration of bile acids and neutral sterols in the colon, change the composition of the colonic flora, and gradually form carcinogenic substances in the intestine. If the fat intake does not exceed 15% of the diet, such as eating more high-fiber vegetables, fruits and coarse grains, the incidence will be significantly reduced. In addition, long-term heavy alcohol consumption, smoking, damage to immune function, so that the gene mutation, will also increase the incidence of polyps.
Countermeasures: Eat a light diet with less grease, eat more high-fiber vegetables, fruits and coarse grains, quit smoking and limit alcohol.
3, inflammatory stimulation long-term chronic inflammation of the intestinal mucosa, such as chronic colitis, ulcerative colitis, Crohn’s disease, etc., these intestinal inflammatory response or inflammatory bowel disease can cause mucosal erosion of the intestinal mucosa, ulcers, connective tissue or granulation tissue formation, glandular epithelium and the underlying tissue hyperplasia, pathological changes mostly manifested as inflammatory polyps, unless the polyp volume is relatively large, requiring endoscopic treatment, generally as long as control inflammation, the polyps will shrink or recede.
Countermeasures: actively prevent and treat inflammatory bowel diseases.
The rate of polyp malignancy is 3% to 10%, and its malignant time is 5 to 15 years. Experts say it is best to treat polyps immediately when they are found. Small polyps with or without a tip can be removed directly by colonoscopy, very simple and cost little; diameter greater than 3 cm polyps without a tip and biopsy pathology report shows that the polyps have been malignant, or colon polyps multiple, extensive lesions, can not be removed endoscopically all, should be performed surgical or laparoscopic treatment. Early malignancy can be treated by laparoscopic early radical surgery, and the prognosis is very good.
For some special patients, such as familial polyposis, the doctor will take the polyps according to the size, number, morphology and pathology of the polyps to be removed microscopically in stages and follow up regularly. Some patients can achieve good results, but some patients may need total colectomy.
Polyps can recur, and everything cannot be done away with. Regular colonoscopy must be done 1-2 years after surgery; patients with family history, even without any conscious symptoms, should have regular e-colonoscopy, anal finger examination, fecal occult blood and other examinations for early detection of lesions. Since colon polyp and colorectal tumor is a disease with family susceptibility and obvious genetic tendency, once diagnosed with this disease, the patient’s immediate family members need long-term follow-up and colonoscopy once in 3-5 years to achieve early detection, early diagnosis and early treatment.