Recently, Mr. Lee went to the doctor with stomach trouble and saw something troubling. What’s bothering him? In the past six months, he often stomach pain and thin stools, especially affecting the work. Then he went to Wuhan Union Hospital to see a gastroenterology specialist, the initial stool test, the results are normal, so the doctor for him to make a colonoscopy, the test report: colon polyps. What to do is good? 1.What is gastrointestinal polyp? A gastrointestinal polyp is a limited lesion that rises above the epithelium of the gastrointestinal mucosa and protrudes into the gastrointestinal lumen. According to the different parts of the digestive tract, polyps are called esophageal polyps, gastric polyps, small intestine polyps, large intestine (colon and rectum) polyps, etc., of which the stomach and large intestine polyps are the most common. The majority of gastrointestinal polyps occur singly, and about 20% of patients are multiple. A few patients have a large number of colon polyps, or even polyps of both stomach and small intestine, with various manifestations of systemic diseases called gastrointestinal polyp syndrome.
2.How are gastrointestinal polyps found?
Gastrointestinal polyps are one of the common gastrointestinal diseases, which can be detected due to pain, bleeding stool, mucus stool, etc. Most patients do not necessarily show symptoms, but are found when doing diagnostic tests or physical examinations.
3.Classification of gastrointestinal polyps and their hazards?
The histological characteristics of polyps under the microscope can be divided into 4 categories: tumor polyps, misshapen polyps, inflammatory polyps and hyperplastic polyps. Inflammatory polyps are related to the inflammatory response of the intestine, grow very slowly and are basically not cancerous. Adenomatous polyps are classified as adenomatous ductal adenoma, villous adenoma, and villous adenomatous ductal adenoma. Research shows that the cancer rate of adenomatous polyps is about 5%-40%, among which the cancer rate of villous adenoma is the highest, the larger the polyp, the greater the chance of cancer.
4.How to deal with gastrointestinal polyps?
If gastrointestinal polyps are found, endoscopic polyp removal treatment is advocated to prevent polyps from becoming cancerous. The most common endoscopic treatment is high-frequency electrocoagulation resection, which uses high-frequency current to produce high heat to the tissue in contact with the trap, and cauterize and cut off the polyp to remove it completely and quickly and stop bleeding. This method is not only easy to perform, painless for the patient, inexpensive, with fewer complications, but also allows obtaining pathological findings of the entire polyp. Some complications may occur during the removal of polyps, but of course these are noted and prevented by the surgeon. After the operation, patients should take rest, prohibit intense exercise, eat a liquid diet, and take gastrointestinal mucosal protectants and hemostatic drugs.
Removal of polyps by colonoscopy with high-frequency electric knife or electrocoagulation is a major advancement in the treatment of intestinal polyps. Compared with surgery, this treatment method is minimally invasive, avoiding the pain of caesarean operation and having precise efficacy. Multiple polyps can be removed at one time, but in elderly patients with arteriosclerosis, no more than 5 polyps can be removed at one time, and in general, no more than 5 polyps can be coagulated. If the removed polyps are malignant and the cancer only invades the mucosal layer, radical surgery may not be performed. If the cancer invades the submucosal layer, but the polyp has a tip or residual tip without cancer, and the tumor is well differentiated, and there is no infiltration of lymphatic vessels and blood vessels, it can be closely observed. Complications of colon and rectal polyp removal often include bleeding of polyps and intestinal perforation, which need to be closely observed and prevented.
The indications for colonoscopic removal are: (1) small polyps without a tip.
(2) polyps with a wide base, but the tip is <2.0 CM; (3) polyps with a wide base, but the polyp itself is <2.0 CM. Contraindications are: (1) severe hypertension and coronary heart disease; (2) intestinal obstruction with severe abdominal pain, abdominal distension, nausea and vomiting; (3) peritonitis; (4) bleeding disorders; (5) polyps with malignant invasion of the tip; (6) pacemakers; (7) polyps with a basal width >2.0 CM; (8) polyps with extensive clusters; (9) pregnant patients; (10 (10) Those who are physically weak or unable to cooperate.
Most gastrointestinal polyps have no clinical symptoms and are mostly found incidentally during endoscopy. Mr. Li’s symptoms were not caused by polyps, and the symptoms persisted after polyps were removed, which may be a functional intestinal disorder or require further examination for other causes. It is worth noting that elderly people, people with family history of disease, and patients with previous history of gastrointestinal polyps need to undergo regular gastroscopy in addition to the above principles.