What are colon polyps
Any polyp-like lesions protruding from the mucosal surface into the intestinal cavity are called polyps before the pathological nature is determined, and can be classified according to the pathology: adenomatous polyps (including papillary adenomas) are the most common, inflammatory polyps, the result of proliferation of intestinal mucosa stimulated by long-term inflammation, misshapen polyps, others, such as mucosal hypertrophy and hyperplasia to form hyperplastic polyps, lymphoid hyperplasia, carcinoid tissues and other disorders.
Clinically, polyps can be single or multiple, and colorectal polyps are more common and have more obvious symptoms. Depending on the severity of the symptoms, polyps can be treated with Chinese and Western medicines, colonoscopy, laser, freezing, ligation and transabdominal or transanal methods.
Symptoms of colonic polyps
1, intermittent blood in stool or blood on the surface of stool, mostly bright red, resulting in haemorrhage is not uncommon; secondary inflammatory infection can be accompanied by a large amount of mucus or mucus blood stool, there may be urgency, constipation or increased stool, long-tipped or near the anal location of the polyp can be prolapsed out of the anus, but also lead to intestinal overturning prolapse.
2.A few patients may have abdominal stuffiness and discomfort, vague pain or abdominal pain symptoms.
3.Low polyps can be palpated by rectal palpation.
4.Anoscopy, rectoscopy or fiberoptic colonoscopy can show polyps under direct vision.
5.Barium enema can show the filling defect.
Diagnosis of colonic polyps
1.History of blood in stool or mucopurulent stool.
2.Polyp found by anal examination or colonoscopy.
3.Barium enema may show filling defect.
Treatment of colonic polyps
1.Single polyp can be resected and examined at the same time.
2.Multiple polyps or polyps with malignant signs can be biopsied by anal anoscopy to exclude malignant changes.
3.Low or long-tipped prolapsed polyps can be removed by anal speculum, rectoscopy, ligation or direct excision through the anus.
4.Wide based or multiple polyps can be excised through the abdomen, perineum and caudal part of the intestinal wall.
5, high polyps feasible fiber colonoscopy high-frequency electrosurgery.
6.Polyp with cancer should be radical resection according to the tumor.
Treatment effect of colon polyps
1.Cure: symptoms disappear, polyps or lesions of intestinal segments removed.
2.Improved: symptoms disappear, most polyps are removed but there are still residual polyps or no rebleeding and mucopurulent stool and polyps are not cut.
3.Unhealed: symptoms exist, polyps are not removed.
Hazards and prevention of colon polyps
Hazards:
First, the polyps look: the kind of small size by the non-tumor polyp with the tip, most of the good people with polyps, generally not easy to malignant change; if the larger size, wide base and wide tip of the polyps, there is a strong possibility of malignant change to cancer.
Second, the number of polyps: a simple polyp has a low rate of cancer; and multiple polyps have an increased chance of cancer.
Third, the tissue properties of polyps: simple inflammatory polyps are less likely to become malignant, while adenomatous polyps, especially villous adenomas, are most likely to become colon cancer.
Fourth, the growth rate of polyps: benign polyps mostly grow very slowly, but if they grow rapidly in a short period of time, with a diameter greater than 2 cm or more, they should be alert to cancerous changes. Such as colonic adenomatous polyps is due to excessive proliferation of colonic mucosal cells, the cancer rate can reach 42%-77%.
Fifth, is to look at the family genetic history: there is a so-called “familial polyposis”, refers to the same family in the next generation can have several people suffering from colon polyps, belonging to autosomal dominant genetic disorders, is caused by a defect in the genes of chromosome 5 in the cell. If one of the parents has polyposis, 50% of the polyps in the offspring have a risk of malignancy; if both parents have polyposis, the risk of cancerous polyps in the offspring can rise to 75%.
Prevention:
1, aspirin against female colon polyps: Some women have a common genetic variant that slows the breakdown of aspirin, and these women can reduce the risk of colon polyps if they take aspirin consistently. In contrast, in women who do not have this genetic variant, aspirin does not reduce the risk of developing colon polyps.
2, calcium supplements help prevent colon polyps: Calcium can be very helpful in fighting colon polyps and colon cancer, even if the patient has previously suffered from these diseases. One study showed that those who took daily calcium supplements had a 19 to 34 percent lower risk of recurrence of colon polyps. Foods rich in calcium include milk and other dairy products, as well as cauliflower.
In addition, vitamin D (which helps the body absorb calcium) has also been shown to reduce the risk of colorectal cancer. You can get enough vitamin D by consuming some animal liver, egg yolks, fish and dairy products with vitamin D. Sunlight also converts a chemical in the skin into available vitamin D. If you don’t drink milk or get sunlight, you may want to consider taking a “vitamin D + calcium” combination supplement. If you don’t drink milk or get sun, you may want to consider taking a “vitamin D + calcium” supplement.
Frequently asked questions about colon polyps
1.What kind of colon polyps can become malignant?
The evolution and regression of colon polyps should be based on their pathological categories. The regression and prognosis of several common lesions are briefly described as follows: adenomas, because they may be multiple or have cancerous coexistence, and there is increasing evidence that benign polyp-like tumors can become malignant over time and under certain conditions.
(1) Multiple adenomas larger than 2.5 cm in diameter, or hard to the touch of fingers or instruments, or obvious congestion, or ulceration on the surface, should be considered to have the possibility of carcinogenesis, and the possibility of carcinogenesis should vary with the nature and size of the adenoma.
(2) Papillary adenoma has a high possibility of carcinogenesis and is considered to be a pre-cancerous lesion with a malignant rate of about 30%. Because of its clinical manifestation of mucus discharge, even a large amount of mucus may be discharged or a large amount of mucus diarrhea may occur, which may reach more than 3000ml per day, resulting in serious dehydration, electrolyte disorders, circulatory failure, acidosis and other metabolic disorders. If supplemental treatment is not given and the adenoma is not treated in time, it can cause life-threatening conditions.
(3) Childhood type polyps are more common in childhood and less common in adulthood, but it is worth noting that there have been reports of malignant transformation of such polyps in China.
(4) Inflammatory polyps and hyperplastic polyps, except for inflammatory polyps, which may become cancerous and it is difficult to determine or possible, hyperplastic polyps are clinically asymptomatic and are mostly found occasionally during colonoscopy, and because they are small, mostly around 0.5 cm, they often do not cause discomfort.
(5) Familial polyposis, a rare hereditary polyposis. The colon and rectum are covered with polypoid adenomas, cancer is only sooner or later, and the cancer is often not limited to one place, for multi-center, in fact, some patients are already colorectal cancer when they seek medical attention.
2.What diseases can colon polyps cause?
Colitis has the following common complications.
Large amount of blood in the stool: blood in the stool is one of the main clinical manifestations of colitis, and the amount of blood in the stool is also an indicator of the severity of the disease.
Intestinal stenosis: It occurs in patients with extensive lesions and duration of the disease lasting for more than 5-25 years, mostly in the left colon, sigmoid colon or rectum. In heavy cases, it can cause intestinal obstruction. In the presence of intestinal stenosis in colitis, it is important to be alert to tumors and identify benign malignant.
Toxic intestinal dilatation: This is a serious complication of colitis, mostly occurs in patients with total colitis, the mortality rate can be as high as 44%, the clinical manifestations are rapid deterioration of the disease, toxic symptoms are obvious. Intestinal perforation: It is mostly a complication of toxic bowel dilatation and can also occur in severe form, mostly in the left hemicolon. Corticosteroid application is considered a risk factor for intestinal perforation. It is accompanied by diarrhea, abdominal pressure and rebound pain, diminished or absent bowel sounds, and increased white blood cell count, and is easily complicated by intestinal perforation.
Colon tumors: about 5% of patients with colitis develop malignant changes, those with a juvenile onset and a history of more than 10 years.
3.What about children with colon polyps?
Any polyp-like lesions protruding from the mucosal surface into the intestinal cavity are called polyps before the nature of the pathology is determined.
According to the pathology can be divided into.
1, adenomatous polyps (including papillary adenomas) are the most common, inflammatory polyps, intestinal mucosa stimulated by long-term inflammation as a result of hyperplasia, misshapen polyps, others, such as mucosal hypertrophy and hyperplasia to form hyperplastic polyps, lymphoid tissue hyperplasia, carcinoid tumors and other disorders.
Clinically, colorectal polyps are more common and have more obvious symptoms. So, how is the treatment of children’s colon polyps?1, fiber colonoscopy electrocautery resection: colonoscopy under direct vision electrocautery removal of polyps has become a common means of polyp surgical treatment today, for polyps with a tip or smaller broad-based polyps, can be removed under fiber colonoscopy with a trap from the polyp root electrocautery. But the treatment process must be extra careful, otherwise it can cause serious complications such as intestinal perforation.
2, surgical removal: rectal polyps can be surgically removed from the root tip in the anoscope, pay attention to the polyp root tip must be clean and complete removal, otherwise it can lead to postoperative recurrence, usually after removal of the polyp root tip ligation, let it necrosis fall off on its own. Surgical excision is the treatment often used for rectal polyps.
4.Why does green tea have a preventive effect on colon polyps?
Continuously taking the drug containing green tea ingredient “catechuic acid” can inhibit the recurrence of colon polyps. According to Kyodo News, this is the first time through clinical trials to verify that green tea drugs can prevent the recurrence of polyps. Colon polyps are the source of colon cancer. The results suggest that cancer can be prevented with a simple green tea drug. Four hospitals in the prefecture, including Gifu University Hospital in Japan, participated in the clinical trial.
Among 125 people who had their colon polyps removed by endoscopic surgery, 60 people took 3 tablets of green tea medicine (1.5 grams in total, 6 cups) per day, and 65 people did not. 1 year later, the rate of recurrence of polyps was compared with that of patients who did not take green tea medicine. The recurrence rate of polyps in patients who continued to take the drug was significantly lower at 15% compared to 31% in patients who did not take the green tea drug. The size of recurrent polyps was also significantly smaller in patients taking the drug. Even with the green tea medication, the recurrence rate was still as high as 60% for those who consumed less than 3 cups of green tea per day in small amounts. This suggests that drinking more green tea can inhibit the recurrence of polyps.