Colon polyp is an endoscopic diagnosis. There are various nature of polyps, including inflammatory, proliferative, misshapen, adenoma, cancer, etc., which need further pathological examination to be clear. Nowadays, the view is that most colon cancers are caused by adenoma carcinoma, therefore, colon adenoma is something that should be treated as early as possible. However, not all adenomas are cancerous, therefore, there is no need to be overly nervous.
Since other types of polyps have been reported to be individually cancerous, for safety reasons, endoscopic treatment is now basically recommended for colon polyps. The most common endoscopic treatment for polyps is electrodesiccation, which is routinely performed in most large hospitals and is generally very safe. However, depending on the polyp site, size, shape, type of pathology, etc., the difficulty of operation varies and so do the risks. The most feared risks include bleeding, perforation, incomplete polyp removal, cardiovascular accidents, etc. Sometimes additional surgery is needed.
After the polyps are removed, they should be sent for pathological examination to further clarify the nature of the polyps and whether they are completely removed. There is no medicine to prevent or treat polyps, the most effective way is to review the colonoscopy or barium enema regularly, once polyps are found, remove them in time. The specific time of review varies from person to person and requires a comprehensive judgment by the doctor according to each individual’s situation.
Case: Ms. Zhang had blood in her stool twice six years ago, and she was very nervous at first, worrying that she had rectal cancer. Colonoscopy revealed sigmoid polyps with two pieces. After excisional biopsy, it was a benign adenomatous polyp. The doctor advised to review the colonoscopy regularly. Ms. Zhang did not have any blood in the stool after the surgery, so she forgot about the doctor’s instructions. Six years later, she had blood in her stool again, and then came to the hospital for examination and found that the polyp had recurred and become cancerous. Ms. Zhang’s case reflects that some people still have the mentality of fluke or avoidance: they do not pay enough attention to colonoscopy, fear or refuse to undergo colonoscopy, and are unwilling to be reviewed after polypectomy, so that colon cancer that can be prevented is not prevented.
Colon polyps are generally recommended to be removed plus biopsy. Colon polyps are divided by nature, the common ones are mainly inflammatory polyps and adenomatous polyps. Although most doctors can roughly determine benign and malignant under the naked eye based on experience, the pathological diagnosis under microscope after biopsy is the gold standard. There are three types of adenomas: tubular adenoma, villous adenoma and mixed adenoma. Adenomas are recognized as precancerous lesions. The highest rate of carcinoma is found in villous adenomas. Tubular adenomas have the lowest cancer rate. Therefore, all detected intestinal polyps should be removed. Adenomatous polyps do not go away on their own and are difficult to be eliminated with medication. If left untreated, they can grow slowly and have a higher chance of becoming cancerous. Inflammatory polyps are relatively safe, sometimes very small inflammatory polyps will disappear on their own, but inflammatory polyps are stimulated by inflammation for a long time, and may develop adenoma. Endoscopic polyp removal is less traumatic, shorter hospital stay, and cuts off the path of polyp cancer.
Polyp can recur and should be reviewed regularly If the polyps are small, less than 0.3cm in diameter, and multiple, it is often difficult to remove all of them at one colonoscopy, so patients usually need to be reviewed regularly and treated several times. Since some patients have poor intestinal cleanliness during colonoscopy, which affects careful observation, missed examinations also happen from time to time. Therefore, polyps are found and should be reviewed regularly, because even if they are removed, there is a possibility of recurrence, so regular review is especially important. Some patients think that colon polyps are cleaned once, and the polyps are benign after pathological examination, so they think that regular review is unnecessary or ignore the review, in fact, we can’t simply think that benign lesions are cut once and that’s it, because of the persistence of adverse factors polyps may recur again, the location and nature of the occurrence may be different.
Therefore, patients who have a history of colon polyps should be reviewed. After removal of a single polyp, pathologically proven to be benign, the colonoscopy should be checked only once a year at first, and no recurrence for 2-3 consecutive years, which means the probability of recurrence of the polyp is small, and then it can be changed to once every three to five years. However, if you have multiple benign polyps, you still need to have a colonoscopy once a year for insurance purposes. If adenomatous polyps and other polyps prone to cancer are found, they should be reviewed more closely after removal, and if cancerous, early surgical treatment should be sought.
It has been clinically found that westernized high-fat and high-protein diets are prone to colon polyps, while the increasing high-fat and low-fiber dietary patterns in China may be an important reason for the increased incidence of colon cancer. Our traditional diet is richer in plant fiber than the Western diet. Eating more green leafy vegetables, tomatoes, eggplants and carrots is beneficial to intestinal motility and reduces the occurrence of polyps.