OVERVIEW
Colorectal non-neoplastic polyps are abnormal growths that protrude from the surface of the colorectal mucosa and are less likely to become cancerous. There are three main types: juvenile polyps, hyperplastic polyps and inflammatory polyps.
Etiology
The etiology and pathogenesis are still unclear. Hyperplastic polyps and inflammatory polyps are considered to be related to infection and injury; juvenile polyps may be pseudomembranous tumors, or chronic inflammation caused by mucus retention or pseudomembranous tumors combined with the manifestation of inflammation.
Symptoms
1. Juvenile polyps
Polyps are mostly spherical or oval, bright red, pink or dark red in color, with smooth surface, the diameter of the tumor is about 1 cm, and most of them are tipped. Clinical manifestations are mainly blood in stool and polyps prolapse from the anus. Blood in stool is mostly bright red, distributed on the surface of feces or dripping blood after stool, with small amount of bleeding, similar to the performance of hemorrhoids.
2. Hyperplastic polyps
Polyps are round, dewdrop-like protrusions, smooth surface, small, hairy, to the rectum and sigmoid colon, there are no obvious symptoms, mostly in the examination of unintentional discovery.
3. Inflammatory polyps
Mainly secondary to chronic ulcerative colitis, Crohn’s disease, schistosomiasis, amoebic dysentery, intestinal tuberculosis and other diseases after the formation of granulomas, also known as pseudopolyps. Such polyps are often multiple, polyps without clitoris, smooth surface, diameter less than 0.5 cm, polyps can disappear after the control of inflammation; if continue to be stimulated by chronic inflammation, there is a possibility of cancer. The general symptoms of inflammatory polyps are not obvious, mainly manifested as symptoms of intestinal inflammation, such as diarrhea, mucus stools, mucus and blood stools, which can be clinically diagnosed through endoscopy and pathological examination.
Examination
Rectal fingerprinting can detect the location, size, shape and the presence or absence of bleeding of most polyps; fiber colonoscopy and X-ray barium enema angiography can detect the tumor and determine its location in relation to the periphery, and pathological biopsy can determine the nature and classification of the tumor. General examination such as blood routine and electrolytes can understand whether the patient has anemia and acid-base balance.
Diagnosis
1. Juvenile polyp
Rectal examination and endoscopy are the main methods of diagnosis. Rectal fingerprinting can be touched with a soft swelling, endoscopy can be seen polyps are purplish-red, not divided into leaves, have a tip, the surface is often decayed and white moss attached.
2. Hyperplastic polyps
Mainly rely on endoscopy and pathologic examination. Pathological histology can be seen in the polyp part of the mucosa thickening, hyperplasia, the structure is basically normal, the number of cells is slightly increased, the cell division band is slightly enlarged, but the cells are not fully differentiated, this limited cell division and full cell differentiation is a sign of non-tumor tissue.
3. Inflammatory polyps
Mainly rely on endoscopy and pathologic examination. Endoscopy can be seen polyp diameter is very small, no tip, polyp surface has congestion, part of the visible edema and erosion. Pathological examination can be seen by irregular expansion of polyps composed of linear tubes and fibrous tissue, there are inflammatory cells infiltration.
Treatment
For the treatment of juvenile polyps, endoscopic electrocoagulation excision is usually used; for the prolapse of the anus of the long tip polyp can be excised through the anus, and the postoperative recurrence is rare. Hyperplastic polyps are clinically observed to be temporary lesions that require no special treatment. Inflammatory polyps are mainly treated for the cause of the disease, and those with cancerous lesions need surgical treatment, radiotherapy, chemotherapy and so on.