Colorectal Polyps

WHAT YOU SHOULD KNOW:

• Colorectal (ko-lo-REK-al) polyps (POL-ips) are small lumps of tissues in the lining of the colon and rectum. They are usually benign (noncancerous) and produce no symptoms. Over time, certain types of polyps called adenomatous polyps, may develop into cancer (tumor). Another type of colorectal polyp is the hyperplastic polyp that usually does not develop into cancer. Polyps may be present in different shapes, such as a sessile (flat) polyp or on a stalk (stem). They may be different colors and sizes, and may be one or more in number. Genetics, increased age, obesity, and a diet high in fat or low in fiber may increase your risk for colorectal polyps. Having other diseases of the colon, such as Crohn's disease or ulcerative colitis, also increases your risk of polyps. The colon and rectum are also called the large bowel. The large bowel is part of the digestive system where stools are formed.
  
  
• Most colorectal polyps have no signs and symptoms. If present, you may have bleeding from the rectum (rear end), abdominal pain, or pale skin or gums. You may also notice some changes in your bowel habits, such as diarrhea and constipation. You may have a colonoscopy, barium enema, sigmoidoscopy, and CT scan to diagnose colorectal polyps. Treatment may include watchful waiting, colonoscopic polypectomy, and surgery. Diagnosing and treating colorectal polyps as soon as possible may prevent them from becoming cancerous.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Some treatments for colorectal polyps carry certain risks. Your bowel may be perforated (torn) when polyps are removed or you may bleed during a colonoscopy procedure. This may lead to an open abdominal surgery. During surgery, you may bleed too much or get an infection. Your chances of preventing polyps from turning into cancer are better if you are treated. Once polyps turn into cancer, they become more difficult to treat and you can have other serious medical problems. Ask your caregiver if you are worried or have questions about your disease, medicines, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Activity:

You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

Food and drink after surgery:

You will able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft food easily, you may slowly begin to eat solid foods.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

You may need one or more of the following medicines:

• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Antinausea medicine: This medicine may be given to calm your stomach and prevent vomiting.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

Tests:

Your caregiver may need to check a sample of your stool for occult (hidden) blood. Blood in the stool may be an early sign of a colorectal polyp. You may also need any of the following tests:

• Colonoscopy: A colonoscopy is a test that is done to look at your colon. A tube with a light on the end will be put into your anus, and then moved forward into your colon.
  
  
• Digital rectal examination: This is also called DRE. Your caregiver will examine your anus (rear end) and use a finger to perform a digital rectal exam (DRE) to check your rectum.
  
  
• Imaging tests:
  
  
  • Barium enema: A barium enema is an x-ray of the colon. A tube is put into your anus, and a liquid called barium is put through the tube. Barium is used so that caregivers can see your colon better on the x-ray film.
    
    
  • CT scan: This test is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your abdomen (stomach). Caregivers look at the pictures to see if there is a colorectal polyp. Before taking the pictures, you may be given dye through an IV in your vein. The dye helps the polyps or cancer show up better in the pictures. Tell your caregiver if you are allergic to shellfish (lobster, crab, or shrimp), as you may also be allergic to this dye.
    
    
  • Virtual colonoscopy: This is a special CT scan that takes pictures of the inside of your colon and rectum. A small, bendable tube is put into your rectum and air or carbon dioxide (gas) is used to expand your colon. Caregivers may then clearly see the different parts of your colon and any polyps while watching the images in a monitor.
  
  
• Sigmoidoscopy: A sigmoidoscopy test looks for changes in your intestinal (bowel) wall that may be caused by a disease or condition. This test may also help find the cause of bleeding or pain. A long, thin tube with a tiny camera on the end is put through your anus into your rectum (rear-end). It also goes to the part of your intestine called the sigmoid. Caregivers will look for problems in your rectum and lower colon. A small amount of tissue may be taken from the intestine wall and sent for tests. Follow your caregiver's instructions for what to do before, during and after the test.

Treatment options:

Treatment will depend on the type and amount of colorectal polyps present, and their location and size. Adenomatous polyps are usually removed as there is a risk of them developing into cancer. You may need any of the following:

• Blood transfusion: You will get whole or parts of blood through an IV during a transfusion. Blood is tested for diseases, such as hepatitis and HIV, to be sure it is safe.
  
  
• Colonoscopic polypectomy: Polyps may be removed during a colonoscopy. Polyps may be removed by snaring (lassoing them) with a wire loop that cuts and burns them off. If they are small, they may just be burned off.
  
  
• Surgery: You may need laparoscopic or open surgery, depending on the type, size, and number of polyps that you have. Laparoscopy is done by inserting a scope into small cuts made in your abdomen. The scope is a long tube with a magnifying glass, a camera, and a light on the end. Open surgery is done by making an incision in your abdomen (stomach). All or part of your colon or rectum may be removed if you have a genetic disease, such as familial adenomatous polyposis. All or part your colon may be removed if a polyp is obstructing your colon or contains cancer cells. You may also need to have some lymph nodes removed if a cancerous polyp is found. After the diseased colon is removed, the surgeon may be able to attach the healthy parts of the colon and rectum back together.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Colorectal Polyps (Inpatient Care)