Colorectal Polyps

What are colorectal polyps?

• Colorectal (ko-lo-REK-tal) polyps (POL-ips) are small lumps of tissue 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. They may be found in different locations in the colon and rectum, and become more common as people age.
  
  
• The colon and rectum are also called the large bowel. They are part of the digestive system in the lower part of the abdomen (stomach). The digestive system is where food is swallowed and broken down. The colon is the first section of the large bowel where stool (bowel movements) form. The rectum is the last part of the large bowel where the stool stays before leaving the body. Diagnosing and treating colorectal polyps as soon as possible, such as with surgery, may prevent them from becoming cancerous.

What causes colorectal polyps?

The exact cause of colorectal polyps is unknown. The following are possible conditions and factors that may put you at risk of having colorectal polyps:

• Age: The chance of gettting colorectal polyps increases with age.
  
  
• Diet: Eating a diet high in fat, such as fried foods, and low in fiber may cause colorectal polyps.
  
  
• Family history: Having a close family member, such as a parent, brother, or sister, with polyps or colorectal cancer.
  
  
• Genetic: You may have been born with genes that may cause colorectal polyps, such as familial adenomatous polyposis. A gene is a little piece of information that tells your body what to do or what to make.
  
  
• Obesity: Weighing more than what your caregiver suggests.
  
  
• Other intestinal problems: Having other diseases of the colon, such as Crohn's disease or ulcerative colitis, increases your risk of polyps.
  
  
• Unhealthy lifestyle:
  
  
  • Being physically inactive. This decreases bowel movements and allows stool to stay longer in the colon.
    
    
  • Smoking or drinking alcohol. Alcohol is found in beer, wine, liquor, such as vodka and whiskey, and other adult drinks.

What are the signs and symptoms of colorectal polyps?

You may have any of the following:

• Bleeding from the rectum.
  
  
• Change in bowel movement habits, such as diarrhea and constipation.
  
  
• Pain in the abdomen.
  
  
• Pale skin and gums.

How are colorectal polyps diagnosed?

Yearly screening for colorectal diseases in all men and women over 50 years old is suggested. You should be screened earlier if you have colon diseases, or a family history of polyps or colorectal cancer. 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 colorectal polyps. 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 for polyps.
  
  
• 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.

How are colorectal polyps treated?

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:

• Watchful waiting: Watchful waiting may be all that is needed for polyps that are small, hyperplastic, and located in the left colon. Your caregiver may want you to have regular checkups to see how your colorectal polyp is doing.
  
  
• 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.

Where can I find support and more information?

Having a cancerous polyp or a genetic disease that causes colorectal polyps, such as familial adenomatous polyposis, may be hard. You and those close to you may feel scared, depressed or angry. These are normal feelings. Talk to your caregivers, family, or friends about your feelings. You may also want to join a support group. This is a group of people who have the same condition as you have. Contact the following for more information:

• National Cancer Institute
  6116 Executive Boulevard, Room 3036A
  Bethesda , MD 20892-8322
  Phone: 1- 800 - 422-6237
  Web Address: http://www.cancer.gov
  

• National Digestive Diseases Information Clearinghouse (NDDIC)
  2 Information Way
  Bethesda , MD 20892-3570
  Phone: 1- 800 - 8915389
  Web Address: www.digestive.niddk.nih.gov
  

• Genetics Home Reference
  National Library of Medicine
  8600 Rockville Pike
  Bethesda , MD 20894
  Web Address: http://ghr.nlm.nih.gov
  

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.

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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.

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