Polyps of the Colon & Rectum

What is polyps of the colon and rectum?Polyps of the colon and rectum, also known as colorectal polyps, are abnormal growths that are found in the inner lining of your colon and rectum. They occur in around 25 percent of adults.

Unfortunately, most cases of colorectal cancers are ‘silent’ tumours which arise from colorectal polyps. This mean that polyps grow very gradually and do not cause symptoms until they become very large.

Most cases of colorectal polyps are discovered during a colonoscopy.

How do I know if I have polyps in my colon and/or rectum?In most cases, polyps of the colon and rectum do not present any symptoms unless they have grown to a large size. This is why screening is highly important as it is able to detect any polyps or abnormalities at an early stage, which increases your chances of a successful treatment and recovery.

While it is rare, polyps can cause these symptoms:

  • Blood in the stools
  • Abdominal pain
  • Excess mucus
  • Change in bowel habits

Do consult your doctor immediately should you have any of the above symptoms.
What causes polyps of the colon and rectum?Normal, healthy cells divide regularly and in an orderly manner. Mutations in certain genes may cause cells to divide excessively even when new cells are not needed. This is known as uncontrolled cell division. The cells accumulate into a mass of cells that become polyps.

Certain factors may place you at risk of developing polyps in your colon or rectum. These include:

  • Age, especially if you are 50 or older
  • Being overweight or obese
  • Lack of exercise
  • Family history of colorectal cancer or polyps
  • Inflammatory intestinal conditions, including Crohn’s disease and ulcerative colitis
  • Alcohol and tobacco use
  • Inherited diseases:
    • Lynch syndrome
    • Peutz-Jeghers syndrome
    • Familial adenomatous polyposis (FAP)
    • Gardner syndrome’s (a type of FAP)
    • Juvenile polyposis (disease which causes many benign growths in your intestine,usually occurring before you are 20 years old)
    • Lynch syndrome

How are polyps of the colon and rectum diagnosed?Polyps of the colon and rectum are usually diagnosed through a colonoscopy. A colonoscopy is a long, flexible tube used to examine your colon. The end of the endoscope is attached to a camera and a light to aid your surgeon’s view of your colon. Should any polyps be found, they are removed at the same time.

A CT colonography may be used to examine your colon. However, if any polyps are found during this examination, a colonoscopy may be required to remove them or for tissue samples to be sent to the laboratory for a biopsy.

Other tests that can be able to detect polyps are a digital rectal examination, sigmoidoscopy, barium enema and a fecal occult blood test.

Why surgery to remove polyps of the colon and rectum?Removal of polyps in the colon and rectum is advised because it is hard to determine if the polyps are cancerous or will turn into cancer. Especially for polyps 1cm in diameter or larger, they have a high risk of being malignant. Nearly all polyps found can be removed via a colonoscopy.

Once a polyp is removed, the chances of it re-occurring is very low. However, some patients may develop new polyps after removal. As such, your surgeon may advise follow-up screening to ensure you are clear of polyps. This will usually be done once in 3 to 5 years after your polyps have been removed.

Screening and early detection can prevent the spread of these cancers.