What are the other Names for this Condition? (Also known as/Synonyms)

• Colonic Polyps
• Polyps of Large Bowel
• Polyps of Large Intestine

What is Colon Polyps? (Definition/Background Information)

• Colon Polyps are extra cells that clump and grow on the lining of the colon or rectum. It is a benign condition that occurs due to abnormal cell growth within the colon tissue
• The clumps present in Colon Polyps are normally harmless, but some types have the ability to develop into colon cancer (which can even be fatal depending on the stage at which it is detected)
• There are multiple types of Colon Polyps, namely:
  • Hyperplastic Polyp of Colon: These are benign polyps with no potential to turn into malignancy
  • Inflammatory Polyp of Colon: Such polyps are associated with inflammatory bowel diseases, such as ulcerative colitis and Crohn’s disease. This type also does not have the potential to turn malignant
  • Adenomatous Colon Polyp: There are 3 types of Adenomatous Colon Polyps and these are premalignant, meaning that they may turn into colon cancer with time. The 3 types include tubular adenoma, tubulovillous adenoma, and villous adenoma
  • Serrated Colon Polyp: These are also known as sessile serrated adenomas. They commonly occur in the right side of the colon. These polyps are also considered premalignant, meaning that they may turn into colon cancer during the course of time
• There is a higher risk for Colon Polyps developing in individuals who are 50 years or older, have a family history of colon cancer, are overweight, or are smokers
• Colon Polyps usually lack any symptoms; therefore, regular colon screening is required in order to detect them. If symptoms are present, they may include rectal bleeding, iron deficiency, vomiting, nausea, constipation, or diarrhea
• A possible complication of the adenomatous and serrated types of Colon Polyp is the development of cancer, if not attended to in a timely fashion
• The treatment of choice to address these Colon Polyps is their surgical removal. When the polyps are completely removed, there is no risk of cancer development from them
• The prognosis for all types of Colon Polyp is excellent, if they are detected and treated early

Who gets Colon Polyps? (Age and Sex Distribution)

• Colon Polyps generally affects elderly or older adults. Rarely, some polyps are known to develop in children as well, especially against a background of inflammatory bowel disease (IBD)
• They can occur in both males and females
• This condition is observed worldwide across all racial and ethnic groups; however, African Americans are more likely to develop cancerous polyps, even before they reach the age of 50 years

What are the Risk Factors for Colon Polyps? (Predisposing Factors)

The risk factors that contribute to Colon Polyps formation include the following:

• A history of ovarian, uterine, or breast cancer
• Type 2 diabetes
• Inflammatory bowel disease including Crohn’s disease or ulcerative colitis

There is also a higher risk associated with the following conditions:

• Being overweight
• Regularly having a high-fat diet, which includes the consumption of vast amounts of red or processed meats
• Living a sedentary or inactive lifestyle
• Smoking
• Alcohol consumption

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Colon Polyps? (Etiology)

The cause of Colon Polyps depends on its type - whether it is hyperplastic, inflammatory, adenomatous, or serrated type.

• Adenomatous and Serrated Colon Polyps occur due to genetic mutation causing abnormal growth
• Hyperplastic and Inflammatory Colon Polyps occur as part of reactive changes due to irritation of the colonic lining or the colon mucosa

What are the Signs and Symptoms of Colon Polyps?

In a majority of the affected individuals, there are usually no signs and symptoms of Colon Polyps noted. In some individuals, however, the signs and symptoms of Polyps of Large Intestine may include:

• Rectal bleeding
• Iron deficiency anemia, which may lead to a feeling of tiredness
• Pain within the abdominal region, which can result in nausea and/or vomiting
• Changes in stool color; changes in normal bowel habits

How is Colon Polyps Diagnosed?

The diagnosis of Colon Polyps may include the following tests and procedures:

• Complete physical examination with detailed medical history evaluation
• Stool sample analysis
• Inpatient or outpatient colonoscopy:
  • Virtual colonoscopy, which is a combination of analysis methods, relying on computer technology and X-rays
  • Flexible sigmoidoscopy, which is a testing protocol utilizing a small camera with an attached light in order to examine the rectum and lower colon
  • Lower gastrointestinal series, which are a combination of analysis methods, combining X-rays and barium to visualize the intestinal region

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Colon Polyps?

• The main complication of Colon Polyps is that some types (the adenomatous and serrated types) can become cancerous, if diagnosis is delayed
• In case of Inflammatory Colon Polyps associated with ulcerative colitis or Crohn’s disease, large polyps can cause severe bleeding

How is Colon Polyps Treated?

In general, the treatment of Colon Polyps involves the following measures:

• Removal while screening: In most cases, the polyps can be removed by a healthcare provider during a screening colonoscopy or sigmoidoscopy
• Larger polyps may be removed via endoscopic mucosal resection via the mouth orifice
• Large Adenomatous Colon Polyps or Serrated Colon Polyps may be removed using sleeve colon resection
  • This procedure can be performed either by an open laparoscopic procedure or an endoscopic laparotomy procedure (keyhole surgery)
  • The sleeve colon resection is performed, since larger polyps may have focus of invasive adenocarcinoma of colon (in some cases)

Generally, proper follow-ups with regular screening and check-ups are important and encouraged, especially if the individual is over the age of 50 years.

How can Colon Polyps be Prevented?

Colonic Polyps may not be preventable, however certain risk factors may be avoided and lifestyle factors considered in order to minimize the risk for the condition. These include:

• Choosing to have a healthy lifestyle; exercising more often
• Smoking cessation; minimizing alcohol consumption
• Losing weight, if one is currently overweight
• Changing one’s diet to include less processed foods with less red meat; having a calcium and vitamin D rich diet
• Taking a daily low dose of aspirin with physician consultation and approval
• Control of inflammatory bowel diseases through medications and follow-up visits
• Regular medical screening  beginning at the age of 50 years - African Americans should begin the screening process by age 45

What is the Prognosis of Colon Polyps? (Outcomes/Resolutions)

• In general, the prognosis is excellent with early detection and treatment for all types of Colon Polyps. If detected early, these may be easily removed
• The adenomatous and serrated types can become cancerous, if they are left undetected. In such cases, the prognosis depends on the stage of the colon cancer and a set of several factors that include:
  • Time of detection: The earlier the cancerous tumor is detected the more positive is the prognosis
  • Colon cancer stage: With lower-stage tumors, when the tumor is confined to site of origin, the prognosis is usually excellent with appropriate therapy. In higher-stage tumors, such as tumors with metastasis, the prognosis is typically poor
  • If the tumor is able to be completely removed, the prognosis is favorable
  • Overall health of the individual: Individuals with overall good health have better prognosis compared to those with poor health
  • Response to treatment of colon cancer: Tumors that respond to treatment have better prognosis compared to those that do not respond so well to treatment

Additional and Relevant Useful Information for Colon Polyps:

Not all colon cancers are associated with polyps. Although most colon cancers are derived from adenomatous or serrated Colon Polyps, some colon cancers do not occur in such polyps. These cancers are difficult to identify and treat due to their flat or depressed nature, when examined during colonoscopy (areas of flat dysplasia are present). Such cancers are often called colon cancers arising in a background of flat dysplasia.