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Intestinal polyps Causes, Symptoms and Treatment

The intestinal polyps are outgrowths forming on the lining inside the colon. They occur in 30% to 50% of adults in industrialized countries. Environmental and dietary factors probably play a role in their appearance.

So-called adenomatous polyps or adenomas are precancerous lesions representing about 70 to 75% of polyps. They are likely to progress to colon cancer.
Other types of polyps do not progress to colon cancer. These are hyperplastic polyps, hamartomatous (juvenile or Peutz-Jeghers) or inflammatory polyps.
Polyps are usually a few millimeters in diameter , sometimes more than one centimeter. They are detected by blood screening in the stool (fecal occult blood test or FOBT), and by colonoscopyexamination also allowing them to be removed most often.

Intestinal polyps usually cause no symptoms . However, they are routinely removed when they are detected as a preventive measure against colon cancer.

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Box: familial polyposis Family
adenomatous polyposis or familial polyposis coli are a disease whose origin is a genetic mutation. In affected people, a very large number of polyps develop on the colon. Because of this amount of polyps, the risk of having colon cancer is very high, almost 100% at 40 years. The usual treatment is surgery to remove the colon to avoid cancer. Other polyposes exist, some at risk of cancer (Gardner syndrome, Turcot syndrome) and others that are benign because polyps do not evolve to cancer (Peutz-Jeghers syndrome, the disease of Cowden, juvenile polyposis).

Possible complications

Adenomatous type polyps are transformed into colon cancer very gradually in 10 to 20 years.

The earlier they are removed , the lower the risk of transformation into cancer.

When to consult?

– From the age of 50 , intestinal polyps must be detected in each of us. Nobody should escape. For this, we have a screening test to ask the attending physician who distributes it for free. This test detects blood in the stool. It must be done again regularly every two years if it is normal.
– In case of abnormal screening test (4% of cases), that is to say blood detection in the stool, a colonoscopy is performed, allowing to remove the polyps if there are any. Most often, there is nothing (the blood in the stool is related to anything else like hemorrhoids or an anal fissure for example), but in 30% of cases polyps are present. In 8% of cases, there is colorectal cancer, often at an early stage.
– In the case of polyps that have been removed, it is generally necessary to have a new screening colonoscopy 5 years later or otherwise, according to the doctor’s recommendation.
– In case of family disease  : Some families suffer from familial polyposes, genetic diseases causing a large number of polyps at very high risk of becoming cancer. When a person has this type of illness, it is important to closely monitor their close relationship.
– When one suffers from Crohn’s disease or ulcerative colitis after the 8 Th or 10 thyear of illness according to evolution. Regular colonoscopy is performed with biopsies because these diseases increase the risk of colon cancer. Nevertheless, this cancer occurs more often on a flat lesion rather than on polyps as in the rest of the population. These lesions resemble polyp lesions under the microscope, but are often more difficult to see in colonoscopy, resulting in systematic sampling every 10 cm.

The symptoms of intestinal polyps

In general, intestinal polyps, especially the small ones, do not cause any symptoms , hence the importance of undergoing screening and colonoscopy if necessary. However, polyps can cause the following symptoms:

– Bleeding through the rectum;
– Blood in the stool;
– Changes in bowel habits that last more than a week (eg constipation or diarrhea);
– Abdominal pain.

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Risk factors of intestinal polyps

Anyone can suffer from intestinal polyps. Certain risk factors, however, play a significant role in their appearance:

– To be over 50 years old,
– To have a first-degree relative suffering from colorectal cancer,
– To have already had a colorectal cancer,
– To have already had intestinal polyps,
– To be part of a family with polyposis family,
– Suffer from chronic inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis (ulcerative colitis).
– Overweight or obesity;
– Smoking and high alcohol consumption;
– Diet high in fat and low in dietary fiber;
– Sedentary lifestyle;
– Having acromegaly 2 to 3 times greater risk of adenomatous polyp and colon cancer.

Prevent intestinal polyps

Basic preventive measures
  • Be physically active ;
  • Favor a diet rich in fruits, vegetables and whole grains.
  • Limit the consumption of meat and sausages: The consumption of red meats (beef, veal, mutton, lamb, pork …) and cold cuts (meats preserved by smoking, drying, salting or adding preservatives) increases the risk of colorectal cancer. The risk is increased by 29% per serving of meat consumed by 100 g / day and by 21% per serving of 50 g of cold cuts / day.
  • Refrain from smoking: the longer you smoke, the longer you smoke, the higher the risk of polyps and colon cancer;
  • Avoiding alcohol abuse: from a single drink consumed per day, the risk of polyp increases, and that of colon cancer also increases by 9%;
  • Calcium intake, especially in dairy products, would help reduce the risks.
  • Treatments containing estrogens (contraception, treatment of menopause) reduce the risk of intestinal polyps by 45% and the risk of colon cancer by nearly 20%. The risk reduction disappears 5 years after stopping treatment.
Screening measures
  • To undergo a screening test after 50 years, and this every 2 years.
  • To have a colonoscopy when the doctor recommends it, and that, to the regularity necessary according to the situation.
  • Learn about people who had polyps or colorectal cancers in the immediate family to adapt screening.

Medical treatments

  • Polyps are not treated with drugs. They are removed by surgery.
  • Minor surgery and cautery . Most polyps can be removed at the moment of colonoscopy, cutting them at the base. Then they are routinely sent to a laboratory for examination and whether they are precancerous or cancerous. The procedure is painless, since the wall of the intestine is insensitive to touch and is performed under general anesthesia.
  • Surgery . In cases of polyposis, when polyps are very numerous, it is sometimes necessary to resort to surgery (laparotomy) to remove a piece of colon.

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