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Colon polyps are benign tumors that form as stalked or sessile buds or mushroom-shaped extensions starting from the intestinal surface and protruding into the intestine. Polyps are described as noncancerous (non-cancerous) tumors or neoplasia.
The question of why polyps form in some people and not in others is still not fully answered. It has been thought that eating a diet rich in fat and low in fiber may be a factor that facilitates the formation of colon polyps, but hereditary factors are considered to be more important. There are studies showing that the use of antirheumatic drugs and chronic aspirin can prevent polyp formation.
There are two different types of colon polyps that are common: hyperplastic polyp and adenomatous polyp. Hyperplastic polyps do not pose a risk for developing cancer, so they are not very important. Most adenomatous polyps do not become cancerous, but almost all colon cancers are thought to arise from an adenomatous polyp.
The distinction between hyperplastic polyp and adenoma can be made by taking a small sample from the polyp (biopsy) or by removing the polyp completely (polypectomy) and examining it. Although it is not possible to say which adenomatous polyp will become cancerous, it is known that adenomatous polyps larger than 2 cm in diameter are more likely to become cancerous. Sometimes, cancer foci can be found in large polyps that cannot be noticed with the eye or biopsy. In this case, complete removal of the polyp is recommended.
As age progresses, the likelihood of polyps in the intestines increases. While it is quite rare under 30 years of age, large bowel polyps are seen in ¼ of individuals around the age of 50 and in almost half of the people around the age of 70. The cause of the formation of polyps is not yet known.
The biggest risk factor for polyp development is being over 50 years old. If a family member has a history of polyp or colon cancer, the risk of developing polyps increases. In addition, a person with a previous polyp or a history of colon cancer is also more likely to have a new polyp.
Collon the other hand, although rare, in some hereditary diseases that can be associated with the presence of multiple polyps in the digestive system and their transformation into cancer, polyps may occur in the intestines at younger ages.
Many polyps do not cause any symptoms, while large ones may cause blood in the stool, but usually do not. Therefore, the best way to find polyps is to screen people who do not have any complaints. Many different scanning techniques can be applied.
These; blood in stool samples, colonoscopyexamination of the large intestine, or the use of a radiological test such as a barium enema (See Colon cancer prevention). If polyp is seen or suspected in any of these methods, your doctor will usually recommend that you do a colonoscopy and see and remove the polyp.
Because colonoscopy is the most reliable way to find polyps. Today, many experts recommend scanning with colonoscopy, in this method, it is possible to remove the polyp in the same session when it is seen.
Most of the polyps seen during colonoscopy can be removed in the same session. Although the technique of each gastroenterologist shows slight differences, the method applied is basically the same. After grasping the polyp stem with a ring-shaped instrument called a polypectomy snare, it is cut and removed using electric current.
This procedure is called polypectomy. The inner surface of the intestine is insensitive to cutting or burning events, so no discomfort is felt during the procedure. The cut polyp is then sent to the pathology laboratory and examined under a microscope to determine what type of polyp it is and whether there are signs of transformation into cancer.
Polypectomy performed during colonoscopy is a procedure that can be performed on outpatients. Although rare, bleeding may occur from the site of the polypectomy. Another risk is the tearing of the same place (perforation), albeit very rarely. Bleeding that does not stop is stopped by intervention during colonoscopy, but rarely bleeding can occur a few days or weeks after polypectomy.
For this reason, drugs such as aspirin, plavix and coumadin that may make blood clotting difficult should be discontinued at least 5 days before polypectomy and coagulation tests should be performed when necessary. The rupture of the intestinal wall (perforation) during polypectomy is a very rare condition and almost always requires surgical intervention.
Your doctor will decide when the next colonoscopy should be done. Various factors will affect the timing, such as the number and size of the polyps removed, the type of polyp, and the presence of colon cancer in your family.
If the polyps are small and your colon has been cleaned well and can be thoroughly examined during the colonoscopy, it is usually recommended to repeat the colonoscopy after three years. If your repeated colonoscopy does not show any signs of polyps, it means that no additional procedure is required for the next five years.
If your removed polyp is flat (without sessile), large, and large (>1cm), your doctor will recommend repeating the colonoscopy after a few months, as a correct approach, to ensure that the polyp has been completely removed.The general approach is after polypectomy, after 3 years in patients with risky polyps (advanced adenoma; >1cm villous or tubulovillous adenoma or adenomas with high-grade dysplasia) or 3 or more adenomas, and 5 years in people with <1cm one or two tubular adenomas. -Repeat colonoscopy after 8 years (See Colon cancer).
