Polyps in the Colon and Rectum (Colonic and Rectal Polyps)

What are colonic and rectal polyps?

Colonic polyps are growths on the inner wall of the colon or rectum. The colon is a section of the large intestine, also called the large bowel. Polyps may also occur in the rectum, another section of the large intestine.

How do they occur?

The cause of polyps is not known. Anyone can have polyps, but some people are more likely than others to get them. You are more likely to have polyps if:

• You are over 50 years old.
• You have had polyps before.
• Someone in your family has had polyps.
• Someone in your family has had colon or rectal cancer.

Polyps usually cause no symptoms. If you have polyps, they should be removed and tested in the lab. Polyps are not immediately harmful but they can turn into cancer and can cause bleeding. If you have polyps, or a close relative has polyps or cancer in the colon or rectum, your healthcare provider will recommend regular colon exams to look for and remove polyps before they become cancerous. If you have any rectal bleeding, you should be checked for polyps or cancer

What are the symptoms?

Polyps usually do not cause any symptoms. In some cases they may cause:

• barely visible red blood in bowel movements
• hidden (invisible) blood in bowel movements, which may be found with an occult blood test (a small sample of bowel movement smeared on a card for lab tests)
• loose bowel movements

How are they diagnosed?

You should be examined for polyps when you reach 50 years old. (You may need to be tested earlier than this if you have a family history of colon cancer or polyps.) One or more of the following procedures may be done to look for polyps:

• Sigmoidoscopy: an exam of your rectum and sigmoid colon (the lower part of the large intestine) with a viewing instrument called an endoscope put into your bowel.
• Colonoscopy: an exam that uses a longer scope to see the inside of your whole colon and rectum.
• Biopsy: a test that removes tissue from the colon or rectum for lab tests. It may be done during a colonoscopy.
• Barium X-ray: a test using X-rays and barium that is injected into the colon through the anus and rectum.

How are they treated?

Polyps should be removed when they are found. Removing polyps is usually rather simple. Your provider may remove a polyp during a colonoscopy. If the polyp cannot be removed by colonoscopy, you may need a laparotomy or laparoscopy. A laparotomy is surgery that uses a cut (incision) in the abdomen to remove the part of the colon that contains the polyp. For a laparoscopy, a thin tube with a light and tiny camera is inserted through a cut in the abdomen. The scope is used to look at your colon or rectum and to guide other tools to remove the polyp. The cuts for a laparoscopy are smaller than the cut needed for a laparotomy.

Malignant (cancerous) polyps are removed with a section of the tissue around them. Removal of part or all of the colon is called a colon resection or colectomy. If the rectum is removed, it is called a proctectomy.

Some people have a rare condition called familial adenomatous polyposis, also called familial polyposis coli, which means there are many adenomatous polyps throughout the colon and rectum. This type of polyp carries a very high risk of cancer. It may need to be treated with removal of part or all of the colon and rectum.

How long will the effects last?

If not removed early, some polyps can become malignant. If cancerous polyps are not treated, they are life threatening. It is important to follow your healthcare provider's recommended treatment.

New polyps may form. Because some polyps become cancerous, you should have a colonoscopy 1 to 5 years after polyps are removed. Your provider will tell you when you need repeat exams.

How can I take care of myself?

• Follow your provider's recommendations for treatment.
• Get enough exercise, according to your provider's recommendations.
• Eat low-fat, high-fiber foods.
• Your healthcare provider may recommend that you take calcium supplements or regular doses of aspirin.
• Ask your provider how often you should have an occult blood test, sigmoidoscopy, or colonoscopy.