What are colonic polyps?

Colonic polyps are growths that project from the lining of the colon (large intestine) into the space inside the bowel. They may cause painless rectal bleeding. They are generally removed soon after they are discovered. Polyps are usually not harmful and are relatively easy to treat. However, some benign (noncancerous) polyps become malignant (cancerous).

How do they occur?

The cause of colonic polyps is not known. The tendency to develop some types of colonic polyps is inherited.

What are the symptoms?

Signs and symptoms may include:

• Bleeding from the rectum or blood in the bowel movement
• Blockage in the colon
• Tenesmus (painful spasm of the rectal muscle, which creates a feeling of needing to have a bowel movement)
• Family history of colonic polyps
• Anemia (low red blood cell count).

Colonic polyps may occur without symptoms.

How are they diagnosed?

To diagnose colonic polyps, your doctor will review your symptoms, examine you, order blood tests and a test of your bowel movement for hidden blood, and perform one or more of the following procedures:

• Sigmoidoscopy: an exam of your rectum and sigmoid colon (the last part of large intestine) with a viewing instrument called an endoscope
• Biopsy: a test in which tissue from the colon is removed from the body for exam under a microscope
• Colonoscopy: a test during which the doctor inserts a longer scope into your rectum to see the inside of your whole colon; the doctor may cut out (biopsy) a small piece of the polyp to examine in the lab
• Double contrast barium enema: barium is injected into the colon by enema into the anus and rectum and then x-rays of the colon are taken.

How are they treated?

Treatment consists of removing the polyps as soon as possible. Your doctor will remove noncancerous polyps using an endoscope. Removing these benign polyps is usually relatively simple. Commonly, your doctor will remove the polyp during a colonoscopy at the time it is detected. If the tumor can't be removed by colonoscopy, you may need a laparotomy, a surgical opening of the abdomen to remove the polyp.

Malignant (cancerous) polyps are usually removed by resection (surgery to remove the polyp and surrounding segment of colon tissue, if necessary).

Highly malignant polyps may require a colectomy, a procedure in which part or the entire colon is removed.

How long will the effects last?

If not removed early, polyps can cause intestinal blockage. If left untreated, cancerous polyps can be life threatening. It is important to follow your doctor's recommendations.

Colonic polyps can recur. Because of their potential for malignancy, your doctor should do a colonoscopy in 1 to 3 years. If there are no new polyps, your doctor should examine you in 3 years unless otherwise indicated.

How can I take care of myself?

If your symptoms last for a while or if you develop new ones, tell your doctor.

In addition to following your doctor's recommendations, maintain a healthy lifestyle by:

• Getting enough rest
• Eating nutritious, high-fiber foods
• Exercising at least three times a week for at least 20 minutes
• Using relaxation techniques, including mental imaging and progressive muscle relaxation exercises
• Developing positive support systems to help cope with the stress of daily life
• Spending time each week in recreation and play.

You should have an occult blood test, flexible sigmoidoscopy, or colonoscopy with your routine physical exam if you are over 40 years old and any of these conditions apply to you:

• A previous diagnosis of inflammatory bowel disease, colorectal cancer, or adenomatous polyps (most polyps are this type, not malignant, but with the potential to become malignant)
• A first-degree relative with colorectal cancer
• A personal history of endometrial, ovarian, or breast cancer
• A family history of familial polyposis coli (a rare condition in which there are numerous polyps throughout the colon; people with this family history should begin regular testing for familial polyposis coli when they are adolescents).

What can I do to help prevent colonic polyps and their recurrence?

If any of your symptoms reappear, tell your doctor. In addition:

• Add high-fiber foods to your meals.
• Follow your doctor's recommendations for checkups. A colonoscopy is usually scheduled within 1 year of treatment.

If you have been diagnosed with colonic polyps, other members of your family should tell this to their doctors, because some types of polyps are inherited.