Polyps in the Colon or Rectum

What are polyps in the colon or rectum?

Polyps are growths on the inner wall of the colon or rectum. The colon and rectum are sections of the large intestine, which is also called the large bowel. The colon is the first part of the large bowel. It is nearly 5 feet long. The rectum is the last few inches of the large bowel at the end of the colon and just above the anus.

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 don’t cause any symptoms. If you have polyps, they should be removed and tested in the lab. Polyps are not immediately harmful but some polyps can turn into cancer and can cause bleeding. If you have a high risk of polyps, your healthcare provider will recommend regular colon exams to look for and remove polyps.

What are the symptoms?

Polyps usually don’t 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 a test of a sample of bowel movement (fecal occult blood test)
• loose bowel movements

If you have any rectal bleeding, you should be checked for polyps and cancer.

How are they diagnosed?

You should be examined for polyps when you reach the age of 50. (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 tests may be done to look for polyps:

• Sigmoidoscopy: an exam of the 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 look at the inside of all of your 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: an X-ray taken of the belly (abdomen) after a special dye is put into the rectum.

How are they treated?

Polyps should be removed when they are found. Removing polyps is usually rather simple and can often be done during a colonoscopy. If the polyp cannot be removed with colonoscopy, you may need a laparoscopy or laparotomy.

• For a laparoscopy, a small cut is made near your bellybutton (navel) and your healthcare provider inserts a lighted tube with a camera through the cut and into your abdomen to look at the colon or rectum. The scope may be used to guide other tools to remove the part of the colon that contains the polyp.
• A laparotomy is surgery that uses a larger cut in the belly to remove the part of the colon that contains the polyp.

If a polyp is cancerous, it is treated by removing a section of the colon and reattaching the ends of the bowel.

Some people have a rare condition called familial adenomatous polyposis, also called familial polyposis coli. This means that there are many adenomatous polyps throughout the colon and rectum. Adenomatous polyps carry a very high risk of cancer. This condition 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 cancerous. If cancerous polyps are not treated, they are life threatening. It is important to follow your healthcare provider's recommended treatment.

You may get more polyps. 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. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.
• Ask your provider how often you should have a fecal occult blood test, sigmoidoscopy, or colonoscopy.