A benign growth of the lining of the colon is called colon polyp. These are formed by the abnormal cells on the end of a stalk of normal cells. It grows from 2mm up to 5cm or more in diameter. Colon polyps can be raised or flat. There can be one or more than one polyp.
Colon polyps are found in one of two shapes:
• Polyps on stems or stalks look like mushrooms and are called pedunculated.
• When they grow directly onto the inner wall of the colon like spilled paint, they are called sessile and are much more difficult to remove.
Some colon polyps are benign while others may already be cancers or have tendency to become cancer. Flat polyps are more likely to become cancer as compared to raised polyps.
Stages of colon cancer:
There are 5 stages of colon cancer:
• Stage 0 – The cancer is found only on the surface of the polyp and has not yet invaded into the central core. This earliest stage has the best prognosis.
• Stage 1 – the cancer is localized to the surface of the colon.
• Stage 2 – the cancer is spreading into the wall of the colon.
• Stage 3 – the cancer spreads to the lymph glands on the outside of the colon.
• Stage 4 – the cancer has overflowed the lymph glands and spread beyond, usually into the liver.Classification of colon polyp
It is the most common type of polyp. Adenomatous polyps usually cause no symptoms. If they are detected early they can be removed during colonoscopy before any cancer cells form. Regular check-up is necessary in patient with history of adenomatous polyp.
These polyps occur most often in left (descending) colon and rectum. They reach up to 5 millimeters in size, they’re very rarely malignant.
It is most often found in patients with ulcerative colitis or Crohn’s disease. They are not true polyps hence they are also called psuedopolyp.
• Villous adenoma or tubulovillous adenoma:
It has a very high risk of cancer as it grows larger. Smaller ones can be removed in piecemeal fashion – sometimes over several colonoscopies. Larger sessile villous adenomas may require surgery for complete removal. Follow up depends on size and completeness of removal.
Male have higher incidences of development of colon polyp as compared to females. Risk of colon polyp increases with increasing age, usually after 40 years of age.
Normally the cells grow and divide in an orderly way. When mutation in gene occurs, it can cause cells to continue dividing when there is no need for new cells. This unregulated growth is the cause of formation of polyps. In long standing cases some of these polyps may become malignant.
• Age above 50 years.
• Family history of polyps.
• Family history of cancer of large intestine.
• History of uterine or ovarian cancer before 50 yeas of age.
• Eating fatty food.
• Smoking and drinking alcohol.
• Rectal bleeding: Bright red blood appears after a bowel movement. Although this may be a sign of colon polyps or colon cancer, rectal bleeding can indicate other conditions, such as hemorrhoids or minor tears (fissures) in anus.
• Blood in stool: Red streaks in stool or stool appears black. Other conditions must be ruled out.
• Constipation or diarrhea: It can also result from a number of other conditions.
• Pain or obstruction: Sometimes a large colon polyp may partially obstruct bowel resulting in abdominal cramps, nausea, vomiting and severe constipation.
• Computerized tomographic colonography (CTC)
• Flexible sigmoidoscopy.
• Fecal blood tests.
• Stool DNA testing.
• Genetic testing. If you have a family history of colorectal cancer, this blood test may help determine if you’re at increased risk of colon or rectal cancer
• Gardner Syndrome
• Inflammatory Bowel Disease
• Familial Adenomatous Polyposis
• Snare: polyps can be removed during colonoscopy or sigmoidoscopy by snaring them with a wire loop that simultaneously cuts the stalk of the polyp and cauterizes it to prevent bleeding
• Endoscopic mucosal resection
• Colon and rectum removal
• If the polyps are removed the prognosis is excellent.
• It can develop into cancer over time.
• Calcium rich diet: Calcium can significantly protect against colon polyps and cancers.
• Include plenty of fruits, vegetables and whole grains in your diet.
• Certain types of fat can increase your risk of colon cancer. It’s important to limit saturated fats
• Limit alcohol consumption.
• Avoid tobacco because smoking and other forms of tobacco use can increase your risk of colon cancer and a wide range of other diseases.
• Stay physically active and maintain a healthy body weight.
• If patient have a family history then regular screening is necessary.
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