Polyps - Types of Polyps, Causes, Symptoms, Diagnosis, Treatment

and protrudes into a body cavity.

The figure on the side shows an example of intestinal polyps, which have developed on the mucous membrane of the colon.

or a cauliflower. When more polyps grow in the same anatomical site, we speak more correctly of polyposis.

Size: there are very small polyps - with dimensions of just a few millimeters - and giant polyps, capable of exceeding 2 centimeters in diameter. Large polyps, as well as agglomerates made up of numerous tiny polyps, tend to cause more marked problems and discomfort than smaller ones.

Cytological composition (benign polyps and malignant polyps). We speak of benign polyps (adenomas or papillomas) when the cells inside them proliferate, originating a more or less expansive neoformation, without causing any damage to the surrounding tissues. Otherwise, the malignant polyp (adenocarcinoma or carcinoma) is able to invade adjacent tissues and organs, triggering a series of catastrophic cellular chain events.

Location: Polyps can originate in multiple anatomical sites. The target of the polyps is constituted by the mucous membranes and, according to the cavity from which they protrude, they are distinguished:

• Polyps of the nose and ear;
• Uterine polyps: endometrial and cervical;
• Intestinal polyps: small intestine (rare), colon and rectum;
• Bladder polyps;
• Stomach polyps.

and conditions such as:

• Allergy;
• Asthma;
• Sinusitis;
• Smog and environmental pollution;
• Medicines (ex: aspirin);
• Immunodeficiency disease;
• Cystic fibrosis.

Symptoms

Possible symptoms of nasal polyps are:

• Ageusia;
• Anosmia;
• Headache
• Nasal congestion;
• Dyspnea;
• Facial pain
• Increased lacrimation;
• Rhinorrhea;
• Eye itching;
• Snoring.

Diagnosis

Typically, the diagnosis of nasal polyps is based on:

• Anamnesis;
• Otolaryngological visit;
• Allergy tests;
• Hematological tests;
• Nasal and olfactory respiratory function test;
• Imaging test (CT or MRI);
• Endoscopic instrumental examinations.

Therapy

Nasal polyps treatment options include:

• Drug therapy: corticosteroids / antihistamines / antibiotics or antifungals;
• Polypectomy;
• Endoscopic sinus surgery.

For further information: Nasal Polyps

Uterine Polyps

Causes

The precise causes of uterine polyps are uncertain. A concerns, however, there are various hypotheses; the most plausible believes that estrogenic changes play a role (epidemiological data show that the most affected women are those in the premenopausal years).

Symptoms

Nasal polyps are responsible for:

• Changes in menstrual flow:
• Dysmenorrhea;
• Menorrhagia;
• Hypermenorrhea;
• Menstrual irregularities;
• Spotting.
• Dyspareunia (pain during sexual intercourse).

Diagnosis

Investigations useful for the diagnosis of uterine polyps are:

• Sonosalpingography;
• Diagnostic hysteroscopy;
• Hysterosalpingography;
• Curettage.

Therapy

Treatment options for nasal polyps include:

• Drug therapy with progestins or gonadotropins (not very effective);
• Surgical removal by hysteroscopy;
• Hysterectomy (removal of the uterus in the case of malignant evolution).

For further information: Uterine Polyps

Intestinal polyps

Causes

Factors favoring the onset of intestinal polyps are:

• Unbalanced diet, rich in red meat, saturated fat and low in fiber;
• Old age;
• Familiarity;
• Sedentary lifestyle;
• Obesity;
• African ethnicity;
• Untreated type 2 diabetes;
• Cigarette smoking and excess alcohol.

Symptoms

Intestinal polyps are responsible for:

• Anemia;
• Abdominal colic
• Abdominal cramps
• Diarrhea / constipation;
• Mucorrhea;
• Blood in the stool
• Rectal tenesmus.

Diagnosis

Investigations useful for the diagnosis of intestinal polyps are:

• Colonoscopy;
• TC;
• Sigmoidoscopy;
• Stool examination
• Barium enema (radiological examination of the large intestine).

Therapy

Treatment options for intestinal polyps include:

• Polypectomy: surgical removal of the polyp via endoscopy;
• Burn (for small polyps);
• For malignant forms, colectomy (removal of the colon) combined with post-operative chemotherapy to prevent recurrence.

For further information: Intestinal Polyps

Bladder Polyps

Causes

The precise cause of bladder polyps is still unknown; some evidence suggests that they play a role in risk factors:

• Smoking;
• Exposure to polycyclic aromatic hydrocarbons, pollutants and smog;
• Schistosomiasis.

Symptoms

Bladder polyps are typically responsible for:

• Alteration of urinary frequency;
• Hematuria;
• Pollakiuria;
• Stranguria.

Diagnosis

In general, the diagnostic process useful for identifying bladder polyps includes:

• Physical examination;
• Cystoscopy;
• Biopsy;
• Washing (or irrigation) of the bladder
• Search for any markers of bladder cancer
• Imaging tests (CT and MRI).

Therapy

Treatment options for bladder polyps include:

• Trans-urethral resection;
• For malignant forms, surgical removal of the bladder combined with post-operative chemo / radiotherapy treatment to prevent recurrence.

For further information: Bladder Polyps

Stomach Polyps (Gastric Polyps)

Causes

The risk of developing stomach polyps (or gastric polyps) increases in the presence of:

• Chronic inflammation of the stomach (gastritis) → hyperplastic gastric polyps;
• Familial adenomatous polyposis (hereditary disease);
• Old age;
• Infections from Helicobacter pylori (H. Pylori);
• Long-term therapy with proton pump inhibitors.

Symptoms

Typical symptoms of stomach polyps are:

• Abdominal pain;
• Abdominal pain on pressure;
• Gastric bleeding;
• Nausea and vomit.

Diagnosis

The investigations useful for the diagnosis of stomach polyps include:

• Endoscopic ultrasound (ecoendobiopsy);
• Gastric biopsy;
• Blood analysis.

Therapy

Small gastric polyps can spontaneously regress, which excludes the need for treatment.
For large polyps, however, surgical removal is required.

In case of gastric polyps dependent on Helicobacter pylori, antibiotic treatment is foreseen.