Intestinal polyps are soft reliefs that form on the mucous membrane of the intestine, especially in the colon and rectum. Although the name has little of appeal, in the vast majority of cases it is neoformations of benign origin. Be careful, however, because with the over time some types of polyps can evolve into a malignant form; for this reason the most effective work of colon cancer prevention is early screening aimed at the identification and eventual removal of intestinal polyps.
If there are cases of colon cancer or familial polyposis among first degree relatives, screening should take place at an earlier age of two, three or even four decades.
Since the average age of onset of adenomas precedes that of colorectal cancers by ten years, in the event of a negative result it will be sufficient to repeat the examination every 3-5 years. If, on the other hand, adenomatous polyps are observed and removed, the doctor will recommend repeating the examination after a short time (within 6-12 months).
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Classification of intestinal polyps
- Pedunculated polyps: protrude from the intestinal wall like a fungus and can be easily removed.
- Sessile polyps: peduncleless, flat, therefore fully adherent to the bowel wall; surgical removal is more difficult.
- Single polyp (single), multiple polyps (1-100), polyposis (> 100). Polyposis can be of sporadic or familial origin (linked to a transmissible gene defect); in the latter case, the risk of degeneration into colorectal cancer is quite high.
- Hyperplastic and inflammatory polyps: they are both of benign origin (they do not present major risks of neoplastic evolution). Inflammatory polyps are often associated with ulcerative colitis, Crohn's disease, infectious colitis and diverticulosis.
- Hamartomatous polyps: these are non-neoplastic lesions often of family origin.
- Neoplastic or adenomatous polyps: based on the macroscopic and histological characteristics they can be in a more or less advanced stage. They are divided into tubular polyps, villous polyps (at increased risk of cancer) and mixed tubular-villous polyps.
- Dimensions: ranging from a few millimeters to three to four centimeters. The benignity of a polyp is inversely proportional to its size, but this does not exclude that even small polyps can be potentially malignant. Statistically speaking, indicatively, the incidence of the mutation in carcinoma is 1% for polyps with a diameter of less than 1 cm, 10% for those between 2 and 3 cm, and 30% for those with a diameter greater than 2 cm.
Intestinal polyps symptoms
For further information: Intestinal Polyps Symptoms
Intestinal polyps are generally asymptomatic and this characteristic contributes to accentuate their danger. They are often identified by chance during an endoscopic or radiological examination; sometimes they can manifest themselves with mucus evacuation, mucous diarrhea or be signaled by rectal blood loss, possibly associated with anemic states. These symptoms are all the more common the larger the size of the polyp and its consequent malignant potential. Large polyps can also cause intestinal obstructions, resulting in abdominal colic. Finally, if located in the rectum, they can be accompanied by tenesmus (feeling of urgent need to defecate).
Risk factors
In the various articles dedicated to the promotion of a balanced diet, we have repeatedly had the opportunity to underline the importance of dietary fiber. The foods that contain it (whole grains and vegetables) have a protective role against various types of cancer, including that to the colon. This benefit is linked to various factors:
- insoluble fibers (present in cereals) retain water and increase fecal mass, diluting any carcinogenic substances and accelerating their expulsion with faeces;
- the soluble fibers (present in vegetables) form a gelatinous mass that "traps" the secondary bile acids and other toxins present in the intestinal lumen;
- the fermentation of dietary fiber operated by the bacterial flora produces short-chain fatty acids which, in addition to reducing the proliferation of pathogens and having anti-putrefactive properties, are an excellent nourishment for the cells of the colon mucosa. All this translates into a better absorption of nutrients at the expense of toxic ones.
- in addition to fiber, plant foods provide the body with a precious load of antioxidants and other substances that can contribute to maintaining human health (isoflavones, lycopene, anthocyanins, folic acid, isocyanates, etc.).
A high consumption of red meat and saturated fats, on the other hand, favors the appearance of intestinal polyps and their evolution into colorectal cancer; the same goes for obesity, poor physical activity, alcohol abuse and cigarette smoking.
As for the non-modifiable factors, it has been seen that the risk of polyps increases from two to four times if only one family member suffers and from 4 to 6 times if the polyps are common to 2 first degree relatives.
Therapy
For further information: Medicines for the treatment of Intestinal Polyps
In many cases, the colonoscopic examination allows not only an accurate diagnosis but also the immediate removal of the polyp (see informative article on polypectomy); the following histological investigations will assess the degree of neoplastic evolution, on the basis of which the doctor will decide if the endoscopic removal was sufficient or if more radical interventions are necessary (removal of the intestinal tract affected by the polyps).
In the case of familial adenomatous polyposis, the colon is generally removed (total colectomy).
Other articles on "Intestinal Polyps"
- Polypectomy
- Intestinal Polyps - Medicines for the treatment of Intestinal Polyps
