What is a colonic polyp ?
A polyp is a benign (non-cancerous) growth of the lining of the colon (large bowel). It can be anything from 2mm up to 5cm or more in diameter. Commonly, the abnormal cells form a small ball (about the size of a pea) on the end of a stalk of normal cells. The type of cell that forms the polyp varies and is important in determining its potential for developing into a cancer.
If it is necessary to spare the colon from its normal digestive work while it heals, a temporary opening of colon onto the skin of the abdominal wall (colostomy) may be done. The proximal end of the colon is passed through the abdominal wall and the edges sewn to the skin. A removable bag is then attached to the skin around the colostomy and the stool then passes into the bag. In most cases, depending on the disease process being treated, colostomies are temporary and can be closed with another operation at a later date.
If a large portion of the bowel is removed or the distal end of the colon is too diseased to reconnect to the proximal intestine, the colostomy may be permanent.
Types of polyp
Metaplastic polyps versus adenomatous polyps : -
The most common sort of polyp is a metaplastic polyp (in which cells change from one normal type to another). These usually do not grow much more than 5mm in diameter and have almost no risk of becoming malignant (cancerous). These polyps can be very similar in appearance to adenomatous polyps, the next most common type, which do have the potential to become malignant.
About 50 per cent of people aged 60 will have at least one adenomatous polyp of 1cm diameter or greater. Familial polyposis coli (familial adenomatous polyposis or FAP ) involves multiple adenomatous polyps, often in their hundreds. This condition carries a very high risk of colon cancer.
Large Bowel Disease
The Division of Gastroenterology provides diagnosis and treatment for many large bowel diseases, including:
- Colon cancer
- Colon polyps
- Ulcerative colitis
- Crohn's disease
- Irritable Bowel Syndrome
Most polyps can be removed during colonoscopy while the patient is sedated. This is done by passing a wire snare down the colonoscope, looping and tightening the snare around the stalk of the polyp, then passing an electric current through the wire. This coagulates the blood vessels and then cuts through the stalk. The polyp is then usually sent to the pathology laboratory for microscopic examination.
The polypectomy is painless because the colon nerves are only sensitive to stretching. Polypectomy is very safe but carries a risk of perforation (going through the bowel wall) in about one case in 300 and bleeding in one case per 100. Bleeding usually stops by itself and only rarely needs treatment with blood transfusion.
As with any surgery, risks include infection and bleeding. Anesthesia-related risks include reactions to medications and problems with breathing.
Additional risks include : -
- Bulging through the incision
- Narrowing (stricture) of the opening
- Blockage of the intestine from scar tissue
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