Overview
As many as 30 percent of middle-aged and older adults have one or more colon polyps - a small clump of cells that forms on the colon lining. Although the great majority of colon polyps are harmless, some may become cancerous over time. Anyone can develop colon polyps, but you're at higher risk if you are 50 or older, are overweight or a smoker, eat a high-fat, low-fiber diet, or have a personal or family history of colon polyps or colon cancer.
Sometimes colon polyps can cause signs and symptoms such as rectal bleeding, a change in bowel habits and abdominal pain. But most small colon polyps don't cause problems, which is why experts generally recommend regular screening. Colon polyps that are found in the early stages usually can be removed safely and completely
Symptoms
Colon polyps range from smaller than a pea to golf ball sized. Small polyps, especially, aren't likely to cause problems, and you may not know you have one until your doctor finds it during an examination of your bowel.
Sometimes, however, you may have signs and symptoms such as : -
- Rectal bleeding - You might notice bright red blood on toilet paper after you've had 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 your anus. Hemorrhoids don't usually bleed consistently over a period of weeks, however, so if your bleeding is prolonged, be sure to tell your doctor.
- Blood in your stool - Blood can show up as red streaks in your stool or make bowel movements appear black. Still, a change in color doesn't always indicate a problem - iron supplements and some anti-diarrhea medications can make stools black, whereas beets and red licorice can turn stools red.
- Constipation or diarrhea - Although a change in bowel habits that lasts longer than a week may indicate the presence of a large colon polyp, it can also result from a number of other conditions.
- Pain or obstruction - Sometimes a large colon polyp may partially obstruct your bowel, leading to crampy abdominal pain, nausea, vomiting and severe constipation.
Causes
Your digestive tract stretches from your mouth to your anus. As food travels along this 30-foot passageway, nutrients are broken down and absorbed by your body to build cells and produce energy.
The last part of your digestive tract is a long muscular tube called the large intestine. The colon is the upper 4 to 6 feet of the large intestine; the rectum makes up the lower 8 to 10 inches. The colon's main function is to absorb water, salt and other minerals from colon contents. Your rectum stores waste until it's eliminated from your body.
Why Polyps Form ?
The majority of polyps aren't cancerous (malignant), yet like most cancers, they result from abnormal cell growth. Healthy cells grow and divide in an orderly way - a process that's controlled by two broad groups of genes. Mutations in any of these genes can cause cells to continue dividing even when new cells aren't needed. In the colon and rectum, this unregulated growth can cause polyps to form, and over a long period of time, some of these polyps may become malignant.
Polyps can develop anywhere in your large intestine. They can be small or large and flat (sessile) or mushroom shaped and attached to a stalk (pedunculated). Small and mushroom-shaped polyps are much less likely to become malignant than flat or large ones are. In general, the larger a polyp, the greater the likelihood of cancer.
There are three main types of colon polyps : -
- Adenomatous - Once adenomatous polyps grow beyond the size of a pencil eraser - about 5 millimeters (mm), or 1/4 inch - there's a small but increasing chance that they'll become cancerous. This is especially true when their diameter exceeds 10 mm. For that reason, doctors normally take a tissue sample (biopsy) from polyps during a sigmoidoscopy and either biopsy or remove large polyps during a colonoscopy.
- Hyperplastic - These polyps occur most often in your left (descending) colon and rectum. Usually less than 5 mm in size, they're rarely malignant.
- Inflammatory - These polyps may follow a bout of ulcerative colitis or Crohn's disease of the colon. Although the polyps themselves are not a significant threat, having ulcerative colitis or Crohn's disease of the colon increases your overall risk of colon cancer.
The Digestive System
Your digestive tract stretches from your mouth to your anus. The last part of this 30-foot passageway is the large intestine. The upper 4 to 6 feet of the large intestine make up the colon. The rectum makes up the lower 8 to 10 inches.
Small Colon Polyps
This image of the inside of the colon shows two small polyps whose diameters are about the size of a pencil eraser (about 6 to 7 millimeters).
Large Colon Polyp
This image of the inside of the colon shows a large polyp. Large polyps are 10 millimeters (mm) or larger in diameter (25 mm equals about 1 inch).
Colon Cancer
This image of the inside of the colon shows colon cancer.
Risk Factors
A number of factors may contribute to the formation of colon polyps and colon cancer.
They include : -
- Age - The great majority of people with colon cancer are 50 or older. Your risk generally starts increasing around age 40.
- Your sex - More men than women develop colon polyps and colon cancer.
- Inflammatory intestinal conditions - Long-standing inflammatory diseases of the colon such as ulcerative colitis and Crohn's disease can increase your risk.
- Family history - You're more likely to develop colon polyps or cancer if you have a parent, sibling or child with them. If many family members have them, your risk is even greater. In some cases this connection isn't hereditary or genetic. For example, cancers within the same family may result from shared exposure to an environmental carcinogen or from similar diet or lifestyle factors.
- Diet - Eating a high-fiber diet - one plentiful in fruits, vegetables and whole grains - can reduce your risk of colon polyps and colon cancer. Fiber seems protective against colon cancer because it provides bulk that moves your stool more quickly through your bowel. This means that cancer-causing substances (carcinogens) in the foods you eat aren't in contact with your bowel wall as long as they might be if you ate a low-fiber diet. Fruits and vegetables are also rich in antioxidants - substances that protect cells from damage caused by unstable molecules (free radicals) that may lead to cancer.
- Smoking and alcohol - Smoking significantly increases your risk of colon polyps and colon cancer. Smokers are 30 percent to 40 percent more likely to die of colon cancer than are nonsmokers. Drinking alcohol in excess also makes it more likely that you'll develop colon polyps. If you smoke and drink, your risk increases even more.
- A sedentary lifestyle - If you're inactive, you're more likely to develop colon cancer. This may be because when you're inactive, waste stays in your colon longer.
- Obesity - Being significantly overweight - 30 pounds or more - has been linked to an increased risk of several types of cancer, including colon cancer.
- Race - If you are black, you are at higher risk of developing colon cancer than if you are white.
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