What Are Polyps?
Polyps are small growths of abnormal tissue, found projecting from the inner lining of the colon (large intestine). Polyps can range in size from a few millimeters to several centimeters. Polyps are very common: In fact, an estimated 25 to 40% of Americans over the age of 50 develop colon polyps. While developing polyps is most associated with being 50 and older, other factors are also considered including: having a family history of polyps/colon cancer, being obese, smoking, heavy alcohol consumption, a history of inflammatory bowel diseases, a poor diet, and other environmental factors.
The vast majority of polyps are harmless, but they can also be precancerous or cancerous in nature. Polyps can take a long time to become cancerous, and are best to be removed upon identification. During a medical exam or colonoscopy, your doctor may identify and remove polyps. Larger or complex polyps are more likely to be cancerous, and can require additional procedures to remove. Colon polyps rarely cause any symptoms, which means scheduling a colorectal screening test is vital for identification.
Identifying Types of Polyps
There are two main categories of polyps: nonneoplastic and neoplastic. Neoplastic polyps are typically precancerous or cancerous, while nonneoplastic polyps are usually benign (non-cancerous). Within these categories, there are many types of polyps. Some of the most common include:
Types of Neoplastic Polyps
- Adenomatous polyps (Adenoma): The most common type of polyp as well as the most common cause of colon cancer. Structurally, they’re described as tubular, villous, or tubulovillous. Tubular adenoma is less likely to develop into cancer, and makes up 70% of adenomatous polyps. Villous adenoma is flatter and more difficult to remove, and makes up 15% of adenomatous polyps. Tubulovillous is a mix of the two.
- Serrated polyps: Serrated polyps cause 20-30% of colon cancers. They are divided into two categories: sessile serrated adenoma (SSA) and traditional serrated adenoma (TSA). SSA’s and TSA’s are very rare and almost always precancerous.
Types of Nonneoplastic Polyps
- Inflammatory polyps: Typically found in people with Inflammatory Bowel Disease. Usually benign.
- Hamartomatous polyps: Rare. Usually caused by autosomal disorders.
- Hyperplastic polyps: A form of serrated polyp, but are very common and almost always benign.
Polyp Shapes
Polyps generally grow in three different shapes: pedunculated, sessile, and flat. Pedunculated (polypoid) polyps grow out from the side of the inner lining of the colon like mushrooms, a clump of tissue on a thin stalk. Sessile polyps, on the other hand, do not have a stalk, but rather grow against the side of the colon. The least common shape is a flat polyp. Flat polyps grow completely flat, or depressed into the side of the colon. Sessile and flat polyps are generally more difficult to detect than pedunculated polyps.
Symptoms of Polyps
There are typically no signs of polyps. However, in some rare cases, they can be associated with symptoms such as:
- Abdominal pain
- Blood in stool
- Diarrhea
- Constipation
- Anemia caused by internal bleeding
- Weakness or tiredness caused by anemia
- Weight loss
- Changes in bowel habits
- Changes in stool color
Diagnosis and Treatment
If you experience any symptoms of colorectal polyps, it’s recommended that you consult a medical professional as soon as possible. Otherwise, most polyps will be diagnosed and treated through a screening test, like a colonoscopy or flexible sigmoidoscopy. In some cases, polyps are too large or complex to be removed immediately and require further surgical procedures.
It’s also important to note that if you have a neoplastic polyp, like an adenoma or a serrated polyp identified and removed during your screening test, you’re still at an increased risk of developing cancer, and will need regular screenings for polyps. The type, amount, and size of the polyps identified will determine how often you need a screening. This can vary from 6 months to 10 years.
The experienced team at GHP has years of experience treating patients with various GI conditions including colorectal polyps. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and to schedule an appointment today.
