Colonic Polyps

What are Colonic Polyps?

Colonic polyps are an abnormal growth of tissue within the lining of the large bowel. They vary in size, location and numbers and can occur anywhere throughout the large bowel.

Types of polyps

There are 4 main types of polyps which are confirmed on histopathology following removal:

• Hyperplastic Polyps
  • Not known to be a precursor to cancer
• Neoplastic Polyps (Adenoma)
  • May develop cancer if not removed during colonoscopy
  • Requires ongoing colonoscopy surveillance to detect and remove further adneoma development
  • Types
    • Tubular
    • Tubulovillous
    • Villous
    • Sessile Serrated
• Harmartomatous Polyps
  • uncommon, abnormal overgrowth of mixed tissue
  • can be associated with different syndromes and an increased risk of bowel cancer
• Inflammatory Polyps
  • associated with inflammatory bowel diseases including Crohn’s Disease and Ulcerative Colitis

Symptoms

• Usually asymptomatic
• Occasionally
  • Change in bowel habits
  • Bleeding
    • Faecal Occult Blood Tests should only be performed on people with no symptoms.
      • A positive test does not always indicate cancer or polyps
      • A negative test does not exclude cancer or polyps
  • Any symptoms need appropriate investigations by your general practitioner and surgical referral for consideration of colonoscopy.

Who is at risk?

• Everyone- the risk of developing colorectal cancer in Australia by the age of 85 was 1 in 10 males and 1 in 15 females.
• People who have bowel symptoms
  • Change in bowel habits
  • Weight loss
  • Change in appetite
  • Bleeding
  • Abdominal pain
• Previous adenoma or cancer
• Family history of polyps or colorectal cancer
• Age >40yo
• Medical Conditions
  • Inflammatory Bowel Disease
  • Familial Adenomatous Polyposis
  • Attenuated Familial Adenomatous Polyposis
  • Lynch Syndrome (HNPCC)
  • Other syndromes

Treatment

Colonoscopy is the most accurate test to diagnose polyps. A colonoscopy allows a clear view of the inner surface of the large bowel, to search for and remove any polyps found, and have them examined under the microscope.

Future reviews

If adenomas are confirmed by a pathologist, it is recommended that the patient has a follow up colonoscopy. The frequency of colonoscopies vary and this needs to be discussed with the surgeon.