By Hugo Elliot
Colorectal cancer is a common disease among Singaporean men. While there is no evidence as to what mainly causes this illness, its development can be traced to small tissue growths that look like mushrooms or bumps protruding from the lining of the large intestine. These are called polyps.
Polyps can grow in other inner parts of the body, but they are usually found in the colon. Most of these abnormal growths are benign or non-cancerous. However, they can also become malignant. Read more about polyps, the signs to look out for, and when a treatment is needed in this article.
Colonic Polyps Overview
Colorectal polyp is another term used to define colonic polyp. These growths of tissues are found in the colon or large intestine. Developing polyps in the colon can happen to anyone. People that are past the age of 50 have a higher risk of having them, as well as people who smoke, are overweight, or have a personal or family history of this condition or colorectal cancer.
It is rare for polyps in the large intestine to cause symptoms. Their existence is often discovered when a person undergoes colorectal screening. People who have colon polyps may experience these symptoms:
- Anemia – Colonic polyps can cause chronic bleeding that leads to anaemia. Shortness of breath and fatigue are indicators that the body has a very low supply of iron as the bleeding remains untreated.
- Blood in the stool – A change of stool colour, especially when it appears black or have red streaks, can be a sign of bleeding in the large intestine caused by polyps.
- Bowel habit changes – Persistent constipation or diarrhoea that goes beyond a week may also suggest the presence of a colonic polyp or colorectal cancer aside from other illnesses that can trigger the changes in bowel movement.
- Pain in the abdomen – Colonic polyps can cause blockage in the large intestine, making it hard for the stool to pass through causing sharp and extreme abdominal cramps or pain.
- Rectal bleeding – Blood in the rectum may be a sign of cancer or polyp.
Colonic polyp has three types:
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- Adenomatous polyps
- Hyperplastic polyps
- Malignant polyps
Adenomatous polyps are small clumps of cells that are commonly found in the large intestine. They may almost never proceed to become cancerous, but there is still a chance that they do. Hyperplastic polyps are tiny growths of abnormal tissues that do not cause harm and become cancerous. Malignant polyps are those that contain cancer cells in the tissues.
Colonic Polyps Diagnosis and Treatment
There are several factors that can contribute to the development of colonic polyps. These are:
- being past 50 years old
- being related to a family member that has a history of colon cancer or polyps
- being diagnosed with colonic polyps in the past
- being overweight
- having been diagnosed with diabetes
- having been diagnosed with uterine cancer or ovarian cancer for those under the age of 50
- having been diagnosed with other inflammatory condition affecting the colon (e.g. Crohn’s disease or ulcerative colitis)
- having unhealthy vices, such as smoking and heavy alcohol drinking
- having a diet that is low in fibre and high in fat
- living a sedentary lifestyle
The chances of growing polyps in the intestine can be lowered by making lifestyle changes. However, it is imperative that one gets a doctor’s consultation when symptoms are already present or if the factors that can cause the development of colonic polyps are not related to a person’s lifestyle.
Diagnosing colonic polyps can be done through Colonoscopy, Barium Enema, CT Colonoscopy, Sigmoidoscopy, or Stool Test.
It is best to treat colonic polyps by removing them through Polypectomy Surgery.
Polypectomy Surgery
Polypectomy surgery is a procedure done to remove polyps growing in the large intestine or the uterus. For colonic polyp removal, this procedure is usually done simultaneously with colonoscopy. Colonoscopy is a procedure where a medical tool called a colonoscope is inserted into the rectum so that the condition of the large intestine can be examined. A colonoscope is a tube that is long and thin that is attached with a tiny light and camera at one end. When a polyp is discovered during colonoscopy, it is common for doctor to do polypectomy surgery to remove it.
Polypectomy surgery can be carried out in several ways:
- Endoscopic mucosal resection (EMR)
- Endoscopic submucosal dissection (ESD)
- Snare polypectomy
Endoscopic mucosal resection (EMR) is done by injecting a saline solution to lift the polyp from the underlying tissue and removing the tissue growth through piecemeal resection, means that the elimination of the polyp is made piece by piece.
In Endoscopic submucosal dissection (ESD), the polyp is taken out in one whole piece after the saline fluid is injected deep into the abrasion.
Snare polypectomy uses a thin wire that is looped around the base of the polyp. The wire is then heated in order to cut the tissues off. Cauterization may be done next just in case there some tissues remain in the lining of the colon.
Preparing for a Polypectomy Surgery
The colon must be free from anything that can hinder the clarity of a colonoscopy procedure. To be sure of this, a patient is requested to completely release bowels and empty the colon at least one or two days before the scheduled colonoscopy. Laxatives and an enema may be prescribed by the doctor to do this. A diet composing of clear foods is also advised.
On the day of the polypectomy, an anaesthetic doctor will assist and administer anaesthesia prior to the surgery. The doctor will check if the patient has had any adverse reaction to anaesthesia before. As soon as everything is set, the patient will be asked to lie on their side on the operating table. Then, they will need to pull their knees up to their chest. The colonoscopy and polypectomy surgery is then performed.
Depending on the patient’s condition, a polypectomy surgery can last anywhere from 20 to 60 minutes.
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Alpine Surgical Practice – Dr Aaron Poh, Consultant Surgeon
3 Mount Elizabeth
#17-16 Medical Centre
Singapore 228510
Phone: +65 6589 8929
Whatsapp: +65 8875 0080
