A polyp is a small growth on the lining of the intestine. Sometimes there is only one polyp, but there can be several present at the same time. There also are rare conditions in which the colon (large intestine) contains a very large number of polyps. Polyps may be either benign (non-cancerous) or malignant (cancerous).
Removal is recommended for two reasons. First, in order to determine whether a colon polyp is benign or malignant, it is usually necessary for a pathologist to examine the tissue under a microscope. Second, most polyps, even though benign, have the potential to grow larger and become malignant if left in place. Removal of these polyps prevents them from becoming cancerous.
What are the alternatives to removing a colon polyp?
Repeated evaluation of a polyp with X-rays or by looking at it directly with either a sigmoidoscope or a long, flexible colonoscope are the only other ways to determine whether the polyp is changing or growing larger. Unfortunately, because cancer develops at the microscopic level, these evaluations cannot reliably predict if a polyp is becoming malignant.
How are colon polyps removed?
The tiniest polyps are removed by burning or cauterizing them; larger colon polyps can usually be removed using a specially designed snare which cuts the stalk of a polyp and cauterizes it at the same time, so that it does not bleed. The snare is passed through a channel in the colonoscope to accomplish this.
Is surgery ever necessary to remove polyps?
Occasionally this may be necessary, either because the stalk or neck of the polyp is too broad to permit safe snaring, or because the colon is positioned in such a way that the colonoscope will not reach the polyp area safely. The great majority of polyps, however, can be removed without surgery.
These are quite rare but worth mentioning. The most important of these are delayed bleeding and perforation of the intestinal wall. A small amount of blood (a teaspoonful or less) is relatively common, but a larger amount may occur in 1 or 2 of every 1000 patients. If significant bleeding should occur, it can be treated by examining the area again and cauterizing the bleeding point. Perforation of the intestine also is quite rare, occurring in only about 2 patients of every 1000 who have colon polyps removed. In the unlikely event that this should occur, patients may experience lower abdominal pain, chills or difficulty urinating. If a perforation occurs, immediate care by your colorectal surgeon is necessary. This may only require antibiotics and bed rest. In some situations, an immediate abdominal operation with a temporary colostomy may be required. The risks of cancer or polyps being present are much greater than the risks of bleeding or perforation.
When specimens are sent to the pathologist, on average it takes four working days to process the specimen and give it careful consideration. The report should be back in our office within one week.
Patients normally are able to resume full activity and an unlimited diet immediately after polyp removal. The doctor should be notified promptly if bleeding persists, or if abdominal pain, fever, chills or difficulty urinating are noted. If intravenous medication was given during the procedure, one should not drive, drink alcoholic beverages or make important decisions for 24 hours after the procedure.
What type of follow-up is necessary?
This depends on the type of colon polyps and whether they are benign or malignant. This will be discussed with you when the results of the pathology examination are known.
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Seattle, WA 98104
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