Colon Polyps

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is a polyp in the colon?

Colon polyps are growths in the lining of the colon. This includes the large intestine and the rectum, which is the last six inches of the large intestine. You may also hear the term colorectal polyp, to include both the colon and the rectum.

A colon polyp can be a flattened bump or lump in the lining—a sessile polyp—or it can grow out of the lining on a stalk. Polyps are not cancerous, but they can be precancerous. This means they will eventually develop into cancer. This process is usually very slow, occurring over 10 to 15 years. The most common form of colon cancer—adenocarcinoma—begins as a precancerous or adenomatous polyp. This makes finding polyps an important part of health screenings for adults. Finding polyps before they become cancerous lets doctors remove them and potentially save lives.

Colon polyps are relatively common in adults. The incidence of colon polyps increases with age. They tend to be rare in younger adults, but may affect up to 40% of older adults. They also tend to occur more often in men than women. Once you develop a colon polyp, you are more likely to have them again in the future.

Most people with colon polyps do not realize it because they do not experience any symptoms. It is most common to find polyps on a screening exam. If you notice rectal bleeding or see blood in your stool, seek prompt medical care. These symptoms could indicate a potentially serious condition. However, they can also be symptoms of relatively common conditions, such as hemorrhoids. Seeing your doctor is the only way to know for sure.

What are the symptoms of colon polyps?

In most cases, colon polyps do not cause any symptoms. As a result, most people do not know there is a problem. Typically, doctors find colon polyps on screening exams, such as a colonoscopy.

Common symptoms of colon polyps

Sometimes, colon polyps cause symptoms including:

  • Blood in the stool. This can appear as streaks on the stool or make the stool look black and tarry. However, you may not always be able to see blood in the stool. Doctors can use a test to find blood you can’t see.

  • Rectal bleeding. This often appears as blood on the toilet paper.

  • Tiredness and lack of energy. This is due to anemia from a bleeding polyp.

Symptoms that might indicate a serious condition

In some cases, polyps can cause symptoms that might indicate a more serious condition. Seek prompt medical care if you have any of the following symptoms:

  • Abdominal pain or painful cramping, which can result if a large polyp is partially obstructing or blocking the bowel

  • Change in bowel habits including diarrhea and constipation lasting longer than a week, which can also occur with large polyps blocking the bowel

All of these symptoms, including the potentially serious ones, can be due to other conditions. See your doctor as soon as possible if you experience any of them. Getting an accurate diagnosis is the first step in resolving the problem. In general, the earlier you seek a diagnosis and treatment, the better the outcome is likely to be.

What causes colon polyps?

Health experts do not fully understand what causes colon polyps. They likely develop as the result of a combination of hereditary (genetic) and environmental factors. These factors affect colon cells in such a way as to trigger their overgrowth in the lining of the colon. In some cases, the changes cause the cells to become cancer cells.

What are the risk factors for colon polyps?

Although the exact cause of colon polyps is unknown, there are a number of factors that increase the risk of developing them. Not all people with risk factors will get colon polyps. Risk factors for colon polyps include:

Certain hereditary syndromes can also increase the risk of developing colon polyps. This includes Lynch syndrome, familial adenomatous polyposis (FAP), MYH-associated polyposis (MAP), Peutz-Jeghers syndrome, and serrated polyposis syndrome.

Reducing your risk of colon polyps

You may be able to lower your risk of colon polyps by changing lifestyle-related risk factors. This includes:

  • Getting regular physical exercise most days of the week

  • Eating a diet high in fruits, vegetables, and whole grains

  • Limiting alcohol intake to no more than two drinks per day for men and one drink per day for women

  • Maintaining a healthy body weight

  • Quitting smoking

  • Treating and controlling IBD and type 2 diabetes

If you have any risk factors for colon polyps, talk with your doctor. It may be necessary to start colon cancer screening earlier or screen more frequently. Otherwise, people at average risk can begin screening at age 50. This is important because finding colon polyps early is an effective way to prevent problems, including colon cancer.

How are colon polyps treated?

In most cases, doctors remove polyps (polypectomy) during a colonoscopy screening exam. A colonoscopy involves inserting a flexible, lighted tube through the anus and into the rectum and colon. A camera allows your doctor to view the entire length of the colon’s lining. Your doctor can perform polyp removal using the same equipment. In rare cases, large polyps may require multiple colonoscopies or even surgery to remove them.

After removal, a lab will examine the polyp to determine if it is cancerous, precancerous, or completely benign. The results can influence how often you need screening in the future.

What are the potential complications of colon polyps?

Colon polyps themselves are not life threatening. However, some types of polyps can become cancerous. Finding polyps early and removing them is a vital part of colon cancer prevention. The less time a colon polyp has to grow and remain in your intestine, the less likely it is turn into cancer. And the earlier your doctor finds a cancerous polyp, the more likely it is that treatment will be successful. Unfortunately, only half of people eligible for screening get it done when they should. Do not delay this potentially life-saving exam. Talk with your doctor to find out when to start.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 27
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