Colorectal polyps
A colorectal polyp is a growth on the lining of the colon or rectum.
Causes
Polyps of the colon and rectum are most often benign. This means they are not a cancer. You may have one or many polyps. They become more common with age. There are many types of polyps.
Benign
Benign refers to a condition, tumor, or growth that is not cancerous. This means that it does not spread to other parts of the body. It does not in...
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Colon cancer is one of the leading causes of cancer-related deaths in the United States. The good news is that early diagnosis often leads to a complete cure. Let's talk today about colorectal polyps. A colorectal polyp is a growth of tissue that sticks out of the lining of the colon or rectum. Polyps are benign, meaning that they're not cancer and they won't spread, but over time certain types can develop into cancer. One of these types is called adenomatous polyps. These are known as pre-cancerous polyps. Polyps bigger than 1 centimeter have a greater cancer risk than polyps under 1 centimeter. Risk factors include your age, family history of colon cancer or polyps, and a type of polyp called villous adenoma. Polyps may also be associated with a few genetically inherited disorders. So, how do you know if you have polyps? Well, usually, you won't have any symptoms. Some people, however, may feel abdominal pain (rarely), have blood in their stool, and feel fatigue from losing blood over time. Usually, a routine colon cancer screening will reveal a polyp through tests called barium enema, colonoscopy, sigmoidoscopy, or virtual colonoscopy. So, what do you do about polyps? Well, because colorectal polyps can develop into cancer, your doctor should remove them. Usually, polyps will be removed during a colonoscopy. If your doctor finds that you have adenomatous polyps, be aware that you may get new polyps in the future. Your doctor will recommend that you have a follow-up colonoscopy in 1 to 10 years, depending upon your age and general health, the number of polyps the doctor found, the size and characteristic of the polyps, and if cancer was found. The good news is that your outlook is excellent if your doctor removes colorectal polyps and performs routine surveillance and screening.
Adenomatous polyps are a common type. They are gland-like growths that develop on the mucous membrane that lines the large intestine. They are also called adenomas and are most often one of the following:
- Tubular polyp, which protrudes out in the lumen (open space) of the colon
- Villous adenoma, which is sometimes flat and spreading, and is more likely to become a cancer
When adenomas become cancerous, they are known as adenocarcinomas. Adenocarcinomas are cancers that originate in glandular tissue cells. Adenocarcinoma is the most common type of colorectal cancer.
Other types of polyps are:
- Hyperplastic polyps, which rarely, if ever, develop into cancer
- Serrated polyps, which are less common, but may develop into cancer over time
Polyps that are 1 centimeter (cm) or larger have a higher cancer risk than polyps smaller than 1 cm. Risk factors include:
- Age
- Family history of colon cancer or polyps
- A type of polyp called villous adenoma
A small number of people with polyps may also be linked to some inherited disorders, including:
- Familial adenomatous polyposis (FAP)
- Gardner syndrome (a type of FAP)
- Juvenile polyposis, a disease that causes many benign growths in the intestine, usually before 20 years old
- Hereditary non-polyposis colorectal cancer (HNPCC), also called Lynch syndrome, a disease that raises the chance of many types of cancer, including in the intestine
- Peutz-Jeghers syndrome, a disease that causes intestinal polyps, usually in the small intestine and usually benign
Peutz-Jeghers syndrome
Peutz-Jeghers syndrome (PJS) is a rare disorder in which growths called polyps form in the intestines. A person with PJS has a high risk for develop...
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Symptoms
Polyps usually do not have symptoms. When present, symptoms may include:
- Blood in the stools
Blood in the stools
Black or tarry stools with a foul smell are a sign of a problem in the upper digestive tract. It most often indicates that there is bleeding in the ...
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- Fatigue caused by losing blood over time
Exams and Tests
Your health care provider will perform a physical exam. A large polyp in the rectum may be felt during a rectal exam.
Most polyps are found with the following tests:
- Barium enema (rarely done)
Barium enema
Barium enema is a special x-ray of the large intestine, which includes the colon and rectum.
Read Article Now Book Mark Article - Colonoscopy
Colonoscopy
A colonoscopy is an exam that views the inside of the colon (large intestine) and rectum, using a tool called a colonoscope. The colonoscope has a sm...
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Sigmoidoscopy
Sigmoidoscopy is a procedure used to see inside the sigmoid colon and rectum. The sigmoid colon is the area of the large intestine nearest to the re...
Read Article Now Book Mark Article - Stool test for hidden (occult) blood
Stool test
The stool guaiac test looks for hidden (occult) blood in a stool sample. It can find blood even if you cannot see it yourself. It is a common type ...
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Virtual colonoscopy
Virtual colonoscopy (VC) is an imaging or x-ray test that looks for cancer, polyps, or other disease in the large intestine (colon). The medical nam...
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- Fecal immunochemical test (FIT)
Fecal immunochemical test (FIT)
The fecal immunochemical test (FIT) is used as a screening test for colon cancer. It tests for hidden blood in the stool, which can be an early sign...
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Barium enema
The barium enema is a valuable diagnostic tool that helps detect abnormalities in the large intestine (colon). The barium enema, along with colonoscopy, remain standards in the diagnosis of colon cancer, ulcerative colitis, and other diseases of the colon.
Colonoscopy
There are 3 basic tests for colon cancer; a stool test (to check for blood), sigmoidoscopy (inspection of the lower colon), and colonoscopy (inspection of the entire colon). All 3 are effective in catching cancers in the early stages, when treatment is most beneficial.
Treatment
Colorectal polyps should be removed because some can develop into cancer. In most cases, the polyps may be removed during a colonoscopy.
Cancer
Colorectal cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). It is also sometimes simply called colon ca...
Read Article Now Book Mark ArticleFor people with adenomatous polyps, new polyps can appear in the future. You should have a repeat colonoscopy, usually 1 to 10 years later, depending on:
- Your age and general health
- Number of polyps you had
- Size and type of the polyps
- Family history of polyps or cancer
In rare cases, when polyps are very likely to turn into cancer or too large to remove during colonoscopy, the provider will recommend a partial colectomy. This is surgery to remove part of the colon that has the polyps.
Colectomy
Large bowel resection is surgery to remove all or part of your large bowel. This surgery is also called colectomy. The large bowel is also called t...
Read Article Now Book Mark ArticleOutlook (Prognosis)
The outlook is excellent if the polyps are removed. Polyps that are not removed can develop into cancer over time.
When to Contact a Medical Professional
Contact your provider if you have:
- Blood in a bowel movement
- Change in bowel habits
Prevention
To reduce your risk of developing polyps:
- Eat foods low in fat and eat more fruits, vegetables, and fiber.
- Do not smoke and do not drink alcohol in excess.
- Maintain a normal body weight.
- Get regular exercise.
Your provider can order a colonoscopy or other screening tests:
Screening tests
Colon cancer screening can detect polyps and early cancers in the large intestine. This type of screening can find problems that can be treated befo...
Read Article Now Book Mark Article- These tests help prevent colon cancer by finding and removing polyps before they become cancer. This may reduce the chance of developing colon cancer, or at least help catch it in its most treatable stage.
- All adults should begin one of these tests at age 45.
Taking aspirin, naproxen, ibuprofen, or similar medicines may help reduce the risk for new polyps. Be aware that these medicines can have serious side effects if taken for a long time. Side effects include bleeding in the stomach or colon and heart disease. Talk with your provider before taking these medicines.
Reviewed By
Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Internal review and update on 02/10/2024 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Centers for Disease Control and Prevention. Colorectal cancer. Reducing risk for colorectal cancer. www.cdc.gov/colorectal-cancer/prevention/. Updated June 12, 2024. Accessed June 17, 2024.
Garber JJ, Chung DC. Colonic polyps and polyposis syndromes. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 126.
National Cancer Institute website. Colorectal cancer prevention (PDQ) - health professional version. www.cancer.gov/types/colorectal/hp/colorectal-prevention-pdq. Updated August 18, 2023. Accessed February 11, 2024.
National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology (NCCN guidelines): colorectal cancer screening. Version 1.2023 - May 17, 2023. www.nccn.org/professionals/physician_gls/pdf/colorectal_screening.pdf. Updated May 17, 2023. Accessed February 11, 2024.
Patel SG, May FP, Anderson JC, et al. Updates on age to start and stop colorectal cancer screening: recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer. Gastrointest Endosc. 2022;95(1):1-15. PMID: 34794803 pubmed.ncbi.nlm.nih.gov/34794803/.
Qaseem A, Crandall CJ, Mustafa RA, Hicks LA, Wilt TJ. Clinical Guidelines Committee of the American College of Physicians, et al. Screening for colorectal cancer in asymptomatic average-risk adults: a guidance statement from the American College of Physicians. Ann Intern Med. 2019;171(9):643-654. PMID: 31683290 pubmed.ncbi.nlm.nih.gov/31683290/.
US Preventive Services Task Force website. Final recommendation statement. Colorectal cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Published May 18, 2021. Accessed February 11, 2024.