Colon polyps are growths in the inner lining of the large intestine.
These growths are common and usually harmless, but some polyps can become cancerous. You may not have any symptoms of colon polyps. That's why it's crucial to have routine colon cancer screening exams starting at age 45.
At UPMC, your providers can remove colon polyps during a screening exam called a colonoscopy.
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What Are Colon Polyps?
Colon polyps are small growths on the inner lining of the colon and rectum. They are also called colorectal polyps.
The colon is the longest section of the large intestine. It absorbs water and nutrients from the foods you eat, then changes the waste products that remain into stool.
The stool passes into the rectum, the end of the large intestine.
Colon polyps can occur at any age, but they're more common among older people. Some people get just one polyp, while others form more.
Most polyps are harmless, but some can become cancerous. Colorectal cancer is slow-growing, and doctors can catch it in the early stages with regular screening. They can remove precancerous polyps during a colonoscopy.
What are the types of colon polyps?
Doctors classify polyps by the way they look and whether they can become cancerous. Polyps can be flat, raised, or mushroom-like with a thin stalk.
Noncancerous polyps
Also called nonneoplastic polyps, these rarely turn into cancer. These include:
- Hyperplastic polyp — A common type of polyp that is small and almost always benign. Your doctor will likely remove them to be safe.
- Pseudopolyps — These growths happen after chronic inflammation in the colon. They typically occur in people with Crohn's disease or ulcerative colitis — two forms of inflammatory bowel disease (IBD). While pseudopolyps are usually not cancerous, they indicate chronic inflammation, which raises cancer risk.
Precancerous polyps
Also called neoplastic polyps, these growths are more likely to become cancerous. They include:
- Adenomatous polyps — These growths could be cancerous or precancerous, so it's vital for doctors to remove them. They have two main growth patterns: tubular adenoma and villous adenoma. Villous adenomas are less common but more likely to be cancerous.
- Serrated polyps — These polyps have a saw-tooth appearance under a microscope. There are two types — sessile and traditional. Both are precancerous, and doctors will always remove them during a colonoscopy.
How common are colon polyps?
Colon polyps are very common. About 20% to 30% of adults in the U.S. get colon polyps. But most people don’t know they have them until they have a colonoscopy.
What causes colon polyps?
Doctors aren't sure what causes colon polyps. It could be a mix of factors linked to your genes, lifestyle, and environment.
What are colon polyp risk factors?
Risk factors for getting colon polyps include:
- A diet high in red meat and processed meat and low in fiber, fruits, and vegetables.
- A family history of IBD, colon cancer, or rectal cancer.
- African American or eastern European descent.
- Being over 45 years old.
- Drinking more than three alcoholic drinks per day.
- Obesity.
- Tobacco use.
What are colon polyp complications?
Some colon polyps will turn into cancerous tumors. There's a chance you could get colon or rectal cancer if you don't remove polyps.
Bigger polyps are more likely to become cancerous than small ones.
How can I reduce my risk of colon polyps?
You can’t completely prevent getting colon polyps. But if you adopt healthy lifestyle habits, you can reduce the risk of polyps forming.
To reduce your risk of getting colon polyps and colorectal cancer, you should:
- Eat a healthy diet with lots of whole grains, fruits, and vegetables.
- Limit the amount of alcohol you drink.
- Maintain a healthy weight.
- Quit smoking.
- Stay active with moderate exercise a few times a week.
What Are the Signs and Symptoms of Colon Polyps?
Most often, there are no symptoms of colon polyps. As a rule, you can't tell if you have a colon polyp without a screening test.
Even colorectal cancer in its early stages usually doesn’t cause many symptoms.
But if a polyp is very large, it can cause noticeable symptoms. Colon polyp symptoms include:
- Blood in your stool.
- Changes in bowel habits (such as having to go more often).
- Constipation.
- Diarrhea.
- Excess mucus in your stool.
- Stomach pain.
When should I see a doctor about my colon polyp symptoms?
You should see a doctor if you have any of the symptoms above. But because polyps don’t usually cause any symptoms, it’s important to get screened for colon cancer.
Having colon polyps doesn't necessarily mean you'll get colon cancer. It takes about 10 years for a small adenoma to transform into cancer. Because colon cancer grows slowly, catching it early means there's a good chance of curing it with regular screening.
How Do You Diagnose Colon Polyps?
The most common diagnostic test for colon polyps is a colonoscopy. It's an outpatient test, which means you go home the same day.
You get ready for the test by drinking a colonoscopy prep fluid to empty out your digestive tract.
During a colonoscopy, you will receive sedation. Your doctor will look at your colon through a camera attached to a long, thin tube. If they find polyps, they'll remove them during the test.
Tests to diagnose colon polyps
Beyond a colonoscopy, other tests to detect your risk for colon polyps include:
- Digital rectal exam, where a doctor inserts a gloved finger into your rectum.
- Fecal occult blood test, which detects blood in your stool. This test is only for people at average risk of colorectal cancer.
- Fecal testing, which detects DNA from altered cells.
- Sigmoidoscopy, which uses a flexible tube to look at the sigmoid colon.
Guidelines for colorectal cancer screening
Current colorectal cancer screening guidelines from the American Cancer Society include:
- For most people, a colonoscopy every 10 years, starting at age 45 through age 75. You may need more frequent screenings if you’re at high risk for colorectal cancer.
- For those at high risk of colorectal cancer, a colonoscopy starting at age 40. This recommendation is for those with a family history of colon cancer or IBD. You should have follow-up colonoscopies every five years afterwards.
- For those who’ve already had a precancerous polyp, a follow-up screening in three to five years.
- For those with a low risk of colorectal cancer, a stool-based test every year to three years, depending on the specific test. These tests can happen at home but are not as accurate as colonoscopies.
How Do You Treat Colon Polyps?
The goal of treating colon polyps is to remove them before they can turn cancerous. That's why providers remove any colon polyps — even if they’re not cancerous — during a colonoscopy. They can get rid of polyps that may turn into cancer in a few years.
Colon polyps won’t go away on their own. Even though they are often harmless growths, providers can’t tell which ones may eventually turn cancerous. It's better to remove all colon polyps during a colonoscopy.
Colorectal cancer typically grows slowly. Doctors can successfully treat up to 90% of people with the disease if they catch the cancer early enough. That's why regular colorectal cancer screening is crucial.
Colon polyp removal during colonoscopy
Doctors can remove polyps during a colonoscopy. They cut them out and burn the tissue to seal off blood vessels to stop bleeding.
Polyp removal is painless. Before the colonoscopy, a nurse will insert an IV into a vein, with medicine to make you feel calm. With the sedative, you'll still be awake and able to respond to your care team, but you won't feel pain.
After doctors remove the polyp, they send it to a lab to see if there's any sign of cancer.
There's no test to find out which polyps may turn into cancer, so it's best to remove all of them.
Large polyps may require a second treatment to remove them fully. In rare cases, you may need surgery to remove an extra-large polyp.
How effective is treatment?
Removing polyps during a colonoscopy is very effective. Once doctors remove a polyp, it rarely comes back.
But you can still develop polyps at other sites in the large intestine. It’s important to follow colorectal cancer screening guidelines to make sure to catch any new polyps before they turn cancerous.
How long does it take to recover after a colonoscopy to remove colon polyps?
You don’t need much follow up care after colon polyp removal. Your doctor will likely tell you to rest at home.
You may have slight cramping, gassiness, or bleeding after the procedure. Most people can return to normal activities within 24 hours.
Questions to Ask Your Doctor
It’s important to be well-informed about colon polyps and colorectal cancer screening. Here are some things you may want to ask your doctor:
- Are there medications or supplements that could help reduce my risk of developing new polyps?
- Are there symptoms I should watch for between screenings that would warrant earlier follow-up?
- Do I need genetic testing or more evaluation based on my polyp history or family history?
- Should I make any changes to my diet or physical activity based on my specific type of polyp?
- What type of colon polyp did you find, and what does that mean for my future cancer risk?
Why Choose UPMC for Colon Polyp Care?
At UPMC, you will receive the most comprehensive, up-to-date treatments for colorectal care. Whether you’re coming to us for a routine colonoscopy or colorectal cancer treatment, you can count on us for compassionate care. At UPMC, you can expect:
- Alternative options when possible — When it comes to screening for colon polyps, you have some choices. Our providers will help you make the decision that’s right for you.
- Care for everyone — Even if you've received colorectal cancer screening or care at another center, UPMC has treatment options for you.
- A team approach — Experts from various fields work together to make sure you have an accurate diagnosis. If you need further treatment for colorectal issues, we will tailor a treatment plan based on your individual needs.
