Rectal Polyps Treatment in Pune: Causes, Symptoms, & More

Rectal polyps are abnormal outgrowths that arise from the rectum (where the large intestine ends). Polyps are one of the most common conditions of the rectum and are seen in 15 to 20% of the population. Rectal polyps are usually benign. A small percentage of the rectal polyps turn cancerous if left untreated over a period of 8 to 10 years. Polyps are diagnosed by digital examination or sigmoidoscopy. A small-sized polyp can be removed during a colonoscopy. Larger polyps require surgical intervention.

Rectal polyps are small, fleshy outgrowths on the rectum (the last part of your large intestine). These polyps are usually sessile (flat) or pedunculated, looking like a stalk of broccoli. Rectal polyps can be of various types.

• Adenomatous polyps- These are the most common types. They develop on the mucus lining of the rectum and colon. Adenomatous polyps can be tubular or villous. Tubular polyps protrude through the lumen (opening) of the rectum, while villous adenomas are known to turn cancerous if not treated on time.
• Adenocarcinomas- When adenomatous polyps turn cancerous, they are called adenocarcinomas (the most common type of colorectal cancer).
• Hyperplastic polyps- These are small polyps found in the rectum and sigmoid colon (end part of the colon). These do not have the tendency to become cancerous and are harmless.
• Serrated polyps- These are the second most common type of polyps seen on colonoscopy. They are located in the proximal part of the colon and derive their name due to their saw-toothed appearance. They are non-cancerous but can turn malignant.

Rectal polyps do not usually turn cancerous. If left untreated for a long time, they may turn cancerous. The size of the polyp also determines its future. 

• Polyp < 1 cm- It has a very low chance of turning malignant
• Polyp =1-2 cms -It has about a 10% chance of turning malignant
• Polyp >2cms- It has a very high chance of turning malignant

Polyps develop due to genetic changes in the cells lining the colon. Normal cells have a definite pattern of dividing and growing. In cases of genetic mutations, the cells grow and divide irregularly and haphazardly. These excess cells accumulate and grow into a polyp.
About 30 to 40% of adults in the 45 to 50 age group suffer from polyps. Men, women, and children are equally predisposed to rectal polyps. Several factors predispose you to colorectal polyps and cancer. These factors include-

• Smoking
• Being overweight
• Consuming excess processed food and red meat
• Being physically inactive
• Drinking too much alcohol
• Having a history of diseases of the large intestine, like ulcerative colitis and inflammatory bowel disease
• Having a family history of colorectal polyps and cancer

Most rectal polyps do not cause any symptoms. This is why doctors recommend regular screening for colorectal cancers, especially if you have a family history and a personal history of large intestine diseases.
Very rarely, rectal polyps may produce the following symptoms-

• Blood in the stool- You may notice fresh, bright red blood streaks in your stools and the pot. Sometimes, a microscopic examination of the stool reveals the presence of blood cells in it.
• Mucus discharge with stools
• Unexplained weight loss
• Symptoms of anemia include breathlessness, easily tiredness, brittle nails, pale skin, frequent mouth ulcers, etc.
• Change in your regular bowel pattern. You may develop constipation or diarrhea.
• Pain in the abdomen (very rare symptom)
• Protrusion from the anus (polyp may come out of the anus)

Most rectal polyps are diagnosed by digital examination. Your doctor may recommend further tests to confirm the diagnosis.

• Colonoscopy- This test involves inserting a colonoscope into your rectum. Colonoscope is a special tube with a camera fitted on it. This camera helps your doctor to view the insides of your rectum. During this procedure, your doctor will look for abnormal patterns in your intestinal lining. Any polyp seen during this procedure is removed.
• Sigmoidoscopy-This is a procedure similar to colonoscopy. Here a scope called the sigmoidoscopy is inserted into your sigmoid colon( area of the large intestine nearest to the rectum). With the help of the camera attached to the sigmoidoscope, the insides are seen in high definition on video monitors.
• Stool Examination- You provide the lab with a sample of your stool which is checked for blood and genetic changes that suggest the presence of polyps. A colonoscopy follows a positive stool test.
• Computed Tomography (CT )Scan- This is an imaging test in which high-definition pictures of your large intestines are taken. This helps your doctor to check for the presence of polyps.

Treatment for rectal polyps involves their removal. People who have undergone polyp removal should undergo tests periodically to check for the development of new polyps.

Polypectomy

• Your doctor will perform a colonoscopy and remove all the small-sized polyps found during the procedure. 
• The polyps are then sent to the lab for further histopathological studies. Once the polyps are removed, it is important to get a colonoscopy done regularly. This is because most polyps tend to recur.

Laparoscopic Removal of Polyp

• If your polyp is large, your surgeon will perform a minimally invasive surgery (ess traumatic procedure with quick recovery) to remove the polyp. 
• This surgery is usually done laparoscopically.

Total Proctocolectomy

• This procedure is performed for malignant polyps in which the surgeon surgically removes the part of your large intestine where the polyp is located. 

Depending on the placement of the polyp, there are different surgical techniques for the removal:

Transanal removal

• This technique removes polyps lying lower down in the rectum. This procedure is done under general anesthesia, and the polyp will be removed via your anus.

Transanal Minimally Invasive Surgery (TAMIS)

• This technique is preferred when the polyp is placed higher up in your rectum.

Rectal polyps do not generally cause any symptoms. However, if left untreated for a long time, they may lead to the development of complications.

• Chronic bleeding that can lead to anemia
• Severe weight loss
• Crampy pain in the lower abdomen
• Development of malignancy (cancer of the bowel)

Rectal polyps affect a significant amount of the population the world over. They can happen to anyone aged 45 years and above. People with intestinal diseases like inflammatory bowel disease and ulcerative colitis have a higher chance of developing polyps. If a family member suffers from this condition, there is a high chance of you developing rectal polyps and colorectal cancer.
While your age, family history, and personal health conditions are not in your control, there are several factors that you can work on to prevent the development of rectal polyps.

• Improve your lifestyle. Indulge in physical activities like exercising regularly. Include aerobic activities and muscle-strengthening activities.
• Work on shedding the extra kilos and maintaining a normal body mass index.
• Quit smoking.
• Avoid alcohol.
• Put a stop to the consumption of red meat.
• Say no to all kinds of junk and processed food.
• Talk to your doctor about the benefits of low-dose aspirin and its role in decreasing colorectal polyps and cancer.

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