What Are Colon Polyps?

Colon polyps are growths that appear on the inner lining of the colon or rectum. They vary in size, shape, and number and are usually asymptomatic, meaning they often do not cause noticeable symptoms. However, over time, some types of polyps can turn into colon cancer, which is why regular screening is vital.

There are several types of polyps, including:

• Adenomatous Polyps (Adenomas): These are the most common type and have the potential to become cancerous.
• Hyperplastic Polyps: Generally considered non-cancerous and less likely to become cancerous.
• Inflammatory Polyps: Often seen in conditions like inflammatory bowel disease (IBD), these polyps rarely develop into cancer.
• Sessile Serrated Polyps: These have a flat shape and can be harder to detect. Some types can develop into cancer.

Why Remove Polyps?

Polyps, especially adenomatous and sessile serrated polyps, can eventually transform into colon cancer if they are not removed. Colon cancer typically starts with these polyps, and as they grow and change, they may develop abnormal cells that can invade surrounding tissues.

By removing polyps early, during routine screenings such as colonoscopy, the risk of colon cancer can be reduced significantly. Regular removal of polyps can prevent cancer from forming in the first place.

How Are Polyps Removed?

Polyps are typically removed during a colonoscopy, which is a procedure that allows doctors to examine the entire colon using a flexible tube with a camera (colonoscope). If polyps are detected during the procedure, they can usually be removed at the same time. The method used for removal depends on the size, location, and type of polyp.

1. Polypectomy: The Standard Removal Method

• How It Works: A polypectomy is the most common method used to remove polyps during a colonoscopy. A wire loop or snare is passed through the colonoscope, which is then used to cut the polyp from the colon lining.
• When It's Used: This method is effective for small to medium-sized polyps. The polyp is gently snared and removed, with minimal risk of bleeding.
• Recovery: After a polypectomy, you may experience mild cramping or bloating, but these symptoms typically resolve quickly. Most people can resume normal activities within a day or two.

2. Endoscopic Mucosal Resection (EMR): For Larger Polyps

• How It Works: EMR is used for larger or sessile polyps (those that lie flat against the colon wall). During this procedure, a special tool is used to inject a solution beneath the polyp to lift it off the colon lining. The polyp is then removed using a snare or another surgical instrument.
• When It's Used: EMR is typically performed when polyps are too large to be removed with a regular polypectomy. It’s also used for polyps that are difficult to reach with traditional instruments.
• Recovery: Recovery time after EMR is similar to that of a standard polypectomy, although the procedure may take longer, and more careful monitoring may be needed for larger polyps.

3. Endoscopic Submucosal Dissection (ESD): For Very Large or Difficult-to-Remove Polyps

• How It Works: ESD is a more advanced technique used to remove very large or flat polyps that cannot be easily removed with standard polypectomy or EMR. It involves making precise incisions in the colon lining to remove the entire polyp in one piece.
• When It's Used: ESD is typically reserved for polyps that are too large or too deep for other removal methods. It requires highly skilled endoscopists and is usually performed in specialized centers.
• Recovery: ESD may require longer recovery times and more careful post-procedure monitoring due to the complexity of the procedure.

4. Surgical Removal: For Invasive or Inoperable Polyps

• How It Works: In rare cases where a polyp cannot be removed safely through endoscopy, surgery may be needed. This involves removing a section of the colon (partial colectomy) that contains the polyp.
• When It's Used: Surgery is typically used for polyps that are suspected of being cancerous or those that cannot be removed by endoscopic means.
• Recovery: Recovery from surgery can take several weeks, and it may require a longer hospital stay depending on the extent of the procedure.

What Happens After Polyp Removal?

After your polyps are removed, your healthcare provider will send the tissue to a lab for biopsy to determine if the polyps were cancerous, precancerous, or benign. This helps guide future screening recommendations and determine if additional follow-up is necessary.

If the polyps were benign, your doctor may recommend continuing regular screenings according to the typical schedule (e.g., every 10 years for colonoscopy). However, if the polyps were precancerous or cancerous, more frequent screenings or further treatment may be necessary.

Risks of Polyp Removal

While polyp removal is generally safe, there are some risks involved:

• Bleeding: Some bleeding can occur immediately after the removal of larger polyps. In rare cases, more severe bleeding may require additional treatment or a blood transfusion.
• Perforation: A rare but serious risk where a hole is made in the colon wall during the procedure. This may require emergency surgery to repair.
• Infection: As with any procedure, there is a slight risk of infection following polyp removal.

Your healthcare provider will explain the risks and ensure that appropriate precautions are taken to minimize complications.

Follow-Up After Polyp Removal

After polyps are removed, follow-up care is important to ensure the best long-term outcome:

• Post-Procedure Instructions: You may be advised to rest for a short period, avoid strenuous activity, and monitor for any signs of complications, such as excessive bleeding or severe abdominal pain.
• Future Screenings: If you have had polyps removed, your doctor will likely recommend more frequent screenings. The schedule may vary depending on the number, size, and type of polyps removed. In many cases, repeat colonoscopies may be recommended every 3 to 5 years.