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Colon Polyps

S.C is a 55 year old man with recent passage of blood through his rectum.  The blood is dark in color and mixed with his stools.  He has been having this bleeding intermittently for last 6 months.  There is no change in his stool consistency or frequency in this time.  He says that his brother recently underwent a 'screening' colonoscopy and several 'polyps' were removed.  His grand father died of 'bowel cancer'.  I performed a colonoscopy which revealed a large polyp in the lower left part of his colon(sigmoid colon).  This was removed with a snare(lasso type device) using cautery to burn the edges of the polyp and minimize th risk of bleeding after polyp removal.  The polyp was then analyzed under the microscope by an expert pathologist and the rpeort came back as 'tubular adenoma'.  His bleeding stopped after removal of the polyp.  He was advised to have a repeat colonoscopy again in 3 years.  Polyps are growths in the inner lining of the colon and can grow into cancer over several months/years.  They occur due to genetic changes in the cells lining the colon.  A diet high in red meats and low in fiber predisposes to formation of polyps and eventually colon cancer.  Currently GI societities recommend that all adults above the age of 50 should undergo screening colonoscopy to detect and remove such polyps.  Broadly there are two types of polyps, one are hyperplastic polyps which have no or minimal risk of cancer and the other are adenomatous polyps which have a risk of turning into cancer.  By looking at a polyp with the scope, it is difficult to distinguish the two kinds of polyps.  Therefore, all polyps need to be removed and analyzed. Depending on how many polyps and their size, and also the family history of colon cancer, we recommend repeating the colonoscopy at intervals of 3 to 10 years. 

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