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Colon polyps are growths next form of the inner lining of the large intestine or colon. Polyps are very common. Approximately 1/3-1/2 of all adults have polyps on colonoscopy.
Colon polyps are usually asymptomatic. Large polyps may sometimes cause rectal bleeding especially for located in the left side of the colon. The rectal bleeding can be overt or occult in which case it may contribute to anemia.
Most of the time colon polyps are diagnosed on colonoscopy done for screening purposes or to evaluate patient’s symptoms such as anemia or gastrointestinal bleeding. Polyps can also be diagnosed on stool tests such as fecal occult blood test or stool DNA tests like Cologuard.
At colonoscopy, when colon polyps are seen, they are routinely removed using biopsy forceps if there are small or a snare which is a noose that has the ability to deliver cautery while cutting the polyp to prevent bleeding. All polyps are retrieved and sent for pathologic analysis. The pathology report will indicate if the polyp is precancerous(adenoma) or benign(hyperplastic). Depending on the size, number, pathology of polyps, repeat colonoscopy intervals are recommended anywhere from 1-10 years after the initial colonoscopy. Overall risk of bleeding with removal of a polyp during colonoscopy is 0.5%. If bleeding occurs during the procedure, we have several tools to stop the bleeding such as applying more cautery or placement of clips akin to surgical sutures.
Colon polyps are caused by a combination of genetic and environmental factors. Patients with a family history of colon cancer are at a higher risk of developing colon polyps. Colon polyps also tend to form in patients who consume a diet rich in saturated animal fats and low in fruits and vegetables. Therefore a healthy plant based diet tends to lower the incidence of colon polyps.