Colonic polyps are small growths that develop on the inner wall of the bowel. Although most are harmless, some may develop into bowel cancer over time. Prevention and early detection are crucial. The Endomedix Gastroenterology Centre Our experts have summarised the latest diagnostic and treatment principles to help you make an informed decision about your health.
What exactly is a colon polyp? The most common types
The histological structure of polyps determines the risk of malignant transformation:
1. Adenomas (Cancerous polyps)
85% of sporadic colorectal cancers develop from these. The types are:
- Tubular adenoma (80-86%): Lower risk.
- Tubulovillous adenoma (8-16%): Medium risk.
- Villosous adenoma (3-16%): The type with the highest risk.
2. Serrated (sawtooth) lesions
Research in recent years has confirmed that these flat, barely noticeable lesions (particularly the Sessile serrated adenoma – SSA) carry a significant risk of cancer in the right side of the colon.
3. Other types
- Hyperplastic polyps: They are usually small and harmless.
- Inflammatory (pseudo)polyps: They develop against a background of chronic inflammatory bowel diseases (e.g. Crohn’s disease, colitis).
Risk factors and symptoms
Risk factors:
- Age: The risk increases significantly for those over 50.
- Lifestyle: A high-fat, low-fibre diet, obesity, alcohol consumption.
- Genetics: Familial clustering or hereditary syndromes (e.g. Lynch syndrome).
When should we be suspicious?
Octopuses are mostly asymptomatic, but it may happen that:
- Rectal bleeding or blood in the stools that is not visible to the naked eye (occult blood).
- Changes in bowel habits (persistent diarrhoea/constipation).
- Abdominal pain is rare.
Diagnosis and removal: The role of colonoscopy
The gold standard for diagnosis is the Colonoscopy. Modern technology (e.g. HD resolution, NBI – virtual chromoendoscopy) makes it possible to accurately determine the type of polyps during the examination itself.
Modern removal techniques (polypectomy):
- Cold-loop polypectomy: For smaller polyps (under 9 mm), without the use of an electric current (safer).
- Hot-loop polypectomy: For larger polyps with a stalk, using electrocautery and vessel ligation.
- EMR and ESD: Specialised techniques for the surgical removal of large (over 20 mm) or flat polyps in a single procedure.
- EFTR: Full-thickness excision for welded or hard-to-reach polyps.
What to do after the procedure: The importance of follow-up
The date of the next examination is determined on the basis of the histological results:
- Low risk (1–4 small adenomas): Generally 10 years Next check-up due in a while.
- High risk (Grade 5+ adenoma, size over 10 mm or severe dysplasia): 3 years A check-up is recommended after this period.
- Removal by cutting after: The first inspection has already 3–6 months This will be necessary in due course.
A guide to the future: Don’t wait for symptoms to appear! For those aged 45–50 and over, screening can save lives. The Endomedix Gastroenterology Centre With its state-of-the-art equipment and experienced specialists, it looks forward to welcoming you for a comprehensive examination and treatment.
