Intestinal polyps, or adenomas, can develop in the lining of the intestine. They are benign bulges that usually do not grow larger than a few millimeters. Only rarely do they reach the size of a few centimeters. Although intestinal polyps are not dangerous at first, they should be examined and treated by a doctor, because they can also become malignant as growths of glandular tissue. Complaints usually occur only when the intestinal polyps have reached a certain size.
What are intestinal polyps?
Intestinal polyps, also called adenomas, are among the benign protrusions of the intestinal mucosa. They can be millimeters or centimeters in size, and among all tumors, 90% are considered benign. If intestinal polyps have developed, in most cases the glandular tissue has proliferated and continues to grow slowly as a tumor. Intestinal polyps that continue to grow over many years, becoming larger in the process, can transform into malignant tumors. Intestinal polyps can occur singly or in multiples and are variously attached to the intestinal mucosa. The growth rate of benign adenomas is very slow, with a maximum of one millimeter. Above a certain size, intestinal polyps can become malignant carcinomas if they are not removed.
Causes
Various causes are responsible for the development of intestinal polyps, which include heredity. In addition, diet is a major cause of intestinal polyps, especially in industrialized countries, where they are correspondingly common. Too many animal fats (meat, sausage) and too little fiber, obesity, nicotine and alcohol promote the development of intestinal polyps. If the intestinal polyps are hereditary, polyposis, Gardner’s syndrome, Cowden’s syndrome and Peutz-Jeghers syndrome are considered causes. Polyposis is a familial adenomatous disease based on a genetic defect. Colorectal polyps arising from Gardner syndrome also find their cause in a genetic defect and in these cases also trigger colorectal cancer in almost all cases. Intestinal polyps and increased brown spotting on the extremities and in the mouth are signs of the cause Peutz-Jeghers syndrome. Intestinal polyps are hereditary in Cowden syndrome and often occur in association with thyroid and breast cancer.
Symptoms, complaints, and signs
In most cases of intestinal polyps, those affected do not feel any discomfort or symptoms. Only when the polyps are larger in size can discomfort occur. Larger intestinal polyps impair bowel activity, causing stool irregularities. Diarrhea and constipation are typical, often accompanied by abdominal pain and cramps in the abdomen. Intestinal polyps are occasionally noticeable by bloody or mucous secretions in the stool. The stool is then black or shows other unusual signs. For example, it may be mushy or even runny later on if the intestinal polyps are holding back parts of the stool or preventing proper digestion. Intestinal polyps can also cause a feeling of pressure in the area of the bowel. This is most noticeable after large meals and at night. In the long term, intestinal polyps can develop into intestinal cancer. If this is the case, it can be noticed by those affected on the basis of unusual stool behavior and a number of other symptoms. These include severe abdominal pain and cramps accompanied by an increasing feeling of illness. Most sufferers lose body weight and feel unwell overall. To avoid such a severe course, a specialist should be consulted at the first signs of intestinal polyps.
Diagnosis
Intestinal polyps are initially completely inconspicuous. Therefore, as a person grows older, an intestinal examination can provide information about whether intestinal polyps are present. Those who suffer from diarrhea or constipation, or who experience abdominal pain more often, should undergo bowel examinations, as these may be indications of intestinal polyps. If blood and mucus are noticed in the stool or the stool is black in color, these may also be signs of intestinal polyps. Intestinal polyps grow invisibly and occur more frequently after the age of 50, although women are less affected by intestinal polyps than men. For this reason, screening examinations have been introduced in Germany, starting as a rectal examination with a finger. If there is blood in the stool, a hemoccult test can be used to determine whether the cause is intestinal polyps.
Complications
Intestinal polyps are benign growths in the intestinal mucosa that do not initially cause health problems and are usually discovered during screening. They grow over a long period of time without any noticeable symptoms. Patients often complain of abdominal pain, nausea and vomiting. In the course of the disease, intestinal polyps can be associated with various complications. Above a certain size, intestinal polyps affect the intestine and its associated functions. Obstruction of stool passage occurs, which can cause intestinal obstruction. When intestinal polyps bleed, the constant blood loss leads to anemia and associated dizziness. Stool irregularities occur, such as constipation, diarrhea, and blood and mucus in the stool. As a result, electrolytes and proteins are lost. The stool may also be black in color. The greatest risk to health is that intestinal polyps over a certain size can degenerate into malignant carcinomas. However, this risk occurs in non-hereditary polyps only after a certain size and prolonged growth. Hereditary colorectal polyps generally have an increased risk of developing colorectal cancer. Intestinal polyps are actually benign intestinal tumors that usually cause only minor symptoms as long as they do not persist over a long period of time. Therefore, the prognosis is positive in most cases. However, if intestinal polyps persist untreated, an increased risk of developing colorectal cancer presents itself.
When should you see a doctor?
The symptoms of intestinal polyps are very mild or, in many cases, nonexistent. Because their presence is often discovered by chance, there are few concrete indications that suggest them. In general, a visit to the doctor is necessary as soon as intestinal symptoms are present that occur over several days and cannot be explained due to other diseases. If diarrhea symptoms occur, constipation occurs, or bowel movements are altered, a doctor should be consulted. If there is bleeding, a feeling of pressure in the abdomen, or a general feeling of malaise, a doctor should be consulted. If there are unusual complaints during sexual practices such as anal sex, this is a cause for concern that should be checked out by a doctor. If there is swelling in the abdomen or a feeling of thickening, a visit to the doctor is necessary. Since intestinal polyps often occur in conjunction with diseases such as colon cancer, control examinations should be performed as early as possible if symptoms are present. In addition, from the age of mid-50s, regular participation in preventive examinations against cancer is recommended so that early detection can take place. If blackish-brown stools occur repeatedly, they should be examined by a doctor. If there are disturbances in digestion, a feeling of fullness or unusual bowel sounds, a visit to the doctor is also advisable.
Treatment and therapy
Intestinal polyps are diagnosed with colonoscopies and if they are larger than 5 millimeters, they are already removed painlessly during the colonoscopy. For this purpose, an endoscope is used through which a small loop can be passed, which is used to separate intestinal polyps from the intestinal mucosa. Subsequently, the tissue of the intestinal polyps is examined for safety to exclude malignant tumors. In the case of hereditary intestinal polyps and large intestinal polyps, surgery is used instead of endoscopy. Once intestinal polyps have been detected and removed, it is relatively likely that intestinal polyps will recur after a few years. In this respect, the therapy of intestinal polyps includes the factor of nutrition, which causally promotes the development of intestinal polyps. In the case of intestinal polyp formation, therefore, the patient himself can do a great deal to prevent further intestinal tumors from developing. A healthy and balanced diet ensures that intestinal polyps do not develop in the first place.
Outlook and prognosis
Normally, intestinal polyps have a good prognosis. If they are detected in time and removed from the intestine, recovery and subsequent freedom from symptoms occur within a few days. Shortly after the procedure, sterile wound care is of particular importance, as germs can enter the organism through the open areas. The ablation site of the intestinal polyps bleeds and must be specially protected so that no secondary diseases occur. The intestinal polyps can form again at any time.Therefore, regular check-ups are important for maintaining health. Six months after the removal of the intestinal polyps, the first hemoccult test is performed. Once it is without findings, a new test is performed every three years for control purposes. In case of manifestation of new intestinal polyps, early removal again gives a good prognosis prospect. The prospect of a favorable course changes as soon as the intestinal polyps remain undetected and linger in the intestine for several years. After about 5-10 years, polyps can mutate in the intestine. They change from a benign intestinal tumor into a malignant tumor in many patients. This creates a life-threatening condition for the affected person. The risk of developing colorectal cancer increases with the size of the polyp. This is promoted with an unhealthy diet.
Follow-up
If the colon polyps have been completely removed, polyp follow-up is recommended based on the patient’s individual risk (concomitant diseases, diverticulosis, family history, histologic examination). For example, if small, non-neoplastic polyps were removed, a follow-up colonoscopy is recommended at ten-year intervals; if three to ten polyps were removed, a follow-up examination should be performed after three years. If more than ten polyps have been removed, close monitoring is initially performed every two to six months, followed by colonoscopy at three to five year intervals. The aim of the follow-up examinations is to detect renewed growth as early as possible and then to treat it accordingly. If symptoms such as changes in bowel movements, blood in the stool, pain or weight loss occur between polyp follow-ups, a doctor must be consulted immediately. Normally, after the polyps have been removed, the patient is informed by the attending physician about the measures or therapies that have been carried out or which therapies still seem necessary. Further check-ups and follow-up examinations can then also be arranged with a gastroenterologist in private practice in the vicinity of the patient’s place of residence. In addition, at a follow-up examination, there is the possibility of being able to contact a special specialist with any problems or questions.
Here’s what you can do yourself
A healthy diet and lifestyle have a positive impact on the development and incidence of colon polyps. Meals should be balanced and high in fiber. It is helpful to avoid intake of unnecessary fats or irritants, such as chili or spicy additives. In addition, intake of toxins such as nicotine or alcohol should be avoided. Sufficient rest, stress reduction, regular sports activities and a vitamin-rich diet are conducive to a strengthened immune system. With this, occurring complaints are minimized and the healing process is supported. In addition, with a stable immune system, the probability of occurrence of intestinal polyps can be reduced. For a good well-being of the intestine, detoxification can be carried out at longer intervals. Between meals, the intestines should always be given time to process. This has a positive influence on the intestinal flora and thus optimizes intestinal activity. People who are overweight can reduce their own weight by changing their diet and at the same time achieve an improvement in their own well-being. At the first signs of problems with the intestines, a doctor should be consulted. Polyps can only be detected during a colonoscopy, so it is helpful to seek medical advice early on. This prevents uncontrolled spread in time.
