The following symptoms and complaints may indicate colon adenomas (colon polyps): Bleeding from the anus Mucus discharge from the anus Changes in stool behavior such as diarrhea (diarrhea) or constipation (constipation). Cramping abdominal pain However, in the majority of cases, it is an incidental finding.
Pathogenesis (disease development) Adenoma-carcinoma sequence Most colon carcinomas develop over years from adenomas – so-called adenoma-carcinoma sequence. An accumulation of mutations (changes in genetic material) are responsible.The adenoma peak occurs circa 10 years before the onset of carcinoma. As the size of the adenoma increases, so does the risk of developing invasive carcinoma. The causes … Colon Polyps (Colonic Adenoma): Causes
General measures Nicotine restriction (refraining from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Preservation of normal weight strive!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis. BMI ≥ 25 → participation in a medically supervised weight … Colon Polyps (Colonic Adenoma): Therapy
1st order Complete ablation of the polyp/adenoma (polypectomy) during colonoscopy (colonoscopy). Polyps ≤ 5 mm either ablation with biopsy forceps (forceps resection) or with cold snare (snare resection; suitable for small polyps ≤ 10 mm) For larger sessile polyps, endoscopic mucosal resection (EMR) is the standard. Transanal (“through the anus“) endoscopic microsurgery (TEM). Partial colon … Colon Polyps (Colonic Adenoma): Surgical Therapy
To prevent colon adenomas/colon polyps (colonic polyps), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Diet too rich in fats (high intake of saturated fatty acids of animal origin and of the polyunsaturated fatty acid linoleic acid (omega-6 fatty acid), contained in safflower, sunflower and corn oil) and low in … Colon Polyps (Colonic Adenoma): Prevention
Medical history (history of illness) is an important component in the diagnosis of colon adenomas (colonic polyps). Family history Are there any gastrointestinal diseases or tumor diseases in your family that are common? Social history Current medical history/systemic history (somatic and psychological complaints). Have you noticed any changes in the stool such as blood accumulation?* … Colon Polyps (Colonic Adenoma): Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Cronkhite-Canada syndrome (CCS) – gastrointestinal polyposis syndrome (polyps in the gastrointestinal tract), which, in addition to the clustered occurrence of intestinal polyps, leads to changes in the skin and skin appendages such as alopecia (hair loss), hyperpigmentation, and nail formation disorders, among other symptoms; Symptoms do not appear … Colon Polyps (Colonic Adenoma): Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by colon adenomas (colon polyps): Mouth, esophagus (food pipe), stomach, and intestine (K00-K67; K90-K93). Ileus (intestinal obstruction) Peranal hemorrhage – bleeding from the anus. Neoplasms – tumor diseases (C00-D48) Colon carcinoma (colorectal cancer)
Classification of polyps/adenomas of the colon (colonic polyps/colonadenomas) according to the WHO classification: Non-neoplastic polyp Neoplastic epithelial polyp Adenoma with the forms: Tubular adenoma Tubulo-villous adenoma Villous adenoma Adenoma with high-grade dysplasia (precancerous/precancerous). Adenoma with carcinoma Other neoplastic polyps Colonic polyps Neoplastic polyps Non-neoplastic polyps Submucosal lesions Benign adenoma Hyperplastic polyp Lipoma Tubular adenoma Juvenile … Colon Polyps (Colonic Adenoma): Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin and mucous membranes Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin changes)? Pulsations? Bowel movements? Visible vessels? Scars? Hernias (fractures)? Palpation (palpation) of the … Colon Polyps (Colonic Adenoma): Examination
Laboratory parameters of the 1st order – obligatory laboratory tests. Test for occult (invisible) blood in stool. Histological examination: this is mandatory for any polyp. Laboratory parameters 2nd order – depending on the results of the history, physical examination and the obligatory laboratory parameters – for differential diagnostic clarification of suspected degeneration. CEA (carcinoembryonic antigen) … Colon Polyps (Colonic Adenoma): Test and Diagnosis
Mandatory medical device diagnostics. As with colorectal cancer screening, the most informative method for clarifying a suspected finding is colonoscopy* (colonoscopy). Colonoscopy can detect mucosal changes of the intestinal wall with a high degree of certainty. Even if a tumor is only suspected in the rectum, the entire colon should always be examined. At the … Colon Polyps (Colonic Adenoma): Diagnostic Tests
