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Polyps Of The Colon And Rectum

What are Polyps?

Polyps are abnormal growths arising from the internal lining of the large intestine (colon and rectum). Some polyps are flat; others have a stalk. Polyps are one of the most common conditions affecting the colon and rectum, occurring in 15-20 percent of the adult population. Although most polyps are benign, certain polyps may eventually turn cancerous.

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What are theSymptoms of Polyps?

Most polyps have no symptoms at all and are found incidentally during an examination of the colon. This may be by colonoscopy, barium enema or CT colonoscopy. Some polyps in the rectum can be found during a rectal examination when the doctor inserts a finger through the anus and feels the polyp. Some polyps can cause bleeding, mucous discharge, change in bowel habits, or rarely, abdominal pain.

How are Polyps Diagnosed?

Polyps are diagnosed either by colonoscopy, barium enema or CT colonoscopy.

In the prevention of colorectal cancer,the early detection and removal of precancerous polyps is key.

Do Polyps Need to be Treated?

As there is no way to predict if a polyp will become cancerous, all polyps should be removed. Most polyps can be removed during colonoscopy, either by catching and cutting them with a wire loop or destroying them by burning with an electrical current. Infrequently, a large polyp cannot be removed and surgery is then required. (video links for polyp removal)

What are the Types of Polyps?

The top two commonest types of polyps are hyperplastic polyps and adenomatous polyps.

Adenomatous polyps are the type that can progress into cancer. It is usually reported as low, moderate or severe dysplasia. After severe dysplasia, it can progress into cancer. Adenomatous polyps are also subdivided into tubular adenoma, villous adenoma and tubulovillous adenoma. The villous type has a higher risk of cancer. Likewise, the larger the size, the higher the risk of cancer. Some reports show that up to 50% of polyps above the size of 2cm contain cancer.

The other subtype is hyperplastic polyp. This was previously believed to be innocuous and will never progress to cancer. However, there are recent reports showing that a large number of hyperplastic polyps together with the presence of a large hyperplastic polyp, there is an increased risk of cancer.

Depending on the type and size of polyp found, your doctor will advise you on how best to manage your specific condition and risk level.

Can Polyps Recur?

A polyp does not recur after it is completely removed. However, new polyps will develop in up to 30 percent of people who previously have polyps. Patients with polyps need repeat colonoscopy to find and treat any new polyps. In some cases of large flat polyps, the endoscopist may take a more conservative approach and leave behind a bit of polyp tissue rather than removing it overzealously and end up cutting or burning a hole in the colon. Under these circumstances, it is safer to leave a bit of the polyp tissues at the edges and complete the removal at a later date.

What Happens after I Have a Polyp Removed?

Your doctor would advise you of the type of polyp that was removed. Based on the nature of the polyp removed, your doctor will advise you on the subsequent follow up. Most follow up would be by colonoscopy at a subsequent date and stool occult blood in between the colonoscopy.

Read on for More Information on Colorectal Cancer:
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Our Colorectal Cancer Surgeon
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Dr Ho Kok Sun
Colorectal & General Surgeon
MBBS (Singapore), M Med (Gen Surg) (Singapore), FRCSEd (Gen Surg), FAMS
Dr Ho Kok Sun has been committed to treating colorectal cancer in Singapore for over a decade. He was the past President of the ASEAN Society of Colorectal Surgeons and the Society of Colorectal Surgeons (Singapore), as well as a founding member of the Eurasian Colorectal Technologies Association. Dr Ho was actively involved in the training of medical students and residents, and has published widely in reputable journals and book chapters. He believes that treatment should always be personalised to the patient’s needs.

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Ho Kok Sun Colorectal Pte Ltd

Colorectal Surgeon

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Mount Elizabeth Medical Centre
#12-09, Singapore 228510

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