Colon Polyps – What they are, what they mean, and what to do

Welcome to our comprehensive guide on colonic polyps and hereditary polyposis syndromes. In this informative article, led by a leading female colorectal surgeon, we’ll unravel the mysteries surrounding these conditions, shedding light on what colonic polyps are, the risks they pose, and how they can be diagnosed with a colonoscopy in Melbourne, and treated by your colorectal surgeon. It’s time to gain a deeper understanding of these gastrointestinal issues and empower yourself with knowledge about prevention and early intervention. Whether you have been diagnosed with polyps, or simply curious about these conditions, we’ve got you covered.

What exactly are colonic polyps?

Colonic polyps are a condition that affects your gastrointestinal tract, which is your digestive system. Before we get into the details, let’s start with what a polyp is.

Imagine your gut as a long, winding tube with an inner lining called the mucosa. A polyp is essentially any little bump or elevation that pops up on the surface of this mucosal lining. These polyps come in various sizes, ranging from a few millimetres to a whopping 10 centimetres! They can appear as solitary entities or in clusters, especially in cases of hereditary syndromes.

The critical point to remember is that some of these colon polyps, particularly a type called adenomas, have the potential to turn into colorectal cancer. In fact, colon cancer, also called bowel cancer, is the third most common type of cancer diagnosed in Australia, with 15,531 Aussies being diagnosed each year.

To simplify, colorectal surgeons categorise polyps into two groups: non-neoplastic (unlikely to become cancerous) and neoplastic (the ones with cancer potential).

Non-neoplastic ones, often referred to as “hamartomatous,” include juvenile polyps and the polyps found in Peuts-Jeghers syndrome. On the other hand, neoplastic polyps are known as adenomas and can be either solitary or multiple. In the case of familial adenomatous polyposis (FAP), you can have more than a hundred adenomas!

Let’s talk numbers: Statistics on colonic polyps

According to researchers and colorectal surgeons, approximately 1 in 10,000 people have a mutation in the APC gene, which is responsible for Familial Adenomatous Polyposis (FAP). There are a couple of variations of FAP, such as Gardner’s syndrome and Turcot’s syndrome, but they all stem from the same gene. Now, it’s important to note that non-adenomatous polyposis syndromes are quite rare.

Understanding the risk factors

Both the familial conditions, whether they are non-neoplastic like Juvenile Polyposis and Peuts-Jeghers or neoplastic like FAP, follow an autosomal dominant pattern. In simpler terms, this means that a person only needs one abnormal gene, inherited from either parent, to develop the disorder.

This makes these conditions quite hereditary and easy to pass on within families. However, it’s crucial to emphasise that most people with adenomas, which are typically precursors to colon cancer, do not have a genetic syndrome like the ones mentioned above.

Progression of colonic polyps

Individuals with FAP are at a significantly high risk of developing colon cancer, often in their thirties. Additionally, there’s an increased risk of other gastrointestinal malignancies, including adenocarcinoma of the duodenum, as well as gastric and ileal adenocarcinomas.

Peuts-Jeghers syndrome is associated with a slightly elevated risk of developing both small and large bowel cancers, along with tumours in the ovaries and pancreas. Meanwhile, Juvenile polyposis is linked to a higher risk of colorectal cancer.

Diagnosing colonic polyps

Now, let’s discuss how we diagnose these conditions. There are a couple of key diagnostic methods:

  • Colonoscopy: Colonoscopy is one of the most effective and important procedures for diagnosing polyps in the colon. That’s because it’s not only a diagnostic tool but also a preventive measure because it allows for the removal of polyps before they potentially become cancerous. This is especially important because some types of polyps, particularly adenomas, have the potential to develop into colorectal cancer over time. Getting a regular colonoscopy in Melbourne is recommended for individuals at increased risk or as part of routine colorectal cancer screening for the general population.
  • Full blood count: Your colorectal surgeon may perform a full blood count to check for anaemia, which could be a sign of rectal blood loss.
  • PR (Rectal) exam: A rectal exam can reveal the presence of a rectal polyp or carcinoma.

Prognosis: What lies ahead

As mentioned earlier, individuals with FAP who aren’t screened and treated early are at significant risk of developing colon cancer, which can be life-threatening.

However, with proactive screening and the prophylactic removal of the colon (known as a colectomy) in their twenties, many individuals can now lead normal lifespans.

The prognosis for other syndromes depends on whether affected individuals ultimately develop colon cancer or another type of cancer. Otherwise, these conditions typically don’t have an impact on prognosis.

Treatment: Taking action

For adenomatous polyposis syndromes, preventive measures often involve the removal of the colon. There are two primary options:

  • Proctocolectomy: This procedure removes the entire colon, necessitating the use of a stoma (an ileostomy bag) for waste removal. The upside is that it virtually eliminates the risk of colon cancer.
  • Colectomy: This approach removes the colon but leaves the rectum intact, eliminating the need for a stoma. However, patients who undergo this procedure need regular follow-up checks (proctoscopy) to ensure they don’t develop rectal cancer. Typically, surgery is performed in the patient’s twenties.

Additionally, regular upper endoscopies (a procedure where a thin, flexible instrument is used to examine or treat issues in the oesophagus, stomach, and the beginning of the small intestine) are recommended in their fifties to monitor the risk of cancer in the upper GI tract, primarily the duodenum. It’s also essential to ensure that family members are screened after the age of twelve.

Speak to a leading female colorectal surgeon in Melbourne

Colonic polyps and hereditary polyposis syndromes may sound complex but understanding them is crucial for early detection and effective management. If you have any concerns or questions about these conditions, it’s essential to reach out to a healthcare professional – and if it helps you feel more comfortable, you can always request a female colorectal surgeon for a consultation or your colonoscopy in Melbourne. Your health is our top priority, and early intervention can make all the difference in the world. Stay informed, stay healthy!