Colonic Polyps and Cancer

Colonic Polyp
Polyp is a discrete mass of the tissue, that protrude into the lumen of the bowel
Polyps are categorized as non neoplastic polyps and neoplastic polyps

Neoplastic polyps

  • Adenoma

Non neoplastic polyps

  • Hyperplastic polyps
  • Juvenile polyps
  • Peutz Jeghers polyps
  • Inflammatory polyps

Adenoma

Adenoma are benign neoplastic polyps, and are of two types, tubular and villous adenomas. Polyps which are larger than 2 cms and with villous morphology are more likely to have transformation to malignancy
Polyps less than 5 mm are called diminutive polyp, these polyps are highly unlikely to have malignant potential

Risk factors

  • Inherited susceptibility
  • Excessive dietary intake of fat and low fiber

Clinical features

  • Most of the polyps are clinically silent
  • Pain abdomen
  • Rectal bleeding
  • Diarrhea and constipation
  • Colonic obstruction

Detection of Colonic Polyps

  • Most of the polyps are diagnosed during colonoscopy.

Treatment

  • Adenomas without deeper invasion can be taken out endoscopically, resected polyp should be submitted for histopathology to confirm the complete resection
  • Polyp with invasion of deeper layers should be taken out surgically

Colon cancer

Colon cancer is a major cause of morbidity and mortality

Risk factors

  • High fat low fiber diet
  • Smoking
  • Colorectal adenomas polyposis syndromes
  • Family history of colorectal cancer
  • Ulcerative colitis and Crohn’s disease

Symptoms

  • Tumor on the right side of the colon, are larger in size and present with chronic bleed and there may be palpable mass also
  • Tumor on the left side of the colon present with change in bowel habits, pain abdomen, anemia and chronic bleed’

Diagnosis

  • Colonoscopy is done for confirmation of diagnosis, biopsy is taken from abnormal areas for histopathological confirmation
  • CECT abdomen and chest are done to r/o distant metastasis

Treatment

  • Surgery is the treatment of choice for colon cancer
  • Patients with advanced disease (disease beyond serosa/lymph node positive cases patients with liver metastasis) should be offered
    chemotherapy

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