Uncle Huang, 50 years old this year, participated in the physical examination, through colonoscopy found that there are multiple polyps of the colorectum, of which the largest polyp diameter is 2.5cm, the disease test result is villous tubular adenoma with low-level intraepithelial neoplasia, that is, precancerous lesions, fortunately found in time, otherwise it is likely to develop colorectal adenocarcinoma. Uncle Huang wondered why his intestines would grow polyps without diarrhea, constipation, abdominal pain, bloating and other digestive tract symptoms.
Chen Lu, deputy chief physician of the Department of Gastroenterology of the Second People's Hospital of Hunan Province, said that large intestinal polyps account for about 80% of intestinal polyps, most of which are located in the sigmoid colon or rectum, more men than women, the incidence increases with age, the incidence of people under 40 years old is 20-30%, and over 40 years old can rise to 25-50%. Adenomatous polyps in large intestinal polyps are precancerous lesions of colorectal adenocarcinomas, especially familial adenomatous polyposis, multiple adenomas and villous adenomas with a high rate of cancer, which is easy to become cancerous. It is believed that the onset of large intestinal polyps is caused by familial, hereditary, inflammatory hyperplasia, environmental and dietary factors.
Clinical symptoms of large intestinal polyps are often inconspicuous, and even if certain gastrointestinal symptoms such as bloating, diarrhea, constipation, etc., are ignored because they are mild and atypical. Some larger polyps can cause intestinal symptoms, mainly for changes in stool habits, increased frequency, mucus or mucus blood in the stool, occasional abdominal pain, a very small number of stools have a mass prolapsed from the anus, some patients can have long-term blood in the stool or anemia, often misdiagnosed as hemorrhoids and other diseases or dysentery and delay its necessary examination. Anyone with unexplained blood in the stool or gastrointestinal symptoms, especially middle-aged and elderly men over 40 years old, especially those with a family history, should pay attention to improving colonoscopy and other examinations to confirm the diagnosis.
Colonoscopy
Deputy Chief Physician Chen Lu suggested that in daily life, we should pay attention to lifestyle adjustments:
Strengthening physical exercise;
Improve the structure of the diet and increase the intake of dietary fiber;
Quit smoking;
For high-risk groups (>50 years of age, especially men, with a family history of colorectal tumors or other cancers, smoking, overweight, or history of gallbladder surgery, schistosomiasis, etc.), aspirin or COX-2 inhibitors (such as celecoxib) may be considered for prevention, but long-term use should pay attention to adverse drug reactions;
For colorectal adenoma patients, colonoscopic colorectal adenoma resection should be performed as soon as possible, and colonoscopy should be reviewed regularly according to the patient's condition after endoscopic surgery, and recurrent adenoma should be removed in time.
Contributed by: Chen Lu, Department of Gastroenterology, Second People's Hospital of Hunan Province
Editor: Liu Yuchen
Photo: Liu Yuchen