Mr. Gao is a retired university teacher, who is usually in good health, and has repeatedly passed loose stools in the past 1 week, and there is no blood in the stool, abdominal pain and bloating, so he doesn't care. This symptom continued for more than 10 days. His wife felt that something was wrong at this time, because Mr. Gao's brother was suffering from rectal cancer, so she urged him to go to the hospital for a check-up to avoid delaying his condition. It doesn't matter, the colonoscopy shows a pedunculated polyp about 1.5 cm on the sigmoid colon. The pathology suggests high-grade intraepithelial neoplasia, i.e., carcinoma in situ. Fortunately, the discovery is relatively timely, confined to the mucosal layer, and regular reexamination after endoscopic excision is sufficient. With the improvement of people's understanding of intestinal polyps and tumors, colonoscopy has been added to many people's physical examination items, and many people have been diagnosed with colorectal polyps.
1. How are colorectal polyps formed?
At present, it is believed that the occurrence of colorectal polyps is related to inflammatory stimuli, genetic factors, and gene mutations. In addition, a high-fat diet, a low-fiber diet, long-term constipation, smoking and drinking, obesity, and aging can also increase the incidence of colon polyps.
2. Clinical manifestations of colorectal polyps
Most patients with colorectal polyps are asymptomatic and are often detected during colonoscopy. The main symptoms are blood in the stool, abdominal pain, diarrhea, intestinal obstruction, etc., and some colorectal polyps will become cancerous. About half of adenomatous polyps > 2 cm in diameter are cancerous, and more than 95% of colorectal cancers originate from adenomatous polyps. If left untreated, familial adenomatous polyposis almost always develops into colorectal cancer, with an average age of 39 years of cancer.
3. How to treat colorectal polyps?
Polyps in the large intestine are very common, and there are many types of polyps, and they are not all precancerous, so there is no need to talk about polyp discoloration. Relatively small polyps, such as colorectal polyps < 0.5cm, are cut out directly by the doctor during colonoscopy. Larger polyps are usually pathologically done first, and if they are inflammatory or hypertrophic polyps, endoscopic excision can be done. If the adenomatous polyp is pathologically suggestive of low-grade intraepithelial neoplasia, endoscopic excision can be performed and colonoscopy can be repeated periodically. If it is a high-grade intraepithelial neoplasia, it can also be said to be a severe dysplasia or carcinoma in situ, just like Mr. Gao, endoscopic resection or surgical treatment can be performed according to the lesion.
4. How to effectively prevent colorectal polyps?
1. Develop healthy and regular eating habits, eat more foods rich in dietary fiber, fresh vegetables and fruits, and eat more grains. Reduce the intake of high sugar, salt and fat, limit the intake of processed meat products and red meat, avoid preserved foods, and avoid overweight and obesity.
2. Keep your stool smooth, drink plenty of water, and it is best to develop a good bowel habit once a day.
3. Quit smoking and drinking, exercise more, and control weight.
4. Timely treatment of intestinal diseases such as ulcerative colitis, Crohn's disease, intestinal microbiosis disorders, etc.
5. Check colonoscopy regularly: For normal people, a colonoscopy should be done around the age of 50. If you have high-risk factors such as constipation, obesity, diabetes, smoking, alcohol consumption, lack of exercise, high-fat and low-fiber, heavy diet, family history of colorectal cancer, etc., it is recommended to complete a colonoscopy at the age of 40-45. If a first-degree relative has colorectal cancer, regardless of whether there are symptoms or not, it is recommended that a colonoscopy must be completed at the age of 40 to detect colorectal polyps in time and treat them in time.
Author: Zhao Kun
Source: Shenyang Seventh People's Hospital
Editor: Ma Ping
Proofreading: Zhang Yan, Chen Zeming
First Instance: Jiang Pengjia
Review: Xu Jiang