3 Mount Elizabeth, #14-15, Mount Elizabeth Medical Centre, Singapore 228510

Colonic Polyps

Colonic Polyps

What are colonic polyps?

Colonic polyps are growths on the colon's lining with varying sizes and shapes. Colonic polyps are usually harmless; however, some do carry the risk of progressing to colon cancer. Colon polyps are classified into two main types, which are:
Non-neoplastic polyps, which are generally benign.
  • Hamartomatous polyps are polyps linked to genetic syndromes.
  • Hyperplastic polyps are the most common type of non-neoplastic polyps. They rarely become cancerous.
  • Inflammatory polyps are often associated with inflammatory bowel diseases (IBD), like ulcerative colitis.
    • Neoplastic polyps, which can potentially become cancerous.
  • Adenomatous polyps are the most common type of neoplastic polyps. They are considered precancerous.
  • Serrated polyps, which include hyperplastic polyps, sessile serrated adenomas (SSAs), and traditional serrated adenomas (TSAs), are all considered precancerous.
    • Colon polyps are growths that form on the lining of the colon with varying sizes and shapes.

    What causes colonic polyps?

    Unfortunately, the main causes of colonic polyps are unknown, as they typically occur randomly. However, some patients may develop colonic polyps due to:
  • Genetic mutations: some polyps are caused by mutations in certain genes that regulate cell growth and differentiation in the colon. These mutations can be inherited or occur spontaneously. Mutations often affect genes responsible for controlling the cell cycle, apoptosis (cell death), and DNA repair mechanisms.
    • For many individuals, colon polyps develop without a clear underlying cause. This underscores the importance of undergoing colonoscopies for cancer screening.

    What are the symptoms of colonic polyps?

    Most colonic polyps are asymptomatic. Hence, they are frequently discovered only during routine gut health screenings. However, when they grow large enough, they can cause the following symptoms:
  • Abdominal pain
  • Changes in bowel habits, like constipation or diarrhoea
  • Changes in stool colour, like black or red stool
  • Iron deficiency anaemia
  • Rectal bleeding

    • Who is at risk of developing colonic polyps in Singapore?

    Some of the common risk factors associated with colon polyps include:
  • Age:
    • the risk of developing colon polyps increases with age.
  • Genetics:
    • a family history of polyps or colon cancer increases the risk of developing colon polyps.
  • History of polyps:
    • having a history of polyps increases an individual’s risk of developing them in the future.
  • Medical conditions:
    • conditions such as familial adenomatous polyposis, inflammatory bowel disease (IBD), and Lynch syndrome increase the risk of colon polyps.
  • Lifestyle factors:
    • lifestyle choices such as a low-fibre diet, alcohol consumption, sedentary lifestyle, smoking, and obesity have all been linked to a higher risk of colon polyps.
    These risk factors increase the pressure and strain on the anus, which can cause tears in the lining, resulting in an anal fissure.
    When colon polyps become large enough, it can cause abdominal pain.

    How are colonic polyps diagnosed?

    One of the key steps to preventing colon cancer is to detect colonic polyps early and have them removed. While most colonic polyps are detected by accident during routine screening, some of the common screening tests that can be performed to diagnose colonic polyps are:

    Colonoscopy:

    a colonoscopy is often used to examine the entire colon. If polyps are found, your doctor may opt to have them removed during the procedure or send them for further investigation to see if cancer cells are present.

    CT colonography:

    a CT colonography, sometimes known as a virtual colonoscopy, is a less invasive imaging test that allows doctors to take pictures of your colon from outside the body to check for the presence of colonic polyps.

    Flexible sigmoidoscopy:

    although a sigmoidoscopy is similar to a colonoscopy, a sigmoidoscopy only assesses your lower colon. If your doctor finds any colonic polyps, they may opt to have them removed during the procedure.

    Stool tests:

    stool tests such as the faecal occult blood test (FOBT) or faecal immunochemical test (FIT) are often done to detect blood in the stool and check for any gene changes to the DNA.

    What are the treatment options for colonic polyps in Singapore?

    At CRCS, the go-to treatment route is to have the colonic polyps removed once they are detected to lower the risk of colon cancer. It is often removed during a colonoscopy and usually takes approximately 30 minutes.
    Polyps may be surgically removed through various procedures, such as a polypectomy, an endoscopic mucosal resection, or an endoscopic submucosal dissection. As a follow-up, individuals must undergo routine monitoring and screening to ensure the colonic polyps do not recur.
    A polypectomy involves removing colon polyps through an abdominal surgery, a laparoscopic surgery, or a colonoscopy.

    Frequently Asked Questions

    Colon polyps are very common and affect between 20% and 40% of adults aged 45 and older. Additionally, they affect roughly 6% of children.

    While most colonic polyps do not cause symptoms, larger ones can cause abdominal pain.

    One of the major risks of leaving colonic polyps untreated is that they can become cancerous, especially if they are larger and precancerous.

    Some of the complications are bleeding, obstruction, and becoming cancerous.

    Colonic polyps carry a 5% risk of becoming cancerous. You might be more at risk if you have more than three polyps and the polyps are larger than 1 millimetre.

    One of the best ways to prevent colonic polyps is to maintain and eat a healthy diet rich in fibre.

    Location

    Colorectal Care Specialists (CRCS)

    3 Mount Elizabeth, #14-15, Mount Elizabeth Medical Centre, Singapore 228510

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