Colonic Polyps and cancer

Colonic polyp

Polyp is 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 Crohns 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

 Staging 

CECT abdomen and chest are done to r/o distant metastasis

Treatment 

Surgery is the treatment of choice for colon cancer