Everyone who discovers intestinal polyps is God's guardian angel

As the saying goes, a physical examination without a gastroenteroscopy is a hooligan. With the popularity of endoscopic screening, "intestinal polyps" appear on more and more people's physical examination reports. What should you do if you find intestinal polyps? How should you review the intestinal polyps after they have been removed? Why do some people keep getting polyps? Is there any way to prevent new polyps from growing? This article will take you to find out.

Intestinal polyps : Polyps are abnormal growths of tissue that originate from the mucosal layer. Before their pathological properties are determined, they are collectively referred to as polyps. Polyps may appear wherever there is mucosa in the human body, and those that grow in the intestinal cavity are called intestinal polyps.

**I never had intestinal polyps when I had colonoscopies before,** so why do I have them this time?

Colonoscopy is one of the most effective methods for colorectal screening. It can directly observe the situation inside the colon and detect and remove colorectal polyps in time. Adenoma is the most common type of colon polyp. Early detection and removal of adenoma can significantly reduce the incidence and mortality of colorectal cancer. With age, the risk of intestinal polyps gradually increases. In the general population over 50 years old, the adenoma detection rate is about 25% to 30%. Of course, in addition to age, the adenoma detection rate is also affected by many factors, including the gender, ethnicity, individual risk factors, quality of intestinal preparation, and the quality of colonoscopy of medical institutions. At present, the American Cancer Society recommends that people aged 45 and above should start colorectal cancer screening. For people with a family history or other high-risk factors, screening may need to start earlier. At the same time, you can't "lie flat" just because you didn't find polyps after a colonoscopy. Maybe the next colonoscopy will find polyps.

I have intestinal polyps, but I don’t feel anything?

Most intestinal polyps may not produce obvious symptoms. Some larger polyps or polyps located in specific parts of the colon may cause symptoms such as blood in the stool, abdominal pain and discomfort, and changes in bowel habits. Therefore, most intestinal polyps are discovered by accident. In fact, a major feature of gastrointestinal tumors is that the symptoms are hidden. Many intestinal cancers also have no obvious symptoms. When obvious symptoms appear, it is already in the late stage! Therefore, even if there are no symptoms, intestinal polyps cannot be ruled out, and colonoscopy screening should be performed on time.

Are pedunculated polyps better, and broad-based ones worse?

"Pedunculated" and "broad-based" are classifications of intestinal polyps based on their morphology. The size and morphology of polyps cannot completely and accurately determine whether they are benign or malignant. Pathological results are the "gold standard" for polyp diagnosis. According to pathological results, intestinal polyps are divided into adenomatous polyps and non-adenomatous polyps. The former are recognized as precancerous lesions and are recommended for resection once discovered. They can be specifically divided into tubular adenomas, villous adenomas and tubulovillous adenomas, among which tubular adenomas are the most common; the latter mainly include inflammatory polyps, hyperplastic polyps, juvenile polyps, etc., which generally do not become cancerous.

**I found polyps during colonoscopy,** why didn’t they remove them for me on the spot?

Different polyps have different treatment methods depending on their type, size, and shape. Some smaller lesions can be quickly removed under endoscopy using simple methods, while some lesions are larger, in special locations, or multiple, and require special endoscopic removal surgery. Some require hospitalization for surgery. Therefore, not all polyps can be removed when they are discovered.

**There is a word "neoplastic transformation" on my pathology report,** do I have cancer?

For biopsied or removed polyps, a pathological evaluation will be performed, and adenomas will be histologically graded, which can be divided into low-grade intraepithelial neoplasia and high-grade intraepithelial neoplasia. Low-grade intraepithelial neoplasia indicates the low-grade malignancy of adenoma histology. The adenomatous cells have mild atypia and are less changed compared with normal tissues. Although there are some abnormal cells, these cells usually still show relatively benign characteristics. They are usually considered to be relatively benign lesions, but they still have certain cancer potential. If not monitored and treated, some may gradually progress to higher-grade lesions. High-grade intraepithelial neoplasia indicates the high-grade malignancy of adenoma histology. The atypia of adenoma cells is significantly increased, and the difference from normal tissue is more obvious. It has shown a certain degree of malignant characteristics and is only one step away from "cancer". It needs to be monitored and removed in time. Therefore, don't be too nervous when you see "neoplasia". Most of them are still in the benign category. Even if they are "high-grade", they can be cured by endoscopic resection.

The biopsy pathology report shows that it is benign. Can I not remove this polyp?

Not all colorectal polyps will develop into cancer. For non-adenomatous polyps, you can discuss with your doctor the necessity and timing of resection. Adenomatous polyps are recognized as precancerous lesions, and resection is recommended once discovered. The time it takes for adenoma to become cancerous varies from person to person and is affected by many factors, including the type, size, location, and histological characteristics of the polyp, as well as individual genetic factors and lifestyle. Generally, low-grade intraepithelial neoplasia usually takes a long time to become cancerous, and resection in the short term will not have any impact, so it is not an urgent matter. For high-grade intraepithelial neoplasia, their canceration rate may be faster and they may develop into colorectal cancer in a short period of time, so it is recommended to resect them as soon as possible.

**My biopsy report showed benign,** but why was there cancer when it was removed?

Biopsy is to take a small part of the lesion surface for pathological evaluation, while after resection, the entire lesion is evaluated for pathological evaluation. To give a simple example, if you bite into an apple and find it rotten, you can confidently say that the apple is bad, but if you bite into it and it is good, it does not prove that the apple is not bad, because you may not have bitten into the bad part.

Can the problem be solved once and for all after the polyp is removed?

After the polyp is removed, it is still necessary to have regular colonoscopy reexaminations. On the one hand, because the "soil" for the growth of polyps, such as personal genes, physical constitution and lifestyle, is still there, new polyps may grow. This is like weeds growing in a field. Weeding is only effective for a period of time. As long as the soil does not change, the weeds will still grow, and weeding can only be repeated. On the other hand, polyps may be missed due to poor intestinal preparation or obstruction by folds. For high-grade intraepithelial neoplasia or colorectal carcinoma in situ, reexamination is more necessary to observe whether there is residue and local recurrence at the resection site. For different types of polyps, it is recommended that you discuss the timing of the reexamination with your doctor.

**Why do I find polyps every time I have a checkup?** Is there any way to prevent this?

The formation of intestinal polyps is usually related to the interaction of multiple factors, although not all the causes are completely clear. Some known risk factors include family history, high-fat, low-fiber, high-protein, high-calorie diets, age, inflammatory bowel disease, etc. Improving lifestyle habits can only reduce the risk of intestinal polyps to a certain extent, but cannot completely eliminate it. There is currently no effective drug or diet therapy to prevent intestinal polyps. What we do is to check in time and remove adenomatous polyps when they are found, so that they have no chance to become cancerous.

If intestinal polyps are found and removed, it will sound the alarm for patients to have regular colonoscopy examinations. Just like "weeding the fields regularly and timely", polyps will not have the opportunity to develop into colon cancer! Therefore, don't be discouraged when you find intestinal polyps. Everyone who finds intestinal polyps is an angel guarded by God!