ANORECTAL POLYP: CHARACTERISTICS AND SYMPTOMS
Polyps are small tissue growths that form on the mucosa of hollow organs such as the nose, stomach, uterus and intestine. Some have a flat shape, others have a kind of stem that keeps them connected to the wall. In the western world, polyps are one of the most common diseases affecting the colon and rectum, with a presence ranging from 15 to 20% of the adult population. Most polyps do not cause symptoms and are frequently detected only accidentally during a proctological examination, endoscopy or radiological examination of the intestine. Two warning signals must not be ignored: the first is a significant change in your intestinal habits that lasts for a several weeks without an apparent reason; the second is the presence of blood or mucus in the faeces.
RELATIONSHIP BETWEEN ANORECTAL POLYP AND TUMOUR
Although most polyps are benign in nature, the relationship between some polyps and cancer has now been verified. Indeed, most colorectal tumours result from a malignant transformation of benign polyps. However, not all polyps are equal and, above all, not all are at risk of malignancy. The size of the anorectal polyp is a determining factor in the likelihood that it will evolve toward an invasive form of cancer:
- minimum (less than 2%) for dimensions below 1.5 cm;
- intermediate (between 2 and 10%) for dimensions of 1.5-2.5 cm;
- significant (over 10%) for dimensions greater than 2.5 cm.
Other influential factors are identified in sexual habits, smoking, previous benign lesions to the anus or rectum (such as haemorrhoids, warts and abscesses), immunodepression and previous diagnoses of other tumours (in areas such as the cervix, vulva, vagina, penis).
ANORECTAL POLYP DIAGNOSIS
When the presence of an anus-rectal polyps is suspected, a correct diagnosis can be made through one or more of the following tests:
- Searching for occult blood in the faeces: allows to detect an invisible and mostly chronic blood loss. Although it is an important test for colon and rectum disorders, its negativity does not exclude the presence of polyps.
- Digital rectal examination: this is the first step of a complete endoscopic visit. Through digital exploration, the specialist can perceive the presence of polyps in the lower rectum.
- Colorectal endoscopy: the proctologist may choose to perform this exam with different procedures depending on the large intestine section to be explored. To prepare for colorectal endoscopy, the patient must perform an intestinal cleaning preparation. The discovery of a polyp requires a subsequent complete inspection of the whole colon. Colorectal endoscopy procedures allow, among other things, the removal or collection of tissue samples (biopsies), to be examined in order to determine the nature of the tissue.
In cases where colonoscopy is not practicable, alternative procedures such as, for example, double-contrast opaque enema, virtual colonoscopy and video capsule colonoscopy may be useful.
REMOVAL OF ANORECTAL AND RECURRENT POLYPS
Although most anorectal polyps are benign in nature, there is no way to predict whether one of them will become malignant. Most polyps can be removed during colonoscopy, but some, due to their size or position, cannot be removed by endoscopic treatment: in these cases, surgery is possible.
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