Recently, a friend said to have a colonoscopy. The reason was that a colleague who was a drinker went to the hospital for examination because of blood in the stool. The colonoscopy showed that there were many polyps in the intestine. The doctor finally removed 23 polyps of different sizes for this colleague. , Now my friend is a little worried.

Because he also loves drinking, he made an appointment with other colleagues a few days ago to have a colonoscopy together, and the results were good. There were only a few small polyps, which were also removed. However, a colleague who went with me found the polyps but did not remove them. The different treatment made him feel a little uneasy, so he wanted to ask me about intestinal polyps, and just thought of it today, let’s talk about it together.

Why do polyps grow in the large intestine? Does it have anything to do with diet and physique? Can it be prevented?

Colon polyps are not uncommon. Anyone can have polyps in the colon. This is related to many factors, especially age. After the age of 50, if you are overweight, lack exercise, or smoke , drinking habits, and even a family history of colorectal polyps or colorectal cancer, as well as a history of intestinal inflammatory diseases such as Crohn’s disease, ulcerative colitis, etc., are more prone to polyps, which are related to frequent intestinal cell regeneration.

The large intestine contains good bacteria and bad bacteria, and it is inevitable that there will be inflammation. After the inflammation occurs, the endometrium is prone to proliferate. This vegetation is generally called polyp. In theory, although colorectal polyps cannot be completely prevented, it can reduce the occurrence of polyps or delay the proliferation of polyps through good living and eating habits, adequate intake of calcium and vitamin D, etc.

Can colorectal polyps develop into colorectal cancer?

Colorectal polyps may not always turn into colorectal cancer, but more than 90% of colorectal cancers are evolved from polyps. Generally referred to as colorectal polyps, it generally refers to the protruding vegetations under the mucosa, most of which are benign, but some will gradually evolve into malignant tumors over time.

Colorectal polyps can be divided into two types: non-neoplastic and neoplastic. Non-neoplastic polyps, also known as neoplastic neoplasms, neoplasms, do not generally develop into colorectal cancer, such as hyperplatic polyps, inflammatory polyps, and hamartomatous polyps.

The polyps that can turn into cancer are called neoplastic polyps. They are adenomas and serrated polyps. The larger the two types of polyps, the higher the risk of turning into malignancy.

Colorectal polyps usually do not have obvious symptoms. Occasionally, abdominal pain and blood in the stool may occur. Because the symptoms are not obvious, it is necessary to pass a colonoscopy to know whether there are polyps, and further through resection and other means to achieve. The purpose of preventing colorectal cancer.

Will the polyp grow again after the same part of the polyp is removed?

In theory, if the polyp is cut cleanly, it will not grow again in the same position. Generally speaking, the doctor performing the excision will choose the most suitable method for excision according to the size, location and type of the polyp, including slice forceps excision, polyp excision ring excision, endoscopic mucosal excision or endoscopy Submucosal dissection, etc.

Although the risk of regrowth after resection is very low, our naked eyes may not see or ignore some problems, and the low risk of regeneration cannot be completely zero, especially if the scope is too large, too wide, or the cells are poorly differentiated polyps are prone to recurrence. Therefore, regular follow-up inspections are still required after polyps are removed. The purpose of follow-up inspections is not only to see whether the wound recurs, but also to evaluate whether other polyps have grown in other places.

Why do some people find polyps during colonoscopy, but the doctor does not remove them, while others also have polyps, and they remove them at the same time after colonoscopy?

The main purpose of colonoscopy is to prevent colorectal cancer. In addition to finding polyps that are already tumorous, we also hope to find lesions that may be colorectal cancer through biopsy. Therefore, in the process of inspection, if polyps are seen, they will generally be removed at the same time to achieve the purpose of preventing colorectal cancer.

But it is true that in some cases, it is impossible or unnecessary to remove it. For example: if there are too many polyps, if it is impossible to remove them all, only the relatively large and dangerous ones will be removed first; or if the polyps are too large to be clearly seen, the subsequent treatment methods will be evaluated and not removed for the time being. However, polyps with obvious canceration are not suitable for endoscopic resection, which may cause follow-up problems.

In addition, some people, such as hyperplastic polyps, or those with insufficient vision or the possibility of infection due to poor bowel cleansing, will not be removed temporarily, and they will be removed together after the next bowel cleansing. And if there is a short-term strenuous exercise or long-term exercise that must be carried out, if there is not enough rest time, it is best not to rush to do the excision. In addition, if you are taking anticoagulants and antithrombotic drugs, it is also recommended to stop the drugs before excision. Or, of course, when the subject is unable to cooperate or has not obtained consent, it cannot be excised.

Patients should be reminded that, when there are polyps that have not been removed, it is recommended to further consult and communicate with the doctor to understand the factors of the doctor’s inspection and evaluation.

How often should colonoscopy be done to prevent colorectal cancer?

The purpose of colonoscopy is to prevent colorectal cancer. How often should it be done?

Actually there is no conclusion. Due to the different constitution of each person, the quality of the examination is also different (such as the degree of bowel cleanliness, polyp observation rate, arrival rate, etc.), it is still necessary to examine the risk factors of colorectal cancer such as constitution, medical history, genes, and living and eating habits to decide the re-examination tracked time.

The general conservative recommendations are: (1) If the bowel cleaning is not complete, it must be reviewed within 1 year. (2) If only 1 to 2 polyps are found after examination and no more than 1cm, the examination can be repeated after 3 years. (3) If there are more than 2 polyps or any one polyp is more than 1cm or has precancerous lesions, follow-up examination must be carried out within 1-2 years.