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Intestinal Polyp – Causes, Symptoms and Treatment

An intestinal polyp is an abnormal tissue growth on the lining of the bowel. Some polyps can develop into colorectal cancer and should therefore be detected and removed early.

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Things worth knowing about "Intestinal Polyp"

An intestinal polyp is an abnormal tissue growth on the lining of the bowel. Some polyps can develop into colorectal cancer and should therefore be detected and removed early.

What Is an Intestinal Polyp?

An intestinal polyp is an abnormal overgrowth of tissue that protrudes from the lining (mucosa) of the bowel. Polyps can develop anywhere along the digestive tract, but they are most commonly found in the large intestine (colon) and rectum. Most polyps are initially benign (non-cancerous); however, certain types – particularly adenomatous polyps (adenomas) – have the potential to develop into colorectal cancer over many years. Early detection and removal are therefore of great medical importance.

Types of Intestinal Polyps

There are several types of intestinal polyps, which differ in their structure and cancer risk:

Hyperplastic polyps: Common, usually small, and generally considered benign with a low risk of becoming cancerous.
Adenomatous polyps (adenomas): These are considered precancerous lesions. Subtypes include tubular, villous, and tubulovillous adenomas. The larger and more villous (finger-like) an adenoma, the higher the risk of malignant transformation.
Sessile serrated lesions (SSL): Flat-growing polyps with an elevated cancer risk that are often more difficult to detect endoscopically.
Inflammatory polyps: These arise as a result of chronic inflammatory bowel diseases such as ulcerative colitis or Crohn's disease. They are generally not precancerous.
Hamartomatous polyps: Rare polyps associated with genetic syndromes such as Peutz-Jeghers syndrome.

Causes and Risk Factors

The exact causes of intestinal polyp formation are not fully understood. Known risk factors include:

Older age (particularly from age 50 onwards)
Family history or genetic syndromes (e.g., Familial Adenomatous Polyposis, FAP; Lynch syndrome)
Overweight and obesity
Smoking and excessive alcohol consumption
A diet low in fiber and high in red or processed meat
Physical inactivity
Type 2 diabetes

Symptoms

Intestinal polyps usually cause no noticeable symptoms and are therefore often discovered incidentally during routine screening examinations. In some cases, the following symptoms may occur:

Blood in the stool (visible or occult/hidden)
Changes in bowel habits (diarrhea or constipation)
Mucus in the stool
Abdominal pain or cramping (rare)
Anemia (low red blood cell count) due to chronic blood loss

Since these symptoms can also occur with other conditions, medical evaluation is always recommended.

Diagnosis

The most reliable method for diagnosing intestinal polyps is colonoscopy. During this procedure, a flexible endoscope is inserted into the large intestine to directly examine the bowel lining. Polyps that are discovered can often be removed during the same procedure (polypectomy) and sent for histological (tissue) analysis. Other diagnostic methods include:

Sigmoidoscopy: Examination of the lower portion of the colon
Virtual colonoscopy (CT colonography): An imaging-based alternative to conventional colonoscopy
Fecal occult blood test (gFOBT / FIT): A screening method for indirectly detecting polyps
Stool DNA test: Detection of DNA changes in the stool associated with polyps or cancer

Treatment

The standard treatment for discovered intestinal polyps is endoscopic removal (polypectomy), which is typically performed during a colonoscopy. Various techniques are available:

Snare polypectomy: A wire loop is placed around the polyp and it is removed using electrosurgical energy.
Endoscopic mucosal resection (EMR): Suitable for flat or larger polyps.
Endoscopic submucosal dissection (ESD): Used for large, flat polyps requiring complete en-bloc resection.

For very large polyps or when an invasive cancer is detected, surgical removal (resection) of the affected bowel segment may be necessary. After polypectomy, regular follow-up colonoscopies are recommended to detect recurrence or new polyp development at an early stage.

Prevention and Early Detection

Because intestinal polyps are often asymptomatic and can carry a significant cancer risk, screening examinations are of central importance. Preventive measures include:

A high-fiber diet rich in fruits, vegetables, and whole grains
Reducing consumption of red and processed meat
Not smoking and limiting alcohol intake
Regular physical activity
Weight management

Most medical guidelines recommend that individuals at average risk begin regular colorectal cancer screening at age 45 to 50. Those with a family history of polyps or colorectal cancer should discuss earlier and more frequent screening with their physician.

References

World Health Organization (WHO) – International Agency for Research on Cancer: Colorectal Cancer Fact Sheet, 2022.
Zauber AG et al. – Colonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer Deaths. New England Journal of Medicine, 2012; 366(8):687-696.
Rex DK et al. – Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Society Task Force on Colorectal Cancer. Gastroenterology, 2017; 153(1):307-323.

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