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Colonic/Rectal Polyps

Colonoscopy

Polyps are growths that protrude from the internal lining of various organs, such as the nose, stomach, colon, and gallbladder. They resemble bumps or pimples on the skin and can be classified into different types. While some polyps are benign and do not increase the risk of developing into cancer, others are benign but have the potential to become cancerous. The mucosa, which is the internal lining of the colon and rectum, is where colonic and rectal polyps form. Both of these parts of the gastrointestinal tract share similar characteristics.

Polyps in the colon and rectum are growths that protrude from the inner lining of these organs. Polyps often emerge later in life as a result of damage caused by factors such as aging and diet. This damage leads to genetic mutations in the lining cells, which, in turn, causes polyps to form.

Colonoscopy can be done either for screening purposes or if someone shows concerning symptoms. Symptoms that may warrant a colonoscopy include rectal bleeding, persistent changes in bowel habits, unexplained abdominal pain, unintended weight loss, and the sensation of incomplete bowel movements. These symptoms may occur alone or in combination. For individuals aged 45 and older who don’t show symptoms, a colonoscopy may be performed as a screening test. Colonoscopy helps to identify polyps or cancerous tumors at an early stage, which increases the chances of a successful cure. The colonoscopy procedure is the same for both screening and symptomatic patients.

Small and flat polyps are typically removed using a biopsy forceps or snaring. A snare is also used to remove polyps with a stalk. Both these tools can be used with a cold cut technique or diathermy to minimise bleeding risk. Endoscopic Mucosal Resection (EMR) is a specialised technique used for removing larger flat polyps. Pedunculated polyps may require a clip to be placed across the stalk to prevent bleeding after snaring. With colonoscopy, polyps that are 2-3cm in size or smaller can be removed without the need for major surgery.

Colonoscopy is a safe procedure that requires bowel cleansing the day before. Bowel cleansing involves taking bowel laxatives and passing multiple stools, and it’s crucial to stay hydrated throughout the process. On the day of the colonoscopy, the patient is given sedation in the endoscopy room. A scope is inserted through the anus and navigated through the large intestine to the caecum. The scope is slowly withdrawn while the colon lining is carefully inspected for polyps or suspicious lesions, which will be removed or biopsied as necessary. It’s important to note that the inspection is performed during withdrawal, not insertion. Additionally, the procedure may include ligation of piles at the end if needed.

Colonoscopy is a safe procedure with a low risk of serious complications. The two most severe complications, perforation and bleeding, occur at a rate of 0.1% each. Colonoscopy is also the most accurate and dependable method for colon examination, with a miss rate for significant abnormalities of less than 5%.