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Causes and symptoms of polyps in the intestine, treatment and removal

Polyps in the intestine is a benign tumor, often localized on its inner walls, as in other hollow organs. Such outgrowths are formed from the glandular epithelium and protrude into the lumen of the intestines, sometimes hold on the leg, and sometimes not, and then talking about the polyps on a broad basis.

Intestinal polyps are referred to precancerous diseases, as they often undergo malignant transformation (especially with a hereditary form of polyposis). Therefore, when detected in the intestine, the doctors clearly recommended surgical removal. The difficulty of diagnosis of the disease is that the polyps give mild symptoms, although it is sometimes possible to suspect their presence in a number of clinical signs (bloating, constipation, itching and foreign body sensation in the anus).

Consistency soft, as for the shape, it can be diverse: spherical, branched, mushroom. Most of the growths are formed in the rectum or in the lower part of the colon. In the higher sections of the intestine the polyp formed very rarely. For example, only 0.15% of cases detected in the duodenum. Their color varies, can be dark red, reddish-gray, with a yellow tinge. Sometimes on the surface of the polyps detected by the mucus.

According to statistics, intestinal polyposis – a disease not uncommon. About 10% of people who reach 40 years of age have benign tumors in the intestine. And men, they formed 1.5 times more frequently. The faster the negative, the better the chances to prevent its malignancy. Often it helps to make the study of feces for occult blood. When surgery to remove polyps from the intestine is carried out in a timely manner, in 90% of cases it is the key of human survival.

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Symptoms of polyps in the intestine

To suspect the presence of a polyp certain symptoms oftenit is impossible, because of the lack of specific clinical manifestations of the disease. The degree of their severity depends on the size of the education, exactly where in the intestine they are located, and if their malignancy or not.

Among the possible symptoms of polyps in the intestines:

  • The mucus and blood that occurs most often in the presence of villous adenomas;
  • If polyps impressive size, the patient complains of intermittent pain with colicky. They occur in the lower part of the abdomen. In addition, there is mucus and blood, and constipation, occurring on the type of intestinal obstruction. Often with large polyps, the person feels a foreign body sensation in the anus;
  • In parallel with the polyps in a patient there are often other pathology of the digestive tract, which causes it to undergo a full examination, during which accidentally found the tumor;
  • Colorectal cancer occurs after 5-15 years after the formation of villous adenomatous polyp. Malignancy occurs in 90% of cases;

  • Obvious symptoms of polyps are persistent violations of peristalsis. It can be both diarrhea, and constipation. The larger the education, the more likely to have constipation because the intestinal lumen narrows. The result is a partial intestinal obstruction;

  • The patient may experience a feeling of fullness of the stomach, to suffer from belching and nausea;

  • When pain in the region of the intestine should be suspected as the beginning the inflammation.
  • An extra reason for going to the doctor is the beginning of bleeding from the anus. This is quite a serious symptom and may indicate a malignant process in the intestine;
  • If the polyp has a long pedicle, it may bulge from the anus, although this occurs rarely;

  • Hypokalemia is the result of disorders of the intestine due to the presence of large polyps tentacles finger-like shape. They emit a significant amount of salts and water, thereby stimulating profuse diarrhoea. This leads to a drop in the level of potassium in the blood.


Causes of polyps in the intestine

Modern medicine does not have unambiguous data on the etiology of intestinal polyposis.

However, there are certain theories that suggest the mechanism of disease development:

  • Chronic inflammation of the intestinal wall. Found that begin to form in the healthy tissues of the polyps can't. Therefore, this assumption relative to their causes seems the most obvious. Inflammatory processes in the mucous membrane, cause the epithelium to regenerate faster and this can lead to uncontrolled growth. In addition, the researchers suggest a link between the process of formation of intestinal polyps and diseases such as dysentery, ulcerative colitis, typhoid fever, enteritis, proktoshigmoidit. The basis for this hypothesis is the disappearance of the recurrence of polyposis after getting rid of these diseases. In addition, to trigger the growth of polyps can constipation and intestinal dyskinesia. It turned out that polyphonie sprawl often found in the intestines where there was stagnation of feces and there was microtrauma;

  • Global health problems the majority of the population associated with environmental degradation. Not notice the weakening of the health of modern people is quite difficult. In the first place it concerns children. The number of children with severe congenital pathologies is constantly growing. Many children suffer from diseases that were previously inherent only in ripe old age. On the formation of polyps the important influence factors such as eating foods with chemicals, lack of exercise, lack of fresh air in the conditions of life in the city, alcohol abuse, Smoking, violation of diet;

  • Pathology of the digestive system and blood vessels. The condition of the intestinal mucosa is largely dependent on blood vessels. Negative impact of varicose veins and diverticular disease, atherosclerosis. Can not affect the health of the intestinal pathology of the digestive system (gastric ulcer, gastritis, pancreatitis, cholecystitis and others);

  • Genetics. It is believed that family history has an impact on the development of the disease. This is confirmed by the fact that even against the background of absolute health in some children found polyphonie sprawl. Scientists explain this fact by the genetic program, causing some sections of the intestine to work differently;
  • Embryonic theory. Scientists hypothesize about what areas of the intestine, in which the formation of polyps was malformed during fetal development. Symptoms begin to appear somewhat later as a result of the influence of additional adverse factors;

  • Food Allergy, gluten intolerance. If only a few decades ago, a problem such as gluten intolerance, were a rarity, now more and more children suffer from this form of food Allergy. When ingested, foods containing this protein, the immune system begins to react rapidly to it. She perceives gluten as a foreign agent, which leads to damage of the mucous membrane lining the intestine. While ignoring the inadequate immune response of the person at risk of serious health problems, including cancer of the bowel disease and development of osteoporosis.

In addition, there are General reasons for development of polyps in the intestine, put forward the most likely factors of their formation in various departments, for example:

  • Rarely emerging polyphonie proliferation within the duodenum are most often the result of gastritis with high acidity, cholecystitis or cholelithiasis. The age of onset ranges from 30 to 60 years;

  • Even less education identify in the cavity of the small intestine. They are combined with other polyps in the intestine and in the stomach, more frequently diagnosed in women aged 20 to 60 years. The appearance of the growths can be triggered by multiple factors, among which leads the inflammatory process;
  • Education, discovered in the colon, are often the result of negative heredity.

What is the probability of degeneration of a polyp in colon cancer?

Ability to malignancy have about 75% of all polyponic formations found in the intestine. Such growths called adenomatous. To determine the subtype adenomatous polyp, you study under a microscope. Polyps can be tubular, glandular-villous or villous just. The most favorable prognosis interms of malignancy give a tubular formation. Villous polyps are the most dangerous and most often transformed in cancer.

In fact, threatens a polyp malignancy, additionally affects the size of education. What it is, the higher is the risk. When the growth in volume exceeds 20 mm the threat is compounded by 20%. Due to the fact that even the smallest polyps will continue to increase, they must be removed immediately upon discovery.

There are varieties of polyps, which threatens malignancy is hyperplastic, inflammatory and hamartoma education.

  • Adenomatous education – the most dangerous. They have a high potential of malignancy.
  • Large polyps malignant reborn with a greater degree of probability.
  • Colonoscopy, proctosigmoidoscopy and sigmoidoscopy – diagnostic procedures required for the regular passage of persons older than 50 years with a dangerous heredity. If growths are not found, then the next time I come to the hospital is recommended after two years;
  • After the removal of adenomatous formation of the person are shown regular survey to detect new polyps in the intestine;

  • Modern medicine has special tests for diagnosing genetic predisposition to the development of colon cancer. This approach gives an opportunity to prevent the start of cancer of the degeneration of polyps.


Diagnosis of polyp in the intestine

The early stage of the disease gives vivid symptoms, so most developed countries have introduced mandatory annual submission of feces for detection of concealed blood. This analysis allows to detect even invisible amounts of blood that go along with feces during defecation. However, even a negative result of the analysis can indicate that a polyp in the intestine is not clear.

Techniques such as MRI and CT, can detect growths in some parts of the intestine. To diagnose them in the rectum and sigmoid colon, it is better to undergo the sigmoidoscopy using a proctoscope. This device gives the ability to visualize the bowel in more detail. In addition, proctologists give a recommendation for preventive undergo sigmoidoscopy every 5 years. This must be done for everyone over the age of 50 years.

Digital research is another way to detect polyphonie growths, fractures, tumors, cysts andhemorrhoids in the terminal rectum and anus.

To visualize the formation of larger than 10 mmallows barium enema. It is carried out by introducing into the colon of contrast medium and performing x-ray pictures.

However, the most modern and informative method of diagnosis of polyps is the colonoscopy. It allows you to get information about any abnormalities of the intestine, and upon detection of a polyp can immediately make him a biopsy. Received biopsy is sent for histological and cytological examination.

The doctor it's important not to take the polyp for another, similar education:

  • Angioma. This tumor, which has multiple vessels and is frequently manifested a strong bleeding;

  • Lipoma is a small tumor, often choosing the localization of the right part of the colon;
  • Fibroidscausing bowel obstruction, is diagnosed very rarely;
  • Non-epithelial tumor, which has no legs and reaches an impressive size;
  • Crohn's disease can cause pseudopolyps, which is found in the upper part of the large intestine;
  • Actinomycosis, which affects the cecum.

To differentiate the type of education helps mainly histology.


Popular questions and answers

  • Do I need to remove polyps in the intestine? The answer to this question is unequivocally positive. Any polyp should be removed, other treatment is not possible.
  • Feel the abdomen when polyps in the intestine? Pain cramping nature can occur with large polyps. If this hurts in the lower abdomen and iliac fossa. In addition, abdominal pain can appear in the background of the associated inflammation.
  • Remove any intestinal polyps during a rectoscopy? During this diagnostic study can be removed education of small size, which is conveniently located. In all other situations require surgery.

Treatment of polyps in the intestine

After was accurately differentiated polyp, the doctor decides on the method of removal. With regard to medical treatment, it is not practiced, soas not able to relieve the patient from the growths. In some cases, shown taking drugs, but this measure is temporary and allows to prepare the patient for upcoming surgery. This is especially true for patients with weakened immune systems and the elderly.

To reduce bloating prescribe drugs from the group of antiflatulent, for example, Simethicone. When there are significant pain we recommend taking antispasmodics, for example, But-shpy.


Removal of polyps in the intestine

Regardless of the size of entities, each of them should be removed. After this procedure is carried out microscopic examination for the presence of atypical cells.

The most popular ways to remove growths in the intestines are:

Transrectal excision of a polyp

The procedure is performed with scissors or scalpel. In this way can be removed from the body only close to the anus polyps. They should be no more than 10 cm from the beginning of the anus, although optimal for carrying out such operations is the distance in 6 cm.

The patient is injected anesthetic local action. Most often used for this Novocaine of 0.25%. General anesthesia is rarely used. Following the commencement of the anesthesia doctor using a special mirror pushes the anal canal and removes a polyp.

When education has leg used Bilroth clamp by which the leg clamp. Formed on the mucosa of the defect was subject to suturing. This is enough for a maximum of 3 knots, made catholisim seam. It does not require removal and a month later completely absorbed. If the polyp is attached on a broad base, then removal of produce, cutting out the tumor from the area of healthy mucous membrane with the oval cut.

In the case where the growths are located further than 6 cmbut closer than 10 cm from the entrance to the anus, the technology of operation is changed. With a rectal mirror the anal canal revealed further stretched with the fingers until its complete relaxation. You then enter a gynecologic speculum of a larger size that allows you to withdraw the intestinal wall without polyp. You then enter a short mirror, and the patient must push. This allows you to bring the education and enables the Clinician to capture it with youran elongated clip Billroth, or window clip. Short mirror the doctor removes, introduces an additional anesthesia in the region of the base of the polyp, and then delete it.

Endoscopic polypectomy

This method of removal of polyps is advisable to apply in that case, if education is located in the middle (proximal) parts of the intestine. This surgery refers to minimally invasive surgical techniques that can be used in drug-induced sleep state of the patient. During the procedure the anus introduces the endoscope through which find a polyp. After its discovery, the tumor is removed by means of endoscopic instruments. The doctor then verifies the absence of bleeding, and if necessary performs re-coagulation. The polyp is extracted from the patient's body using an endoscope.

If growth is large, it is necessary to uninstall not entirely, and in parts. This procedure is called kuskulana. This is a fairly complicated technique, during which there can be an explosion of intestinal gases, as well as perforation of the intestinal wall, if the burn is too strong. Therefore, to conduct such an operation can only be trained proctologist or gastroenterologist. After removal of a polyp of large size, exceeding 20 mm, the patient should be re-endoscopy after a year. The person is not removed from the register proctologist and every 3 years needs to undergo this procedure aimed to detect possible relapse.

It is successful in eradicating

In the cavity of the rectum is introduced a proctoscope. According to him, the polyp is carried out electroperu. She jumped on the polyp, through it passes current. The temperature of the loop increases, the epithelial tissue is heated. As a result, the tumor receives thermal burn and omertvenie. When the noose tightens, education is cut and taken out.

This method has several advantages, first, it allows to prevent the development of bleeding as there is an instant coagulation of blood vessels.

Colostomy or resection

Surgery is indicated when detection of polyps in the sigmoid colon, as well as in the diagnosis of fuzzy entities having a wide base. The procedure will require the injection of General anesthesia. Then the doctor performed an incision in the left iliac fossa and the rectum is removed in the formed lumen. Polypoid phase is probed and revealed. Previously healthy areas impose restrictive soft gomy. The tumor and part of the mucous membrane on which it is located, excised, then this place is sutured. Itself rectum is sutured in two rows, and anterior abdominal wallin layers.

Enterotomy

Surgical intervention to remove polyps that have a small footprint and mountable on the leg. Depending on which part of the intestine was subjected to pathological lesion isolated duodenotomy (duodenum), ileostomy (ileum), anatomia (jejunum). A necessary part of the small intestine dissected with a scalpel or electrocautery, the polyp removed and the resulting hole is sutured. Surgery often does not lead to complications, as the clearance of standard enterotomy narrowed slightly.

Segmental resection of the small intestine

Surgery is indicated when detected in the small intestine polyps are large or if their base is wide. The plot, which localizes the lesion is subjected to excision. The ends of the intestine closer together, and formed the inter-intestinal anastomosis. Such interference often causes digestive disorders in the future, as the patient suffers from "short bowel syndrome".

As for the forecast for recovery, it is favorable in that case, if education was detected early and removed promptly from the body. The longer the polyps are located in the intestine and the larger the size and the number, the greater the risk that they will be reborn into a malignant tumor. The likelihood of relapse remains high even after complete removal of the tumor, it is up to 30%. It is therefore important follow-up for patients and passing them regular surveys.


Diet after removal of polyps in the intestine

Rehabilitation of the patient after the operation in the first place depends on the diet. Recovery consists of several stages and should be done according to certain rules.

  1. After surgery comes the first stage of the diet. It lasts for 3 days after the intervention. The patient may not drink or consume food in the first 24 hours. When that time expires, the person can quench their thirst. The maximum volume of liquid that was adopted at once, should not exceed 50 ml. in addition, the patient will be to drink vegetable broth, or fruit compote on the basis of unsweetened fruit. After another 12 hours they are allowed rice-water, weak broth or jelly. You can also vary the strict menu of the patient after surgery decoction of rose hips. Such limitations are due to the fact that it is necessary to eliminate peristalsisintestine and reduce its excretory function. Produced by the bile and digestive enzymes can negatively affect the joints and damaged tissues.

  2. The second phase of the diet starts three days later after the intervention. If the patient feels well, the diet can be expanded by the introduction of liquid cereal, meat souffle (from lean meat), mucous soups, and soft boiled eggs. As for cereals, the preference should be given to millet, oatmeal and rice. When you enter a new product is very carefully to monitor the health of patients. If, after the ingestion of a particular dish, there is an increase in gas formation, or painful sensations appear, it is important to give up such food. The second stage of the diet aims to gradually increase the load on the operated intestine. At this time the patient is necessary to normalize the stool. To follow this diet to the moment of discharge from the hospital.

  3. The third stage begins after two weeks after surgery. For the next four months the patient will have to stick to a sparing diet.

The physician should acquaint the patient with the basic rules of nutrition:

  • It is important to stick to the regime. If the products are ingested at the same time, this will allow the enzymes start to be produced in advance. In this case, the process of digestion will not be as difficult for a recovering bowel;
  • Should smaller meals. This will improve the motor function of the intestine, to reduce the burden on him. The number of meals shall not be less than 6, but the portions should consume a small;

  • It is important to avoid fermentation processes in the intestine, they can cause the development of peritonitis. To do this you should not include in the diet legumes. Under the restriction, get the nuts, asparagus and mushrooms;

  • To prevent constipation the patient should receive a sufficient amount of liquid. Its volume depends on the patient's body mass and the average is 3 liters. Definitely in the menu should include entrees;
  • The fatter the food, the stronger the secretes bile. Its excessive content negatively affects the process of tissue regeneration of the intestine;
  • It is important to refuse to accept too rough food that can injure the intestines. Products must be either thoroughly cooked or baked;
  • Should be added to the diet of dairy products, eggs and lean meat. They all contain protein, which promotes rapid tissue repair;
  • Under the full ban of sour, spicy and fried foods. This is due to their ability to chemical irritation of the intestine.

Menus should be designed and drafted so that it fully meets the needs of a man walking on the mend. It is important to do, despite the existing restrictions. Normal bowel movements is the key to regular bowel movements. This contributes to the prevention of dysbacteriosis and constipation, and therefore, to some extent reduces the risk of recurrence of polyps.