Causes, symptoms, treatment and removal of polyps in the rectum
As to the form of such tumors, can be detected by four types: the polyp has either the form of the fungus (underneath is thick or thin feet), or like a bunch of grapes, a sponge or a tight knot.
Despite the fact that the detection rate of polyps in conducting sigmoidoscopy does not exceed 7.5%, distributed as they are much closer. Error the available statistics is quite understandable, and primarily arose from an asymptomatic disease. In addition, there is evidence that at the opening of polyps in the rectum detected in 30% of deaths.
Those people who have crossed the age limit of 45 years should undergo a colonoscopy as a preventive measure, as polyps are found in 10% of cases in adult patients. 1% of patients are carriers of malignant tumors. And what of the polyps, the greater the risk of malignancy.
The content of the article:
Symptoms of polyps in the rectum
Suspected polyp symptoms quite difficult, as clinical signs are nonspecific and could indicate many other diseases of the intestine.
However, the reason for immediate treatment to the doctor should be following symptoms:
- A feeling of discomfort and a feeling of a foreign object in the anus. Most often, this symptom indicates the presence of a tumor in the rectum. Such feelings arise in response to the pressure of the tumor on the opposite wall of the intestine. However, expressed feeling of discomfort appears only in the case when the growth reaches a large size. The patient is not experiencingfeeling a foreign object on a regular basis. Unpleasant feeling occurs periodically and is colicky. In addition, the discomfort can appear in the pubic area or side. If the pathology has progressed, the pain may be constant, they change their character and become unbearable;
- Pain the lower abdomen. Pain never are the companions of young polyps, the negative feelings appear as the disease progresses. Painful reaction is the response of the receptors of the colon to the existing congestion. Because the larger the tumor, the narrower the lumen of the intestine, the stool output in a natural way is very difficult. A sick person suffers from regular constipation prolonged. The constant presence of feces in the intestine, stretches it loops, which in turn causes pain. In addition, pain in the abdomen can be triggered by increased gas formation;
Violation of the chair, manifested in diarrhea and constipation. This symptom is an early manifestation of polyps. Patients often suffer from constipationthat arise due to mechanical obstacles in the form of a polyp. If in the early stages constipation may alternate with diarrhea, the greater the polyp, the less likely to get diarrhea. The chair may not occur more frequently than two times a week. The length of his absence depends on the number of existing polyps. It often happens that a long delay of a chair forcing people to come to the consultation to the doctor;
The presence of mucous and blood content in the stool. The blood that is released from the anus and visible to the naked eye is a terrible symptom. It usually indicates damage to blood vessels submucosa of the rectum. In addition, the blood may signal the entrapment of the polyp or its necrosis. To discover blood, you need to look at the stool, it often is on the surface and has the appearance of red veins. Mucus is a constant companion of polyps in the intestine. The fact that education have increased excretory function. Normally, the mucus needed to lubricate the rectum making passage through it of the stool more comfortable. However, the polyp irritating to the intestinal wall and further stimulates the secretory glands. When mucus accumulates in the anal sinuses and stays there for a long time, it can cause infection. In this case, the patient after prolonged constipation stool will stand out withand even mucous purulent contents.
The clinical picture of the disease can vary. It depends on the histological structure of education itself.
So, there are:
Adenoma or glandular polypus. That's when these tumors are seldom observed a discharge of blood, due to their infrequent ulceration. They are dense and have a pinkish hue to the tone of the mucosa of the intestine. Despite the fact that bleeding in such polyps is a rare, they are most often malignant reborn. The size of adenomas is 20 to 30 mm. Way of connecting with various rectum – may be both thick, and thin stalk;
- Villous polyps, and adenomas, are formed from epithelial tissue. It was under such a variety of formations, the patient is most often observed rectal bleeding. This is due to the peculiarities of their structure, because they are penetrated by blood vessels. In addition, villous polyps are most susceptible to necrosis and formation of ulcers. Due to the impressive size of the spines (up to 30 mm and more) the patient often suffers from constipation;
- Hyperplastic polyps, which diameter do not exceed 5 mm. They are soft and not too much rise above the mucous membrane of the rectum. These tumors often grow completely asymptomatic;
- Glandular-villous polyps have a mixed structure. They are observed in 20% of patients and can only give a very meager symptoms. Bleeding observed in these lesions is rare, most often the amounts of blood invisible to the naked eye. To identify blood in the stool only in laboratory conditions.
Causes of polyps in the rectumNumerous studies designed to determine the cause of the occurrence of such polyps, indicate that this disease is multifactorial. Furthermore, it was found that the healthy mucous membrane of the intestine is an environment in which polyps are formed. So if sprawl was diagnosed, it means that the intestinal lining has undergone pathological changes.
Among the risk factors can be identified:
- Burdened heredity. On the development of tumors in the rectum huge impacthaving a genetic predisposition of the patient to intestinal polyposis. When only one person in the family suffered from this disease, the risk of detection of these tumors in the descendants of increases several times. The present study shows that polyps are formed from blood relatives 10 times more often than in the General population. Do not leave without attention the antenatal factor. In that moment, when the fetus is formed by the wall of the rectum, there are certain violations. Then, as they grow older person, they begin to worsen under the influence of various precipitating factors and eventually lead to the formation of polyps;
- Malnutrition and prolonged constipation. The excess contents in food of animal fats affects the digestive system in General and on the state of the rectum in particular. Such products have very little fiber, essential for the normal formation of stool. The process of refining are many ready-made meals, the frequency of use which should be reduced. The most harmful are the chips, carbonated sweet water, smoked meat and fish, products made with white flour, margarine and sugar. Of course, this is not a complete list of products that can impair peristalsis. Including them in your diet in large volume, man himself contributes to the fact that the stool for a long time linger in the intestines. As a result of prolonged constipation and exacerbate the risk of developing polyps. Canned foods and canned sodas additionally have a negative impact on the intestinal mucosa. For example, potentially toxic Bisphenol A, used in the production of tin packaging, can be found in paints, in the composition of the plastic and other parts not related to the food industry. Use the intestines will not bring excessive consumption of palm oil, rich in TRANS-fats, and alcoholic beverages;
The pathology of the intestine, with chronic. The disease can trigger the development of polyps, are colitis, proctosigmoiditis and ulcerative colitis. Each of them in the long contributes to the dangerous changes in the mucosa of the rectum and growth of tumors;
Acute intestinal infection. During the infectious process is affected, primarily the colon. It then becomes a prerequisite for the formation of polyps in the rectum. Dangerous are diseases such as rotavirus infection, salmonellosis,dysentery. Even if you manage to get rid of the disease quickly enough, each of these infections leaves its "imprint" on the intestinal mucosa. As a result of inflammation and oxygen deficiency occur structural changes in the epithelial tissues of the intestine, subsequently developing polyps;
- Physical inactivity and poor environmental conditions. It's two quite important factors for modern people. Sedentary work is provoking the stagnation of blood in the pelvis, as a result there disorders of the venous and lymphatic outflow. This contributes to the swelling of tissues, which together with chronic constipation stimulates the growth of polyps.
What is the danger of polyps in the rectum?These tumors pose a real threat to the health and life of man. There are several dangers:
- The degeneration of a polyp to a cancer. A particular danger in this respect represent an adenoma that is diagnosed most often. The subtype of adenomas – villous adenomatous polyps that have multiple finger-like appendages. They malignities more often. Significantly increases the risk of malignant transformation with extensive growth of the polyp, and in the presence of a wide base. Such adenomas are more aggressive, as the lack of legs contributes to the accelerated migration of malignant cells into nearby structures;
- The development of intestinal obstruction. In the presence of a rectal polyp of a large size stool stagnate. This leads to intoxication, to his dehydration as a result of violations of electrolyte balance. If the patient does not provide adequate medical care, obstruction threaten the development of necrosis of the intestine. The consequence will be the hit of fecal content into the abdominal cavity, the development of peritonitis and the death of the patient;
Acute enterocolitis develops on the background of constantly irritated the intestinal wall it formed ulcers, they become inflamed, the process captures all the sections of the intestine, including the rectum. The patient suddenly begins to experience pain, it made him sick, vomiting, raised body temperature, fecal blood is detected. If a man will not be in time medical aid, he may die due to perforation of the wallsintestine and development of blood poisoning;
- Abscess. The lack of adequate treatment of a polyp may lead to inflammation. Infection from the rectum penetrates into adipose tissue, which formed a purulent SAC. It can be located inside adipose tissue and outside. The person begins to suffer from pain, increasing the body temperature. In the transition of the disease into a chronic form impaired ability to work, a person becomes lethargic and gets tired quickly;
- Violations of the chair, which is manifested in alternating constipation and diarrhea. When adenomatous formations, patients often suffer from watery diarrhoea that is caused by the abundant secretion of salt and water by the polyp. Due to the leaching of potassium in a person develops hypokalemia, which affects all body systems negatively. The inability to contain gas and feces is often unpleasant complication polyps located near the entrance to the anus;
- The formation of fecal stones. If feces are in the gut, this can lead to them hardening and forming stones. Such round seals disrupt the digestive system, lowers immune defenses, leads to intoxication of the body, cause discomfort and pain in the abdomen;
- Cracks in the rectum. They are formed due to obstructed defecation, as a sick person all the time have to strain the muscles of the anal canal. Special crack deliver pain while trying to empty, often provoke slight bleeding, sometimes can cause sepsis. On the background of constant discomfort when trying to empty the bowel, a person begins to fear each subsequent defecation and unconsciously try to postpone. This leads to the formation of constipation and fecal stones;
- Anemia is another threat posed by the polyps. The patient with the persistent loss of blood experiencing fatigue, weakness, lack of energy.
Diagnosis of polyps in the rectumDiagnostics at suspicion on this pathology includes the following types of research:
- Palpation of the anorectal region. A similar technique in cases of suspected polyps, rectal use in the first place. Finger examination gives you the opportunity to feel the rectum for 100 mm from the entrance toanus. If you intend to conduct a sigmoidoscopy, a preliminary palpation is still definitely possible. It allows you to assess the condition of the sphincters and the mucosa, may suggest the presence of a polyp. After the survey the decision on the need for further diagnosis;
- Sigmoidoscopy. The procedure allows to determine the condition of the mucous membranes of the rectum and beginning of the colon. Implemented with the help of proctoscope. Allows you to inspect the intestine for the first 30 cm. To fully unfold the pleats of the colon, the physician uses a special blowout. For the procedure there are some contraindications. Among them is the narrowing of the lumen of the intestine, expressed in rectal bleeding, bowel disease in the acute phase, cracks the anus. To the procedure was comfortable for the patient and gave as much information as possible, it is necessary to carry out the correct preparation of the patient. This requires a cleansing enema with boiled water, made according to the schedule agreed with the doctor;
- The barium enema. This method of diagnosis is used somewhat less often than the sigmoidoscopy. It is the introduction into the intestinal lumen of contrast agent. It is well visualized under the influence of x-ray beams, which also allows you to see the intestinal wall. This method requires patient preparation. For the procedure a barium enema the patient must be completely empty, so you must do an enema with boiled water. In the evening you can take a laxative. Dinner should not consist of foods which are digested for a long time. It is important for a few days before the study to eliminate from the diet foods that help you poop. This applies to coffee, legumes, and cabbage. In the morning before the procedure for Breakfast;
- CT. This method of diagnosis is the most painless for the patient, and also gives reliable information about the condition, shape and size of polyps without the intestines;
Laboratory studies. To confirm the diagnosis the patient must donate blood for biochemical and General analysis. By themselves, these methods will not give the doctor the opportunity to put a definite diagnosis. However, they are able to complement the picture of the disease. So, prolonged bleeding, you will see a decrease in the number of hemoglobin, which is an indication of anemia. Moreover, it investigates the feces to detect concealed blood particlesundigested food and mucus. Often coprogram gives you the opportunity to determine the etiology of the pathological education, because its results can be seen, whether the patient is suffering from dysbiosis.
Answers to popular questions
- Whether it is necessary to remove polyps in the rectum? These tumors after their diagnosis subject to mandatory removal. Otherwise, you risk to obtain the above-described complications.
- How many heals rectum after removal of polyps? The recovery period may take up to three months. It all depends on the volume of the done operation. As a rule, the wound heals after two weeks after removal of a polyp.
Treatment of polyps in the rectum
Conservative therapy is used in the detection of this pathology. None of the drug is not able to remove the polyp from the body or make it smaller. However, sometimes the surgery the patient can be prescribed drugs. They have as their object the removal of pain or the elimination of increased gas formation.
As the most commonly prescribed antispasmodic Nospanum and to eliminate flatulence – Simethicone.
Removal of polyps in the rectumSurgical intervention is the only method that enables to remove pathological growths of the mucous membrane of the rectum. Depending on what type of polyps are, and how many of them there are pieces, will be assigned to either full operation or endoscopic procedure.
The patient before the procedure, you must prepare. For this he assigned several enemas to clean bowel. 12 hours before the procedure cauterization is necessary to refrain from eating. Can also be assigned special laxatives, for example, Mukofalk.
Electrocoagulation of rectal polyps can be carried out not in all cases. Operation to relieve the patient only on single formations, located not further than 30 cm from the entrance to the anus, but not closer than 10 cm from him. In addition, there should be no signs of malignancy and the polypthe size should not be less than 10 mm or more 30 mm.
During the procedure in the cavity of the intestine enter the interior, after examination of the tumors the doctor brings to him a diathermy loop. It captures the doctor the swelling of the stem, then using a high frequency current occurs coagulation of the polyp, and then it is excreted from the gut.
If the polyp is small in size (up to 3 mm), it can be applied fulguration. The education touch once, causing the polyp is burned. However, this procedure has a risk of perforation of the intestinal wall.
If the rectum is found villous and adenomatous polyps, which are at a close distance from the beginning of the anal canal, transanal excision is shown. Preparation for the procedure is to conduct cleansing enemas.
Before the operation the patient is doing the anesthesia. For this purpose, the Novocaine of 0.25%. After the beginning of action of the drug in the anus, inserted a rectal mirror.
When a polyp clinging to the intestinal wall of the small leg, the doctor crosses it near the base. When the bed of the polyp is broad, then it is an oval excision. The resulting wound is treated with antiseptic.
Among the shortcomings of this intervention mainly secrete high likelihood of bleeding. To prevent it, you must either suturing or subsequent electrocoagulation of blood vessels. After 3 months, the patient must undergo a test sigmoidoscopy.
Transanal endoscopic microsurgery
In this case, to remove tumors from the rectum use proktoskop. It is equipped with equipment for blowing of the intestinal wall, camera and lighting. Polyp removed using a specialised tool equipment. This method has several advantages, including the removal of polyps from any of the rectum, prevent bleeding by immediate coagulation and resection of the growths, as a whole.
It is successful in eradicating
To conduct this intervention requires electropedia, with its help remove the tumor. When it is draped over the polyp, the doctor will submit the current loop will heat up and destroy polyphonie tissue. Cells are necrotic, then the doctor will tighten the loop and cut education.
It is important that during this procedure there is an instant coagulation of blood vessels, and therefore, bleeding will not occur. This is especially true when the removal of polyps from the rectum, asmost of them have developed blood net. Therefore, the development of rectal bleeding is often a complication that appears after resection.
Removal of polyps by laserEducation may be removed from the rectum using a laser. This may be a cauterization or excision of a laser beam. Like any other surgery, this intervention requires training of the patient. Laser cauterization cannot be performed when polyps are of large size, as it significantly increases the risk of perforation of the intestinal wall. Also with the help of this technique does not eliminate villous formation. The procedure does not require General anesthesia and is performed under visual control. Coagulation is performed in stages, which allows to reduce the invasiveness of the procedure. Parallel to the evaporation of abnormal cells is the sealing of the vessels. This helps to ensure that the bleeding as a complication of the operation, will not occur.
Excision by the laser is possible if the villous type polyps. However, they should be located no more than 80 mm from the entrance to the anus. For the pain, apply local anesthesia. The advantage of this method, except for the lack of bleeding, also is the fact that the disinfection of the treated area by using high temperatures. This ensures that after treatment will not have infectious complications. To minimize the likelihood of recurrence, the place of attachment of growths also coagulated. The procedure itself is fairly quick and does not take more than 20 minutes.
Resection of the rectum
If at the stage of diagnosis were signs of malignancy formations, then used the radical method of surgical treatment – resection. It involves the removal of the rectum together with the existing polyps. Also, the intestine can be cut partially, then the surgeons talking about hysterectomy. The procedure will require the injection of General anesthesia.
If a polyp is detected in the lower or middle lobe of the rectum, the doctor performs a lower anterior resection. When you start to act the anesthesia, the surgeon makes an incision in the abdominal wall, located in the lower abdomen. Then produces directly the removal of part of the intestine. The volume of the cut area depends on the size of the malignancy and the degree of development of the cancer process. If the rebirth has already happened, and the cancer cells penetrated into nearby tissues, requirescomplete removal of the rectum. When doctors detect metastases, in addition to rectal removal from the body of exposed lymph vessels, which are located nearby. After performing total resection with anus connect the remaining free end of the ileum.
As for the forecast for recovery, it is favourable, subject to timely detection and competent treatment. Relapses may occur, they are not more than 30% of cases. Often re-growth occurs after a year. Therefore, it is important the control colonoscopy, which must be held 12 months after surgery. If the result is negative, then the second diagnosis should be conducted not less than five years. The optimal period are 3 years. This is due to the absence of specific preventive measures to prevent the recurrence of the disease.