“Doctor, why didn’t you cut the polyp for me three years ago, now it’s cancerous!” In the hospital, a woman asked the doctor angrily with the examination report.
Ms. Wang is 51 years old. She was found to have polyps by colonoscopy in the hospital three years ago. At that time, the doctor recommended that she be hospitalized for colonoscopy to remove it again. No matter what, it dragged on for three years.
Recently, because of blood in the stool, she went to the hospital again for examination, and found that the polyp in the same location was cancerous and could no longer be removed by colonoscopy. It may have metastasized and had to undergo surgery.
Faced with such a result, Ms. Wang regretted her carelessness and complained that the doctor did not remove her cleanly at one time.
In medicine, many people jokingly call colon cancer “fool’s cancer” because it is the best preventable cancer, as long as the polyps are removed, The risk of cancer will be greatly reduced, but there are still many people who are too negligent about intestinal polyps like Ms. Wang.
I. How can polyps grow in a well-rounded intestine?
Intestinal polyps, as the name suggests, are small lumps of protuberance in the intestinal tract, generally referring to the protruding vegetations on the surface of the rectal mucosa and protruding into the intestinal lumen. Most polyps are benign polyps, but it is not ruled out that some polyps have a tendency to become malignant, about more than 95% of colorectal cancers are evolved from intestinal polyps .
Intestinal polyps are relatively unfamiliar to people because they grow in places that are not easily detected. The reasons for the growth of polyps are often related to the following life factors:
1. Long-term constipation
It is difficult to pass stools smoothly for a long time, and the Coarse residues and foreign bodies can stimulate the intestinal mucosal epithelium, and cause intestinal mucosal damage, resulting in abnormal cell proliferation.
2. Inflammatory stimulation
The rectal mucosa is stimulated by inflammation for a long time, and the mucosa is hyperemic, edema, and eroded After the ulcer heals, the scar gradually shrinks, making it easier to form polyps.
3. Improper diet
Nowadays people no longer eat three meals a day. Protein, low-fiber diets are not uncommon, and such eating patterns tend to increase the incidence of intestinal polyps.
4. Inheritance
The formation of intestinal polyps is closely related to gene mutation and genetic factors. Mutated genes can be passed from parents to offspring offspring. In genetic opportunity, men and women are equal.
Second, what are the symptoms of intestinal polyps?
It sounds scary to have “meat bumps” in the intestines, but most polyps are relatively insidious and have no obvious clinical symptoms. Only a small number of patients may have abdominal pain. , blood in the stool, changes in bowel habits and other systemic symptoms.
1. Blood in the stool
Similar to hemorrhoids, intestinal polyps may also cause blood in the stool. However, unlike hemorrhoids, the blood in the stool of patients with hemorrhoids is generally bloody and will not blend with the stool, but the blood in the stool of intestinal polyps will have mucus or dark blood clots in the stool, usually Continuous or intermittent.
2. Diarrhea
Intestinal polyps can easily cause intestinal dysfunction, and patients are prone to diarrhea symptoms. If you have recurrent diarrhea, or even mucous stool, it’s a good idea to check your bowel function.
3. There are “grooves” in the stool
There are polyps in the intestines, and the stool will squeeze with the polyps during the transportation process, resulting in excretion The stool has “grooves”, the surface looks like strips and grooves, the shape will become thinner, and more mucus is attached.
4. Stomach pain
Intestinal polyps may cause intestinal blockage. When you squeeze, you will feel more obvious abdominal pain.
Third, why did the doctor not remove the polyp immediately after finding it?
Although most intestinal polyps are benign, due to the high probability of malignant transformation, as the number of polyps increases, the chance of cancerous transformation will increase exponentially. Therefore, when intestinal polyps are found, doctors generally recommend that they be removed if they are found. Most people can remove it when they are found directly, and a small number of people need to operate again.
Department of Gastroenterology, Shenzhen University General Hospital, Director Xu Long said that generally in the process of gastroenteroscopy, if polyps are found, if the diameter of the polyps is less than 5 mm, and the number of polyps is less than 5 can be clamped under the endoscope. If the diameter of polyps is greater than 5 mm, or the number of polyps is large, simple biopsy forceps may result in residual diseased tissue, and elective admission to the hospital for cold excision, high-frequency electrosurgery or APC (internal excision) is recommended. Microscopic argon ion beam coagulation).
Although the operation of colonoscopy to remove polyps seems simple, bleeding risk should also be considered. If the polyp has a rich blood supply,If the number is large and the risk of cancer is high, it is better to complete the preoperative examination and re-excision.
Fourth, how to make polyps no longer “come back”?
After the polyp is removed, is “everything good”? Wait a minute, according to the analysis and research, the recurrence rates of 1-5 years after intestinal polyp resection are 37%, 47%, 41%, 48%, 60%, respectively. Therefore, in order to reduce the risk of recurrence, we must pay attention to protecting the fragile large intestine.
1. Eat more fruits and vegetables
Vegetables and fruits contain rich fiber, which is good for feces excretion and stimulates intestinal movement , reduce the residence time of feces and reduce the toxicity of harmful substances to the gastrointestinal tract.
2. Exercise more and control your weight
Active exercise can activate immune cells and skeletal muscles, Reduce oxidative stress, thereby reducing the risk of colon polyp recurrence. More exercise can also promote intestinal peristalsis and reduce the contact between intestinal mucosa and carcinogens. In addition, the occurrence of colorectal polyps is also related to blood lipids, age, etc. Therefore, patients must pay attention to weight control to avoid the adverse effects of residual fat on the digestive tract.
3. Regular review
A physical examination should be done once a year. If it has not recurred for two or three years, it can be changed to a five-year review colonoscopy< /strong>. In general, beginning at age 40, a colonoscopy should be done for both men and women, with or without symptoms, and with or without risk factors. For patients with intestinal polyps removed, if abdominal pain, blood in the stool, bloody stool, etc. occur within 1 month after surgery, they should also seek medical attention in time.
Although intestinal polyps have a certain possibility of malignant transformation, patients do not need to worry too much. Timely detection and treatment can effectively block the process of lesions. Of course, after polyps are removed, bad living habits should also be changed, and regular review should be done to minimize the possibility of malignant transformation.
References:
[1] “Intestinal polyps, can you cut it? The doctor said: 85% of bowel cancer is caused by it! “. Shenzhen People’s Hospital. 2021-03-19
[2] “Will polyps be directly removed after gastrointestinal endoscopy?”. Life Times. 2021-05-08
[3] How do intestinal polyps grow? Do you want to cut? 》.Shanghai Release.2021-11-14