Polyps are benign cancers that occur of the gastrointestinal tract, especially in the colon. They are very common in the general population with about 50% having them but most remain asymptomatic. There are no known causative factors but there is a strong link to low chronic high fat low fiber diets, obesity, and smoking. Furthermore, they have a strong genetic linkage as shown by the familial tendencies to develop them.
They take many years to grow and cause obstruction of the alimentary canal as the major symptomatology. Colonoscopy is a tried and tested approach to diagnosing and treating the colon polyps. It involves putting in a flexible tube with has a camera at the end to visualize the colon lining as well as resect the small polyps or take biopsies if needed.
For small polyps, they are easily removed during colonoscopy.
In advanced polyps, an endoscope containing a loose noose is inserted into the lumen of the colon. Upon finding a polyp, the noose of an endoscope is used to strangulate the base of the polyps until it cuts off. It is the electric current which is passed on the noose (diathermy) which cuts it off and ensures that no bleeding occurs thereafter. The cut polyp is then sucked into the endoscope out for pathological investigations.
Air is normally pumped into the colonic lumen for proper visualization during the resection.
The greatest risk is that of bleeding following removal of the polyps in polypectomy. Secondary injuries to the associated structures and perforation of the colonic lumen may occur during the procedure.
The patients should be assessed if they are fit for the surgical procedure through a thorough history taking and physical examination.
The use of laxatives preoperatively is indicated to provide appropriate visualization of the colonic lumen without much of the fecal hindrances. The patient should have gotten adequate antibiotic cover before the surgical procedure to
avoid the risk of sepsis/infections.
You are required to show up to the health care facility about a day to the surgery. This will give the caregivers enough time to run the lab blood tests required and other tests that might be required before the surgery.
The patient is required not to have taken any fluids at least 2 hours before the procedure. If general anesthesia is used, then the patient is required to have fasted at least 8-12 hours before the procedure.
An Intravenous line is required to feed the required drugs into the body system of the patient.
A water drip may or may not be employed.If the patient is taking any anticoagulation medication, they should discuss with the doctor incharge on how to stop or minimize the dosage.
Consent of the patient before the procedure should be taken.
Laxatives are continued postoperatively to minimize the risk of constipation on a healing colonic lumen.Adequate water intake is recommended following the procedure.The patient will be feeling bloated and passing lots of gas because of the air that was passed into the colon during the procedure but this will slowly go away on its own. The use of NSAIDs might help reduce the size of the polyp.Follow up for the pathology report of the biopsied tissues as well as a regular reassessment of the gut for new polyps formation especially if hereditary. This could be at a 5-year interval.
If left unresected, some of the large polyps could become cancerous and the polypectomy procedure averts this. Development of the advanced polyp into cancer is usually slow with an average time of about 10 years. Polyps hardly recur if resected well. New polyp formation can occur, however, if you have been previously diagnosed with a polyp or if you have a strong genetic predisposition. Therefore regular assessments should be considered. Preventative measures such as taking a fiber-rich diet and calcium laden foods are effective at counteracting the polyp growth. Measures such as decreased or no alcohol consumption as well as no smoking in addition to promoting the overall health of the patient, they are also a protective measure against the polyp growth.