What are childhood juvenile polyps and how to treat them? Polyps in children

Polyps in the intestines are benign tumors. They grow and develop in the intestine from the mucous membrane or under the mucous membrane. Polyps always grow into the lumen of a hollow organ and are supported by a stalk.

Intestinal polyps do not pose any danger and do not cause discomfort, however, if proper treatment is not provided, over time they can develop into cancer.

Polyps may be the result chronic inflammation intestinal mucosa. Proponents of the embryonic theory believe that during embryonic development in some cases there is an excess of embryonic material that turns into a neoplasm due to inflammatory process.

Colon polyps are one of the most common negative factors affecting the functions of the colon and rectum. The prevalence is 15-20 percent of the adult population.

Polyps, under certain circumstances, can become malignant tumors. That is why doctors take intestinal polyps seriously and consider them a precancerous disease.

Symptoms of intestinal polyps

Polyps in the intestines most often do not express themselves in any way, only then can a person feel something when there are a lot of polyps and they grow.

Treatment of intestinal polyps

The method of treatment for both single polyps and multiple polyposis is determined in each case individually. It is worth remembering that conservative methods Treatments in the case of a single polyp or polyposis are ineffective, and the only treatment method is operation.

Surgery to remove intestinal polyps

Removal of polyps in the intestines is carried out for any size of formation. In order to prevent the development of cancer, immediately after detection of a neoplasm, it must be eliminated.

The operation to remove the tumor depends on how quickly the intestinal polyps grow and is performed using endoscopic equipment.

During the procedure, a endoscope. Unlike colonoscopy, in this case the device is equipped with a special loop electrode, which allows you to grab, clamp and cut off the stalk of the polyp.

The treatment of a polyp in the intestine is influenced by the symptoms of its manifestation. So, if the size of the polyp exceeds the average, it is removed in parts in several stages.

To prevent the scar from becoming a cause of inflammation or infection after the operation, it is cauterized. For this purpose it is used electrocoagulation method.

The method of eliminating polyps described above is well tolerated by patients and does not require anesthesia or anesthesia. Injury to intestinal tissue is minimal, and the scar after surgery is extremely small.

Depending on the symptoms of the disease, treatment of the polyp will become more complicated.

In cases where the patient has intestinal polyposis, the removal operation looks somewhat more complicated. In this situation, it is necessary to resect the polyps along with the affected part of the intestine.

This operation is carried out under full anesthesia and can last quite a long time. This is necessary to prevent further growth of tumors.

After such an operation, you should long recovery period. It includes taking a complex of anti-inflammatory and antibacterial drugs, special diet.

Diet after removal of intestinal polyps

A diet after removal of a polyp in the intestine is necessary for patients in any case. After all, improper nutrition with polyps in the intestines provokes new damage to the intestines, which will lead to the development of a polyp.

The diet after surgery should include plenty of liquid and semi-liquid food, maximum limitation of flour products and the use of various kinds of spices.

The diet menu for polyps in the intestines should contain foods rich in fiber(vegetables fruits). It is recommended to drink plenty of fluids and completely avoid drinking alcoholic drinks, products containing caffeine.

Treatment of intestinal polyps with folk remedies

Before using folk remedies in the treatment of intestinal polyps necessary consult your doctor.

If you have polyps, herbal medicine can become your faithful ally in the fight against this disease. There are many methods and recipes that will help you treat your body without even leaving home.

Causes of intestinal polyps

A consensus regarding the cause of the appearance and growth of polyps in the intestines among medical experts has not yet been achieved.

Based on numerous studies and observations of patients with colon polyposis, several assumptions have been made regarding the most probable causes appearance and development of polyps:

1. Chronic inflammatory processes:
   • nonspecific ulcerative colitis;
   • Crohn's disease;
   • chronic form of dysentery and giardiasis;
   • chronic enteritis and colitis;
   • membranous colitis.
2. Environmental influence.
3. Pathologies of blood vessels and organs involved in digestion.
4. Genetic abnormalities.
5. Allergies.
6. Bad habits.
7. Eating a lot of preservatives.

The risk of transformation of benign polyps into malignant ones is quite high. The so-called adenomatous polyps are especially dangerous. Therefore, periodic inspections using special methods, especially in adults who have crossed the 50-year mark.

Types of intestinal polyps

Diagnosis of intestinal polyps

If colonoscopy is not possible, it is recommended CT scan. If a polyp is detected, the doctor will suggest a biopsy, which is necessary to determine the histological form of the formation and further treatment tactics.

Multiple polyposis can be familial, congenital, or occurring against the background of other diseases (colitis). Polyposis is classified as a precancer, since the incidence of malignancy is 99.9%.

Familial polyposis is a hereditary disease that affects several family members. They are usually detected in children, less often in at a young age. The localization of polyps corresponds to the entire length of the intestine.

In the case of multiple polyposis, the clinical picture is more pronounced. Characterized by diarrhea, mucus and blood in feces, abdominal pain without clear localization, progressive weight loss, and anemia.

Prevention of intestinal polyps

You can protect yourself from polyps in the intestines by following some simple rules rules:

• limit the consumption of alcoholic beverages;
• Instead of animal fats, you should consume vegetable ones;
• eat rough plant foods saturated with fiber (apples, beets, zucchini, pumpkin, cabbage);
• harmonize a correct, rational diet.

Questions and answers on the topic "Intestinal polyps"

Polyps in the intestines are a benign tumor-like formation. It rests on a stalk or on a wide base and hangs from the walls of the intestine into its lumen. Polyps in the intestines can appear as a result of chronic inflammatory processes intestinal mucosa .

There is also a theory that even during the period of embryonic development, in some cases there is an excess of embryonic material. It is this that turns into such a formation during inflammation. Hyperplastic intestinal polyps - small, they are most often found in the rectum. Such polyps are not neoplastic formations.

Hamartomatous polyps in the intestines grow from ordinary tissues if their combination is unusual or a certain element of the tissue develops disproportionately.

Juvenile intestinal polyps - These are polyps of the hamartomatous type in the colon.

Adenomatous polyps in the intestines are optional traitor . Depending on the type and size of such polyps, the likelihood of their subsequent degeneration depends. Tubular have pink color, smooth and dense surface. For villous adenomas characterized by the presence of a large number of branch-like outgrowths on the surface. In most cases, they have a wide base and soft consistency. Basically, the disease is asymptomatic, but in some cases the stool may become watery, with the presence of dark blood. Villous adenomas are more heavily saturated with cells, which is why there is a greater risk of their degeneration. Another type of adenoma is tubular villous adenomas . They contain elements of both types of adenomas. Inflammatory intestinal polyps appear due to the growth of the mucous membrane as a reaction to an acute inflammatory process. These are not neoplastic formations, but so-called pseudotumors .

Symptoms of polyps in the intestines

Typically, people with intestinal polyps do not show significant symptoms of the disease. In villous adenomas, stool may contain a large number of mucus. It may also occur bleeding . If the polyps in the intestines are too large, they can create an imitation of the symptoms of partial intestinal obstruction, and cramping will occur. painful sensations.

According to studies, in 95% of cases from adenomatous and villous polyps colorectal cancer occurs within 5-15 years. Due to the fact that the disease occurs without pronounced symptoms, polyps are found in the intestines mainly during endoscopic examination . But if villous tumors grow to a large size and reach two to three centimeters, the patient may experience discharge of blood and mucus, painful sensations in the abdomen and anus, occur. A person may experience both diarrhea and diarrhea. If villous tumors reach very large sizes, then due to too strong discharge mucus may be significantly disrupted. This is due to large losses squirrel And electrolytes . Also, due to intussusception, polyps in the intestine can cause partial obstruction or acute complete obstruction.

If the patient complains of the presence of the symptoms discussed above, then the specialist must conduct a digital examination of the rectum and sigmoidoscopy . During a digital examination, a section of the rectum about ten centimeters from the edge is accessible for inspection. anus. It is very important to apply this diagnostic method without fail, because for a specialist it is an informative method for identifying a number of concomitant diseases in the rectum and surrounding tissue, and in men, identifying problems in prostate gland .

Before performing sigmoidoscopy, it is necessary to thoroughly prepare for the procedure by giving cleansing enemas or pre-taking laxatives orally. Sigmoidoscopy is a method that gives a broader picture: it allows you to find most of the formations in the intestines, because more than half of all polyps are located in straight And sigmoid colon , that is, in the penetration zone of the rectoscope, which is inserted 25-30 cm. If polyps are found in the intestines, the sections of the colon that are located above, as well as the stomach, should be very carefully examined. After all, quite often polyps affect different parts of the gastrointestinal tract. For further research apply X-ray And endoscopic studies.

Another method often used to detect polyps is irrigoscopy . With its help, you can identify most polyps, the size of which reaches 1 cm in diameter. But small formations are quite difficult to detect. In view of this, during examinations for the purpose of prevention, you should use colonoscope , which allows you to diagnose polyps of any size.

The doctors

To remove thin-pedunculated intestinal polyps, loop electrocoagulation methods are mainly used during colonoscopy. If the polyps have a wide base, they are usually excised. If the shape or size of the polyps are such that they cannot be removed by endoscopy, then they are removed by surgery . The same applies to polyps with signs of malignancy.

According to specialist observations, synchronous polyps , that is, those that appear simultaneously are observed in 20% of cases, while in 30% of cases asynchronous formations are swept aside. In view of this, specialists prescribe barium x-rays, as well as a full colonoscopy, to identify polyps. These methods can be combined and applied every three years. Every year, people with polyps have their stool checked for occult blood.

Polyps in which the process of degeneration has taken place and the so-called early cancer , removed using endoscopic technique. But the doctor takes into account some features. Thus, it is important that such polyps meet the following characteristics: they must be pedunculated, malignant degeneration is observed only on the head of the polyp, the formations have not sprouted elements venous or lymphatic system .

After the operation, patients must remain under regular follow-up. If benign polyps in the intestines were removed, the patient should be examined after about two months. After this, a visit to a specialist every six months is required. If villous tumors have been removed, then the examination must be carried out every three months. This schedule is relevant in the first year after the removal of polyps, then the examination is carried out once a year. It is important to note that after removal of polyps, it is possible relapses of the disease.

Medicines

Prevention of polyps in the intestines

It is important to consider that if you have relatives who have been diagnosed with intestinal polyps, the risk of developing such a disease increases four to five times.

Therefore, it is important to adhere to preventive measures. So, it is very important to eat healthy foods, drink plenty of water and take fiber regularly. The consumption of refined foods is not recommended. You should stop smoking and try to maintain a healthy and active lifestyle. It is also very important to prevent constipation , which can provoke inflammatory processes and, as a result, the development of polyps.

Polypous growths in the intestines are one of the most common pathologies of the digestive organs. Polyps are predominantly localized in the large intestine and rectum. They grow for a long time without symptoms and are often discovered accidentally during an endoscopic examination. Due to the high risk of malignancy, polyps in the intestines are recommended to be removed surgically.

What types of polyps are there?

Depending on the morphological structure, intestinal polyps can be of the following types:

• glandular (adenomatous);
• hyperplastic;
• villous (papillary);
• juvenile;
• glandular-villous (adenopapillary).

Glandular polyps are more common in the large intestine. They are identified by specialists in most patients with polypous growths. An adenomatous polyp is capable of magnesization (malignancy). Outwardly, it resembles mushroom-shaped growths located along the mucous membrane. Typically, a glandular adenomatous polyp does not bleed, which is why the start of treatment is delayed.

A hyperplastic polyp is not prone to malignancy. It is a soft nodule that rises slightly on the mucous membrane. At the same time, the intestine is practically unchanged in appearance due to the small size of the neoplasm (hyperplastic polyps in diameter do not exceed 3–5 mm).

Villous polyps can be in the form of nodes or creeping formations of a rich red color. They are localized in the rectum, have many vessels, so they often bleed and produce copious mucous discharge. They are benign tumors, but are subject to surgical treatment.

Juvenile polypous growths can reach large sizes. They have a pedicle and are detected mainly in children and adolescents. They are not prone to malignancy. Situated singly.

An intermediate form between papillary and adenomatous formations are adenopapillary polyps in the intestine. They are accompanied by an average oncogenic risk.

Why do polyps appear?

It is impossible to indicate the exact causes of polyps in the intestines. Experts only make assumptions by analyzing patient histories over the past decades. Doctors put forward several hypotheses that explain why polypous growths may appear on the intestinal walls. One of the main reasons is a chronic inflammatory process in the mucous membrane associated with poor nutrition, infectious diseases, bad habits, and low fiber content in the diet.

Formations with a high oncogenic risk appear due to the high content of animal fats and fried foods containing carcinogens in the diet. Due to the lack of fresh fruits and vegetables, intestinal motility decreases, its contents remain in contact with the intestinal walls for a long time. Carcinogens from processed food are absorbed into the epithelium, causing hyperplastic processes in glandular cells.

People at risk for polyp formation include people who:

• often consume drinks and foods that irritate the mucous membranes digestive tract;
• suffer from chronic constipation;
• have undergone traumatic diagnostic or surgical procedures on the intestines;
• abuse alcoholic beverages;
• have chronic pathologies Gastrointestinal tract, especially of an infectious-inflammatory nature;
• engage in heavy physical labor;
• lead a sedentary lifestyle;
• eat fast food, fatty meats, products instant cooking, which contain carcinogens and preservatives;
• get little fiber from food.

Possible complications

Any formations in the intestines, especially polyps prone to malignancy, should not be ignored by specialists. They often form without additional signs, and a person may not be aware of their presence for many years until will undergo examination or no obvious clinical manifestations of the disease will appear. But why are polyps in the intestines so dangerous? Why do they need to be treated on time?

The main danger of polyps is magnetization. It is the risk of degeneration into cancer that worries specialists the most. Adenomatous polyps of the large intestine are especially dangerous. They are not prone to ulceration, and the patient does not know for decades that he is suffering from a precancerous pathology. average speed degeneration of a glandular polyp into cancer - 7–10 years. But experts prefer not to take risks and perform the operation immediately after detecting polypous growths.

For a long period of time and active growth Polyps can lead to the following complications:

• chronic constipation;
• bleeding;
• intestinal obstruction;
• prolonged flatulence;
• anemia;
• constipation, diarrhea;
• volvulus;
• perforation of the intestinal wall;
• chronic inflammation of the intestinal walls due to damage to the walls of the neoplasm.

To avoid complications, it is necessary to immediately contact a specialist for additional examination when the first symptoms of polyps appear in the intestines.

People with a history of severe inflammatory diseases Gastrointestinal tract, unfavorable heredity, regular preventive examinations by specialists are recommended. This will get you started early treatment and get rid of polyps in less traumatic ways.

Clinical picture of polyps

In most patients, there are no signs of polyps for a long time, until the formations reach maximum sizes. Neoplasms grow and compress surrounding tissues, causing local ischemia. They interfere with the movement of feces, causing constipation, bleeding, pain and other signs of intestinal polyps.

Duodenal polyps grow asymptomatically. The pain appears at the height of the disease, is localized in the abdominal area, accompanied by heaviness in the stomach, nausea, frequent belching. In active growth, the polyp can close the lumen of the duodenum, as a result of which food remains in the stomach for a long time. In this state, the pain becomes acute, reminiscent of intestinal obstruction.

Polyps in the small intestine also grow for a long time without significant symptoms. Patients complain of regular flatulence, abdominal pain, and constant nausea. If the tumor is localized at the beginning of the small intestine, attacks of vomiting often occur. Large polyps lead to volvulus, intestinal obstruction, cause bleeding and others acute symptoms requiring immediate medical attention.

A polyp in the large intestine grows for a long time unnoticed by the patient. It can form as a result of another gastrointestinal pathology. Polyps in the intestines of this location are in most cases accompanied by the release of mucus and blood from the anus. Several months before the appearance of characteristic clinical manifestations Patients note discomfort in the intestinal area; digestive disorders may appear in the form of alternating diarrhea and constipation.

How to detect intestinal polyps?

In order to identify polypous growths on the intestinal walls, specialists use the following research methods:

• colonoscopy;
• esophagogastroduodenoscopy;
• endoscopic biopsy;
• CT scan;
• Magnetic resonance imaging;
• irrigoscopy;
• sigmoidoscopy;
• histological examination.

For staging accurate diagnosis To determine the number and location of tumors, it is necessary to undergo not one study, but several at once. If specialists do not yet prescribe surgery and choose a wait-and-see approach, regular endoscopic examinations of the intestinal lumen are carried out, during which the condition of the mucosa and the quality of the treatment can be assessed.

Features of treatment

Start treating intestinal polyps as early as possible. Conservative therapy is used at the preoperative stage to reduce the size of tumors. In most cases, surgery is required. Conservative treatment also used in the presence of multiple polyps covering the entire mucosa gastrointestinal tract. Watchful waiting is also used for elderly patients who have contraindications to surgery.

Among the common methods surgical treatment the following can be distinguished:

• endoscopic polypectomy;
• transanal removal of formation;
• removal of the polyp during colotomy;
• resection of part or all of the intestine.

Rectal polyps are removed using endoscopy. Microsurgical instruments are inserted through natural openings and, under optical control, a specialist excises the tumors. The collected materials are subject to further detailed study. If specialists detect malignant cells, treatment will be supplemented with chemotherapy.

Endoscopic surgery is often combined with electrocoagulation of the base of the polyp. Since surgery is performed without massive damage, the rehabilitation period is shortened. Patients tolerate endoscopic removal of polyps well, and the risk of recurrence of the pathology if medical recommendations and diet are followed is minimal.

Transanal removal of tumors is carried out with special scissors or a scalpel, after which the mucous tissue is sutured. Such operations are used when it is necessary to remove polyps located close to the anus. Excision is performed under local anesthesia. For the convenience of the surgeon, the anal canal is expanded using a rectal speculum.

Colonoscopy is used in the presence of wide polyps or polyps localized in the sigmoid colon. The neoplasms are excised along with adjacent mucous tissues, and then sutures are applied. With familial and diffuse polyposis, it is often necessary to perform resection of the entire large intestine. During the operation, specialists connect the end ileum with the anus.

No specialist can guarantee the absence of relapse after polyp removal. All removed tissues are subject to histological examination; during the first years after surgical treatment, patients regularly undergo preventive diagnostics.

It is indicated not only for patients with a history of polyps, but also for all people over the age of 40 years.

Diffuse polyposis

Diffuse polyposis is a hereditary pathology accompanied by multiple lesions polyps of the entire large intestine and adjacent parts of the digestive tract. The disease most often occurs among relatives of patients with the same pathology. Polyposis leads to the development of colorectal cancer. It is almost impossible to avoid the development of the disease, since it occurs as a result of a mutation in a certain gene responsible for the proliferation of the mucous membrane of the digestive canal. As a result of this defect, rapid proliferation of epithelial tissues occurs with the formation of multiple polyps.

Patients most often learn about the presence of diffuse polyposis in adolescence, when abdominal pain appears, bloody diarrhea and others characteristic features diseases. Such patients do not gain weight well and often look exhausted. Due to chronic blood loss, anemia develops and the skin becomes pale. The proctologist is able to detect numerous polyps even during a routine rectal examination.

Magnetization of polypous formations occurs in most patients. Treatment is always prompt, and the sooner patients seek help, the lower the risk of developing bowel cancer. On early stage it is possible to perform resection of the rectum and sigmoid colon. In this case, the sphincter can be preserved. At widespread polyposis requires the use of anastomosis. If cancer is detected, a total colectomy is performed, removing the sphincter and creating a stoma in the abdominal wall.

Diet for polyps

The frequency of polyps is directly affected by the nature of nutrition. If the diet is low in fiber and contains a lot of food rich in carcinogens, favorable conditions are created for mucosal hyperplasia, progression of constipation and damage to the epithelium by feces with its further growth. Do not get carried away with legumes, pickles and smoked meats. These products can provoke an inflammatory process in the digestive tract.

A strict diet for polyps in the intestines is not carried out. It is recommended to avoid alcohol and spicy foods that irritate the mucous membranes. The diet should contain natural fiber. You can get it from vegetables, fruits, and cereals. Fiber, like a sponge, cleanses the intestines and moves stool, preventing constipation. Food should be at a comfortable temperature - warm, but not hot or cold.

• mashed porridge;
• soups with low-fat meat broth;
• non-acidic fruits, boiled vegetables;
• seafood;
• lactic acid drinks, cottage cheese.

Alcohol is contraindicated in any form. Drinking alcohol can cause bleeding and provoke the development of intestinal obstruction with large polyps. It is also recommended to stop smoking, as nicotine and tar contain carcinogenic substances that can cause tissue degeneration.

Prevention

High-quality prevention of intestinal polyps should begin long before they are detected. No one is immune from the development of this disease and the risk of their occurrence cannot be completely excluded. But by following the following recommendations, you can reduce the likelihood of the growth of polypous formations to a minimum:

• follow the rules of a balanced diet, consume fried foods containing carcinogens as little as possible;
• increase the amount of plant fiber in your food and fermented milk drinks, which support healthy intestinal microflora;
• give up strong alcoholic drinks and smoking;
• treat gastrointestinal diseases in a timely manner, fight chronic constipation;
• lead an active lifestyle, control your weight;
• do not neglect preventive examinations; upon reaching 40 years of age, regularly carry out intestinal diagnostics using modern techniques.

With polyps in the intestines, meals should be frequent. Eat small meals, but at least every 2-3 hours. In this case, processed food will not stagnate in the intestinal loops for a long time. Particular attention to the prevention of polyposis should be paid to people who have a hereditary predisposition to the appearance of polyps.

Will traditional medicine help?

Many people are interested in whether traditional medicine will help with polyps in the intestines? It is worth immediately noting that polypous growths are serious neoplasms, often complicated by colorectal cancer. If the adenomatous polyp or adenopapillary formations are not removed in time, tissue magnetization may occur within several years. Therefore, folk remedies should be considered only as a complement to surgical methods for removing intestinal tumors. Even if the polyp does not show signs of malignancy now, they may appear in a few months or years.

About efficiency traditional medicine Polyposis is still being debated in the scientific world. Many doctors believe that traditional methods can only be used with for preventive purposes, and polyps must be removed immediately before they become malignant. To use or not traditional methods Treatment is up to you to decide.

One of the well-known ways to combat polyps is to use a special mixture based on pumpkin seeds, chicken yolks and vegetable oil. You need to take 12 dessert spoons of pumpkin seeds, grind them into flour, mix with 7 boiled chicken yolks and 2 cups vegetable oil. The resulting composition must be thoroughly mixed and kept in a water bath for 15 minutes. After this, treatment can begin. The medication is taken in the morning, before meals, for a week. Single dose - 1 teaspoon.

Anal polyps are removed with a mixture of dry celandine powder and boric vaseline. Tampons with this composition are inserted into the anus several times a day. Polyps are also treated with a decoction of hop cones. The product is used for a week, and then take a short break. Bee products are useful for polyposis. Take regularly natural honey, pollen, royal jelly. All these products have increased biological activity, the ability to activate the body’s internal reserve reserves and set it up for recovery.

- benign neoplasms originating from the glandular epithelium, rising above the intestinal mucosa, located on a pedicle or broad base. Most polyps are asymptomatic, but when they reach large sizes they can manifest symptoms of intestinal obstruction, signs of growth and ulceration. When making a diagnosis, the main importance is given to endoscopic techniques with biopsy; X-ray methods and stool analysis for occult blood are also used. Due to the high risk of malignancy, all intestinal polyps are recommended to be removed surgically.

General information

Intestinal polyps are a very common pathology of the gastrointestinal tract. Frequency of occurrence of polyps in various departments intestines varies significantly - most of the neoplasms are located in the colon and rectum, much less often polyps are detected in the small intestine. Duodenal polyps are extremely rare pathology– they are detected in no more than 0.15% of all endoscopy. In the vast majority of cases, an intestinal polyp is discovered unexpectedly during an endoscopic examination.

Scientists have not yet developed a unified theory of the origin of gastrointestinal polyps. The absence of a characteristic clinical picture and a general approach to the treatment of polyps is also big problem. The opinions of various authors regarding the choice of volume and treatment tactics are strikingly different. Today, most surgeons are inclined towards minimally invasive endoscopic and surgical methods removal of intestinal polyps, and conservative therapy is used only as preparation for surgery. This is due to a high risk of malignancy and recurrence of polyps (in approximately 30% of patients). Many studies in the field of gastroenterology are aimed at finding diagnostic methods that would allow one to suspect and identify a polyp on the early stage, before his transition to malignancy.

Causes

The exact reasons for the formation of intestinal polyps have not yet been determined. Risk factors are: hereditary predisposition, poor environment, low level physical activity, unhealthy diet (large amounts of fats and carbohydrates, lack of fiber), intestinal dysbiosis, frequent constipation, diverticula and malignant intestinal tumors.

Scientists identify three main theories of the formation of intestinal polyps: the theory of irritation, the dysregenerative theory, and the theory of embryonic dystopia. If we follow the irritation (inflammatory) theory, intestinal polyps are an intermediate link between inflammatory diseases and intestinal cancer. According to the disregenerative theory, when an acute inflammatory process develops or when the intestinal mucosa is injured, regenerative processes are launched. Each time after this, traces of disruption of the regeneration process remain in the mucous membrane at the microscopic level in the form of thickening of the glandular epithelium. Normally, after some time, these processes are eliminated, but if regeneration is started too often, pathological changes gradually accumulate, leading to the formation of intestinal polyps. The theory of embryonic dystopia considers intestinal polyps as a product of improper embryonic development of its mucous membrane, from which polyps are formed as a result of inflammatory processes and injuries.

Intestinal polyps localized in the duodenum are extremely rare - isolated observations of this pathology have been described. Almost all patients with intestinal polyps of this localization underwent surgery with suspected malignant tumor. Most often, polyps are located in the area of ​​the duodenal bulb (acid-induced) - they are formed in patients suffering from gastritis with high acidity; less often in the area of ​​the sphincter of Oddi (bile-related) - in patients with cholelithiasis and cholecystitis. Among patients with polyps in the duodenum, people of working age (30-60 years) of both sexes predominate.

Intestinal polyps are least often found in the small intestine. In the literature there are isolated descriptions of intestinal polyps with this localization, and in half of the patients they are combined with polyps in other parts of the digestive tract (stomach, large intestine). In the initial parts of the intestine (small intestine), polyps are usually detected at the age of 20-60 years, somewhat more often in women. Mostly polyps have a glandular structure, although fibromatous and angiomatous intestinal polyps are also found; It is possible to identify both single and multiple polyps (located in compact groups or diffusely throughout the intestine).

The most common location of intestinal polyps is the colon. Such intestinal polyps are formed in adolescence, less often in childhood or adulthood. Many authors speak in favor of a hereditary predisposition to intestinal polyps localized in the colon. The most common theory for the occurrence of polyps in the colon is inflammatory. Single or multiple intestinal polyps of the specified localization are detected in 12-15% of the population after 40 years, accounting for more than 70% of all benign neoplasms large intestine. In children and young people, colon polyps are detected more often - in 26%. In approximately 3% of patients, intestinal polyps are a precancerous condition at the time of detection. In 70% of cases, polyps are localized in the terminal parts of the large intestine (descending, sigmoid, rectum), the remaining 30% are evenly distributed in the ascending, transverse part of the colon, hepatic and splenic angle. No significant differences were found by gender. Rectal polyps account for 90% of all cases of colon polyposis and in eight out of ten people precede colorectal cancer.

Symptoms of intestinal polyps

Intestinal polyps located in the duodenum do not manifest themselves in any way in approximately 67% of cases. When the tumor reaches a large size, the patient begins to experience pain, intestinal obstruction and bleeding from the ulcerated mucous membrane of the polyp. The pain can be of a different nature, but is most often localized in the epigastrium, near the navel. Pain syndrome often accompanied by a feeling of fullness in the stomach, rotten belching, and nausea. If an intestinal polyp obstructs the lumen of the duodenum, food begins to linger in the stomach, causing a clinic of high intestinal obstruction: the pain becomes cramping, vomiting of eaten food appears, and a splashing sound is detected on auscultation of the abdomen. Based on the clinical picture, it is not possible to establish a diagnosis of intestinal polyps in the duodenum, since its symptoms simulate a tumor of the pyloric part of the stomach, bile ducts or small intestine.

Intestinal polyps located in the small intestine usually have very serious symptoms, as they can lead to intussusception, perforation of the intestinal wall, intestinal obstruction, volvulus and profuse bleeding. Very often, polyps of the small intestine become malignant. On initial stages diseases of intestinal polyps with this localization can manifest as flatulence, nausea, and belching. Often there are cramping pains that can spread from the epigastrium to the iliac region. If the polyp is located in the initial parts of the small intestine, uncontrollable vomiting may occur. Large intestinal polyps can present with four groups of symptoms: acute intestinal obstruction(most often associated with intussusception, less often with intestinal inflection or volvulus); growth and ulceration of the polyp (bleeding in every third patient, palpable tumor); partial or intermittent intestinal obstruction; asymptomatic clinical picture.

There are no characteristic signs indicating the presence of polyps in the large intestine. In addition, intestinal polyps of this localization often form against the background of another pathology, an inflammatory process. Asymptomatic Intestinal polyps are observed only in the presence of a single colon polyp in no more than 3% of patients. For others, a feeling of discomfort in the intestines appears several years before the clinical picture of the polyp develops. Almost 90% of patients note the release of mucus or blood during bowel movements (the lower the polyp is located, the brighter the blood, the less it mixes with feces); every second person notes alternation of diarrhea and constipation, a combination of these symptoms with tenesmus. Against the background of diffuse polyposis, the clinical picture is so vivid that it can imitate a severe intestinal infection. Abdominal pain, itching and burning in the rectum and anus are very common. Against the background of diarrhea and intestinal bleeding, the patient’s general condition begins to suffer - weakness, pallor, dizziness, and exhaustion appear.

Diagnosis of intestinal polyps

The diagnostic program for intestinal polyps usually includes various x-ray examination techniques, endoscopic examination, and stool analysis for occult blood. You can receive a referral for examination at a consultation with a gastroenterologist, but hospitalization in a hospital may be required to complete the diagnosis.

X-ray techniques are widely used to identify intestinal polyps localized in the small intestine (they are effective in 93% of cases). The most common is radiography of the passage of barium through the small intestine, which allows identifying defects in intestinal filling. To make the study more accurate, bowel relaxation with the help of antispasmodics and local administration of contrast through a probe can be made possible. Such intestinal polyps should be differentiated from chronic enteritis and intestinal tuberculosis.

To diagnose colon polyps, X-ray (irrigography, double contrast) and endoscopic (sigmoidoscopy, colonoscopy with biopsy) methods, digital examination of the rectum, and stool analysis for occult blood are used.

Treatment of intestinal polyps

All patients with suspected intestinal polyps are hospitalized in the gastroenterology or surgery department for examination and treatment. After verification of the diagnosis, the tactics and scope of surgical intervention are selected. Conservative treatment of intestinal polyps is possible only in the presence of diffuse polyposis of the entire gastrointestinal tract, uncomplicated juvenile polyposis, and also as a temporary measure in preparation for surgery and in weakened elderly patients.

The only treatment for duodenal polyps is their removal. Endoscopic biopsy with polyp removal is the preferred method of surgical intervention to stop bleeding from the ulcerated mucosa.

If small pedunculated polyps of the small intestine are detected, an enterotomy is performed to remove the polyps. In all other cases, segmental resection of the small intestine with mesentery is indicated. Postoperative mortality in the presence of intestinal polyps of this localization is quite high - up to 15% - which is due to late diagnosis, the development of intussusception and diffuse peritonitis.

Treatment of intestinal polyps localized in its distal parts (large intestine) is also surgical. Endoscopic removal of polyps (excision or electrocoagulation), segmental resection of the colon is possible, and in case of diffuse polyposis or malignancy - radical surgery(hemicolectomy, subtotal or total coloproctectomy).

Prognosis and prevention of intestinal polyps

The prognosis for intestinal polyps is generally favorable if they are identified and removed in a timely manner. It should be remembered that long-term, large, and multiple polyps have a high potential for malignancy. In more than 30% of cases, after removal of intestinal polyps, there is a relapse within several years, so a history of intestinal polyps requires an annual endoscopic examination.

There is no prevention of intestinal polyps; the only way to prevent the malignancy of a polyp is regular screening of the entire population after 40 years.

Colon polyps are benign tumor-like formations growing from the glandular epithelium internal walls intestines. Such neoplasms are spherical, branched or mushroom-shaped growths that rise above the level of the mucous membrane and have a wide base or a thin stalk. They can be different sizes and forms, single or multiple, but they all have one thing in common - the appearance of polyps is considered dangerous sign and precancer condition.

If earlier in medical circles there was an opinion that polyps could exist for a long time without degenerating into malignant form, That latest research Scientists confirm that in most cases, colon polyps degenerate into cancer within 8-10 years.

Polyps can be detected in both adults and children, and it is noted that the risk of their occurrence increases in proportion to age and among patients over 60 years of age, such formations are diagnosed in 50% of cases. Let's take a closer look at what causes the formation of polyps, how diagnosis and treatment are carried out, and what preventive measures can prevent their occurrence.

The exact reasons for the formation of polyps have not yet been identified, but there are several main factors leading to their appearance:

In the vast majority of cases, development benign formations is asymptomatic. They can be discovered accidentally during endoscopic examinations to identify completely different diseases. Adverse manifestations are observed in cases where polyps reach large sizes or multiple growth occurs. The main symptoms are as follows:

• Pain during defecation.
• Abdominal pain, which is localized in the anus and lateral abdomen. They can be bursting, aching or cramping, intensify before defecation and subside after bowel movement.
• Digestive disorders and constipation.
• Rectal bleeding, mucus discharge from the rectum.
• Development of symptoms of exhaustion and anemia.

Appearance in stool blood is the most characteristic symptom. Blood is released in small quantities; there is no extensive bleeding with polyposis. With significant growth of polyps, mucus begins to be released from the anus; in the anorectal area, due to constant wetting, symptoms of irritation and skin itching are noted.

Such manifestations are nonspecific and are characteristic of many other gastrointestinal diseases. That's why this pathology not so easy to identify and differentiate from other diseases.

Classification - types of colon polyps

Depending on the number, the following classification of colon polyps is accepted:

• Singles
• Multiple
• Diffuse family

The number of polyps in different patients can vary significantly. Some patients are diagnosed with a single tumor formation, while others have a significant number, sometimes up to several hundred. In such cases, the term “polyposis” is used. Diffuse familial polyps are distinguished by the fact that the disease is inherited and the number of polyps that grow rapidly can range from hundreds to several thousand.

There are four main forms of colon polyps:

• Adenomatous. Such polyps most often degenerate into malignant ones. With this form of polyps, they speak of a precancerous condition, since the tumor cells are not similar to the cells of the glandular epithelium from which they are formed. Adenomatous polyp of the colon is histologically distinguished into three types:

1. Tubular. This type of polyp is a smooth and dense formation of pink color.
2. Villous- is distinguished by multiple branch-like outgrowths on its surface and is red in color due to the abundance of blood vessels that can easily be injured and bleed. The prevalence of villous tumors is about 15% of all colon neoplasms. They differ large sizes and prone to ulceration and damage. It is this type of tumor that most often degenerates into cancer.
3. Tubular-villous– consists of elements of villous and tubular polyps.

• Hamartromic. Such polyps are formed from normal tissue, with disproportionate development of one of the tissue elements
• Hyperplastic. This type of polyp is often found in the rectum, they are small in size and are most often diagnosed in older people. A hyperplastic polyp of the colon is characterized by elongation of the epithelial tubes with a tendency to their cystic growth.
• Inflammatory. Polyps of this type grow in the intestinal mucosa in response to an acute inflammatory disease.

The results of observations of patients indicate that over time, most polyps grow and increase in size, creating a real threat to the health and life of the patient, since the risk of their degeneration into a malignant tumor is quite high. That's why it's so important timely diagnosis pathological process and qualified health care in the treatment of the disease.

If you suspect the presence of polyps in the large intestine, you should contact a gastroenterologist or coloproctologist. At the appointment, the specialist will ask about complaints, previous diseases, lifestyle and nutritional patterns. Important role may have information about the presence of diseases of the large intestine in close relatives. Next, the patient will have to undergo a thorough examination.

It is known that more than 50% of colon polyps are localized in the rectum and sigmoid colon. Therefore, at the initial stage, the coloproctologist uses a digital examination method, which makes it possible to palpate the rectum to a depth of 10 cm and identify its pathological changes. Further, when diagnosing colon polyps, laboratory and instrumental methods research.

Laboratory testing methods include:

• General blood analysis. Low level hemoglobin will indicate hidden bleeding in the large intestine as a result of damage to polyps.
• Fecal occult blood test. It will detect blood in the stool and suspect the presence of polyps.

In addition, the endoscopic procedure involves not only examining the intestines, but also removing foreign bodies and removal of small polyps. Colonoscopy allows you to see all pathological changes in the intestinal mucosa (cracks, erosions, diverticula, polyps, scars) and evaluate it motor activity. In addition, using a colonoscope, you can expand areas of the intestine that are narrowed due to scar changes and photograph inner surface intestines.

Quite a complicated and painful procedure. It is only executed experienced specialists in specially equipped rooms.

• . An endoscopic examination that allows you to visually assess the condition of the intestines to a depth of 30 cm. Performed using special device– a sigmoidoscope equipped with illumination, optics and special forceps that allow you to do a biopsy (take a piece of tissue for analysis).
• CT (computed tomography) or MRI (magnetic resonance imaging)– modern, painless and very informative methods research. Such examination methods significantly alleviate the suffering of patients and simplify the work of doctors, as they allow one to obtain detailed images of the organ in three-dimensional format and visualize the disease with maximum accuracy.

All research methods are aimed at identifying pathological changes and completing a course of treatment in a timely manner.

Treatment of colon polyps by removal

No methods of conservative drug therapy can cope with polyps, so the only radical method treatment pathological formations– surgical. Removal of colon polyps produced by different methods, the choice of treatment tactics will depend on the type of neoplasm, the number of polyps, their size and condition.

Thus, single and even multiple polyps can be removed during a colonoscopy procedure. For this purpose, special endoscopic equipment is used. A flexible endoscope with a special loop electrode is inserted into the rectum. A loop is placed around the stalk of the polyp and the tumor is cut off.

If the polyp is large, then it is removed in parts. Tumor samples are sent for histological examination, which reveals malignant formations. Endoscopic removal of colon polyps is the most gentle procedure; it is well tolerated by patients and does not require recovery period. The next day after the operation, performance is completely restored.

Small polyps can be removed using modern alternative methods: laser coagulation, electrocoagulation, radio wave surgery. The intervention is carried out using a narrowly directed laser beam or high-power radio wave. In this case, the surrounding tissues are not injured, and the cut occurs at the cellular level.

Simultaneously with the removal of the polyp blood vessels coagulate, which prevents the development of bleeding. When using the electrocoagulation method, tumor-like formations are cauterized with an electric discharge. Such interventions are the least traumatic and painless, are performed on an outpatient basis, and do not require long-term rehabilitation.

Diffuse multiple polyposis is treated surgically, performing an operation for total removal (resection) of the affected area of ​​the intestine. After removal of large or multiple tumor-like formations, as well as villous polyps of any size, it is necessary to be under the supervision of a doctor for 2 years and undergo a control endoscopic examination a year later.

In the future, it is recommended to undergo a colonoscopy once every 3 years. If polyps that have turned malignant have been removed, the patient should undergo a follow-up examination once a month during the first year, and once every 3 months thereafter.

The only one effective method treatment of polyps is surgery, but in some cases patients are treated folk remedies. Treatment of colon polyps with folk remedies is carried out after consultation with a doctor and under his supervision. Basically, folk remedy therapy is used to detect small polyps of those types that rarely degenerate into cancer. Most often, infusions and decoctions of medicinal herbs are used for treatment:

At the 2nd stage, the solution is made at the rate of 1 tablespoon of celandine juice per 1 liter of water. Enemas with the solution are given for 15 days and again take a break for 2 weeks. At the 3rd stage, the course of treatment similar to the second stage is repeated. After completing the third stage of treatment, the polyps should disappear.

Prevention of colon polyps

Special, specific prevention There are no colon polyps. However, experts recommend:

• Adjust your diet and follow the principles healthy eating. This involves giving up fatty, fried, high-calorie foods, flour and confectionery products, and sweets. You should avoid eating fast food, carbonated drinks, strong coffee, smoked foods, pickles, spices, marinades, canned food and processed foods.
• Give preference healthy food: vegetables, fruits, cereals, lean meat and fish, herbs, dairy products. Include whole grain bread, bran, vegetable oils. Adjust drinking regime and drink at least 1.5-2 liters of fluid per day ( green tea, juices, fruit drinks, compotes).
• Give up bad habits(smoking, alcohol), do not overeat, try to move more, do not refuse feasible physical activity.
• If any adverse symptoms occur (especially bloody discharge from the rectum) undergo a timely examination by a coloproctologist and gastroenterologist. It is advisable to undergo an endoscopic examination of the intestines once a year, especially after reaching 50 years of age.
• If polyps are detected, remove them in a timely manner, this will help avoid them malignant degeneration and protects against colon cancer. (Read also for more details)