Polyps in the large intestine: What does their discovery during colonoscopy mean?

Colonoscopy is one of the most important examinations in the prevention of colon cancer. Its great advantage is that, in addition to diagnosis, it also allows for the immediate removal of polyps, which can be a precursor to cancer.

If your doctor tells you after a colonoscopy that they have found and removed a polyp, this does not necessarily mean bad news. However, it is important to understand what polyps are, what risks they pose, and what to do after they are found.

What are polyps and how do they develop? 

Polyps are abnormal growths on the mucous membrane that most commonly appear in the large intestine or rectum. They can vary in shape – some are flat, others have a stalk (like a small mushroom). Most polyps do not cause any symptoms, so people are often unaware of them until they are detected during a colonoscopy.

Polyps develop for various reasons – risk factors include:

• Age over 50

• Family history of polyps or colon cancer

• Poor diet (low fiber, high red meat)

• Smoking and excessive alcohol consumption 

• Obesity and lack of exercise

• Inflammatory bowel disease (e.g., ulcerative colitis, Crohn's disease)

Types of polyps and their risks 

Not all polyps are equally dangerous. It is important to perform a histological examination – i.e., microscopic analysis of the tissue after removal. Based on this, they are divided into several groups – the most common are:

1. Hyperplastic polyps

- They are usually small and are found mainly in the rectum and the left (terminal) part of the large intestine. – With almost no risk of malignant transformation, hyperplastic polyps in the rectum do not need to be removed after thorough visualization.

2. Adenomas (adenomatous polyps)

– The most common type with the potential to develop into cancer. – They are divided according to their microscopic appearance into tubular, villous, and tubulovillous adenomas.

The risk of malignant cancer cells in a polyp also depends on its size (those larger than 10 mm are more risky) and the number of polyps.

3. Sesile serous lesions

– They are inconspicuous, may resemble hyperplastic lesions, but have significant potential for malignancy. – They are often found in the right side of the colon.

What does finding a polyp during a colonoscopy mean? 

Finding a polyp does not necessarily mean cancer, but it does indicate an increased risk of developing cancer in the future. Therefore, polyps are removed immediately during colonoscopy (if it is safe to do so), and their type, size, and number are then assessed. These factors determine the next course of action – especially the interval at which a follow-up colonoscopy should be performed.

When and how often should the intestine be monitored after polyp removal?? 

Recommendations for follow-up vary according to the riskiness of the finding:

In low-risk patients (e.g., 1–4 small adenomas smaller than 10 mm, with low-grade dysplasia, removed in their entirety), a follow-up colonoscopy in 10 years is sufficient.

For higher-risk patients with a larger number of polyps, or with larger and more advanced polyps, earlier check-ups are necessary – typically every 3 years, or even sooner in certain cases, depending on the method of removal.

A specific group consists of patients with a significant family history and genetic predisposition (e.g., FAP, Lynch syndrome), who require individual monitoring at shorter intervals.

What can you do for your health if polyps are found? 

Finding a polyp is a warning sign, but also an opportunity to take action. Here are some practical recommendations:

• Keep your check-up appointments. 

• Change your lifestyle – eat a diet rich in fiber (vegetables, fruit, whole grain products), less red meat.

• Stop smoking and limit alcohol.

• Maintain a healthy weight and be physically active.

• If you have a positive family history, inform your doctor – you may need to start monitoring earlier.

  
  

Conclusion: Polyps in the large intestine

Polyps in the large intestine are a common finding, especially in people over the age of 50. Most of them are benign, but some types can gradually develop into cancer. Regular colonoscopies, a properly set-up monitoring plan, and lifestyle changes are key to this, to avoid serious illnesses. Visiting a gastroenterologist at the right time is not something to be afraid of, but rather a preventive measure that can save your health. Do you need to schedule a colonoscopy in the near future and have questions about this examination? In both cases, you can rely on the team of top experts at Dr. Gastro.