Polyps in the intestines - symptoms and how to remove them. Intestinal polyps: symptoms and manifestations

Any person over 40 years old has a good chance of discovering an intestinal polyp. Doctors diagnose benign neoplasms of the digestive tract in every tenth patient from this age group. It is important to identify polyps in the intestines as early as possible, while their size is small and the possibility of degeneration into a malignant tumor is low.

What are polyps

When the glandular layer of the intestinal mucosa begins to grow, intestinal polyps are said to have formed. Pathological outgrowths of the mucous membrane can be attached to the intestinal walls with a thin stalk or located on a wide base. The shape of the growths looks like a ball, a mushroom, fingers, and can branch.

If there are many growths, intestinal polyposis is diagnosed. The growths can be located either singly or in limited groups. In severe cases, polyposis affects the entire intestine.

The location of pathological growths is the thick section. The overwhelming number of polypous neoplasms are found in and. Polyps in the small intestine account for less than 5% of cases. The presence of polypous neoplasms in the duodenal region is associated with previous gastritis, ulcers or cholelithiasis.

Intestinal polyps differ in histological structure. There are the following types of polyps in the intestines:

• adenomatous;
• hyperplastic;
• inflammatory;
• hamartomatous.

Most often, adenomatous polyps appear in the intestines, which in turn are divided into:

• tubular;
• tubular-villous;
• villous.

The most dangerous are adenomatous villous and tubulovillous polyps. The risk of degeneration into oncology for growths of this type is close to 70%. Tubular benign formations undergo cancerous degeneration much less frequently.

Except structural structure, it is important to determine the size of the formation and its shape. The greatest risk for the formation of a cancerous tumor exists in growths with a diameter of 1 cm and on a thick base. Any type of growth grows all the time and reaches a diameter of 1-2 cm in a few years.

Sometimes in patients with ulcerative colitis, after suffering infections, bulges resembling polyps - pseudopolyps - are found on the mucous membrane of the colon. These growths are a consequence of enhanced tissue regeneration, a kind of scars on the mucous membrane. Pseudopolyps interfere with normal digestion and have a slight tendency to malignancy. It is necessary to distinguish them from true polyps in order to choose the right course of treatment.

How do intestinal polyps appear externally?

Symptoms of polyps in the intestines depend on the location of the tumor, its size, and tissue structure. In women from 35 to 65 years old, small intestinal polyps are more often detected. Formations less than 5-8 mm show practically nothing. As the tumor grows, the characteristic symptoms become more and more apparent.

Clinical signs of an intestinal polyp in the small section are:

• intestinal obstruction;
• cramping pain in the navel area;
• digested blood in stool;
• uncontrollable vomiting of food just eaten;
• belching, flatulence, nausea.

Symptoms of polyposis in women are similar to inflammation of the stomach, chronic enteritis, and duodenal ulcer. If polyps form predominantly in the colon and rectum, a different picture is observed.

Signs in adults:

• white mucous and scarlet bloody streaks in the stool;
• the lower abdomen twists with pain;
• constipation and intestinal dyskinesia;
• feeling of a foreign object in the anal canal;
• watery diarrhea with mucus;
• belching, distension of the stomach and intestines;
• emaciation, pallor, constant fatigue.

According to medical statistics, growths in the thick section more often appear in men after 50 years of age. Symptoms of polyps do not have specific features. It is possible to determine an intestinal neoplasm only after a hardware examination.

Consequences of polyps in the intestines

Polyps in the intestines are extremely dangerous. Detection of the disease late stage threatens with a number of serious consequences. Destruction of a large appendage and ulceration of its surface is fraught with severe bleeding from the anus. Bleeding is observed when a polyp breaks off and damages a large vessel. A detached large growth can block the intestinal lumen and cause blockage. At the site of the severed growth, a wound is formed that turns into a fistula, threatening perforation and peritonitis.

The main danger of polypous tumors is the potentially high possibility of their transformation into cancer. The risk of developing colorectal cancer exists in all types of tumors.

Even relatively harmless tubular polyps grow quickly in the intestines. Over time, they develop unfavorable villous components. It is extremely unwise to ignore a detected intestinal tumor, no matter how small and benign. The consequences of carelessness will be disastrous for health.

Why do polyps grow in the intestines?

The medical community has not yet come to a consensus regarding the causes of intestinal polyps. It has been suggested that their occurrence is facilitated by:

• long-term inflammatory process of the intestinal wall. This is confirmed by the high incidence of polyps in patients suffering from ulcerative colitis, paraproctitis, and various intestinal infections;
• The causes of the formation of polyps in the intestines include constant, frequent constipation. Damage to the mucous membrane by dense feces, the formation of chronic microtraumas of the mucous membrane triggers the mechanism of polyp formation;
• acute, but more often chronic exposure to chemical toxins. They receive a dose of chemicals from poor-quality food, untreated water, and unfavorable ecology;
• increased sensitivity to certain food components;
• diseases of the blood vessels supplying blood to the digestive tract;
• pathologies of other parts of the gastrointestinal tract - gastritis, duodenitis, cholecystitis, pancreatitis;
• weakening of immune defense;
• intrauterine pathologies associated with the formation of the gastrointestinal tract;
• hereditary tendency, since the presence of relatives with intestinal polyposis automatically places the patient at risk;
• unhealthy eating behavior, bad habits, eating foods with infectious contamination.

The unifying condition for the formation of polypous growths is long-term negative impact on the mucous membrane of organs digestive system.

How to detect a polyp in the intestines

Diagnosis of polyps is a complex set of research procedures. The external picture of the disease does not have specific signs for successful differential diagnosis.

Polypous structures are distinguished from:

• malignant degeneration;
• hemorrhoids;
• cystic formations;
• vascular, muscle, fatty tumors;
• inflammatory lesions of the digestive tract.

The presence of polyps up to 10 mm in size in the intestines is not detected external signs. For this reason, people over 50 years of age undergo stool tests for occult blood once a year. Examination of the rectum by a proctologist will reveal those located close to anus overgrowth.

The following will help detect pathology in the upper intestinal sections:

• MRI and CT will indicate the likely site of attachment of the process;
• sigmoidoscopy and sigmoidoscopy will show doctors what the growth looks like;
• X-ray with barium sulfate (irrigoscopy) will reveal large formations in the thick section;
• A colonoscopy will not only find the tumor, but also take a piece of tissue for examination under a microscope.

What to do if you are found to have a polyp

Having received a diagnosis of intestinal polyp and a referral for surgery, many try to get rid of intestinal polyps without surgery. By turning to alternative methods, people trigger the disease and harm their own health. Polyps can only be treated by surgical removal. No drugs, spells, herbs, or acupuncture will remove the polyp; it will not resolve or heal on its own.

Surgical removal

Surgery to remove polyps in the intestines is called polypectomy. There are several approaches to surgical removal of polyps. The method of surgery to remove polyps depends on the location of the growth, its size, shape, attachment to the wall, and the number of outgrowths.

If the growth is located no further than 6-10 centimeters from the entrance to the anus, its excision with a scalpel through the rectum is indicated. They are removed under local novocaine anesthesia. Having expanded the anal canal with a speculum, the doctor places a clamp on the stalk of the polyp or cuts out a growth on a wide base. The wound is sutured with catgut; no stitches need to be removed.

Polypectomy using an endoscope is optimal for tumors of the middle segments of the intestine. The operation is performed under general anesthesia. An endoscope inserted into the rectum identifies the growth, removes the polyp and cauterizes the vessels. A growth larger than 2 cm is removed in parts.

You can remove the polyp rectally by placing an electric loop on it. Electricity passes through the growth, creating a limited burn. Then the loop is compressed, and it cuts off the growth, while simultaneously coagulating the vessels. The method is effective and ensures rapid healing of the mucous membrane without bleeding.

Treatment for those with a tendency to malignancy is carried out through an incision in the abdomen on the left. The area of ​​the organ affected by polyps is excised. Healthy areas are stitched together.

Having discovered the appendage in the small intestine, it is removed through the incised abdominal wall. Depending on the size and method of attachment of the outgrowth, a more or less significant portion of the intestine is removed.

After surgery, polyps may reappear. Complications of polypectomy include indigestion, dyspeptic disorders, and intestinal inflammation.

The postoperative period requires adherence to strict nutritional rules. Recovery takes place in several successive stages:

• The first day after the intervention you cannot eat or drink. On the second day, give half a glass of water, and a few hours later - a light vegetable or fruit decoction. By the third day, the menu is expanded to rice water, chicken broth, rosehip infusion;
• Guided by the patient’s condition, they begin to gradually give pureed liquid porridges and soups, chicken soufflé, and steam omelet. Each new dish is introduced carefully, monitoring the patient's reaction. If you notice gas formation, pain, or discomfort, refuse the dish. Follow this diet for up to 2 weeks from the day of surgery;
• then, for 4 months, the list of foods consumed should include fermented milk products, lean meat, and eggs.

They organize meals often, but little by little. Avoid fatty, spicy, pickled and smoked foods. Avoid gas-forming foods - legumes, bread and rolls, mushrooms, nuts, coarse fiber. You should drink 2 liters of liquid, but do not drink soda, kvass, strong tea and coffee, or alcoholic beverages.

Traditional recipes for intestinal polyps

Only surgery can radically cure intestinal polyposis. However, in preparation for surgery, folk remedies will come in handy during recovery. Anti-inflammatory, antibacterial, wound healing therapy will relieve pain, swelling, and stimulate regeneration.

Thyme

An effective remedy traditional medicine To treat the intestines, use thyme or thyme. From May to September, thyme blooms with small pink flowers on dry slopes and meadows. The herb contains thymol, borneol, tannins, and organic acids. A decoction is prepared from 2 tablespoons of dry herbs and 300 ml of boiling water. After infusing and straining for an hour, drink 2-3 tablespoons three times a day. It will relieve intestinal pain, bleeding, and give rest to the nerves.

Sage

A water infusion of sage will soothe irritated mucous membranes, normalize stools, and stop nausea. Pour two teaspoons of chopped herbs and sage leaves into 200 ml hot water, but not boiling water. Simmer in an enamel bowl in a water bath for 15 minutes. Remove and let sit for 30 minutes. Take 100 ml of warm infusion 2-3 times a day.

Coltsfoot helps not only with coughs. A decoction of the plant is used for inflammatory lesions of the digestive tract. Biologically active components trigger tissue repair mechanisms. The decoction is prepared by pouring 2 tablespoons of flowers and herbs into a thermos with a liter of boiling water. In an hour the medicine is ready. Drink 100 ml of warm, strained broth four times a day.

Prevention of intestinal polyps

Prevention of intestinal polyps is divided into primary and secondary. Primary measures aimed at preventing the disease in healthy people, look like this:

• healthy eating habits;
• feasible physical education, hardening;
• compliance with daily routine and biorhythms;
• sufficient sleep;
• giving up alcohol and cigarettes;
• annual preventative medical examination.

Reaching 50 years of age serves as an incentive to examine the intestines for polyposis neoplasms. The presence of chronic gastrointestinal diseases and the detection of polyps in the intestines in relatives are alarming factors.

Secondary measures apply to patients who have undergone surgery to remove polyps. People are registered at the dispensary. Every year they take stool tests and do a colonoscopy. Preventive measures detect relapses of polyposis at an early stage. Close attention is paid to those whose histological studies showed the presence of villous epithelium.

The growth of the glandular epithelium of the large or small intestine in the form of a ball, mushroom, multiple villi is called intestinal polyps. The initially benign nature of the growths turns into malignant as they grow and develop. Large growths bleed, break off, and damage the intestinal wall. Polyposis is diagnosed after stool tests, X-rays with contrast, and intestinal endoscopy. The shoots are removed surgically. After the operation, follow strict diet. Prevention of the disease consists of an annual medical examination and a healthy lifestyle.

The information on our website is provided by qualified doctors and is for informational purposes only. Don't self-medicate! Be sure to consult a specialist!

Gastroenterologist, professor, doctor of medical sciences. Prescribes diagnostics and carries out treatment. Expert of the group for the study of inflammatory diseases. Author of more than 300 scientific papers.

Polyps in the intestine are benign neoplasms that can occur in any part of the intestine. A polyp is a tumor-like growth on a wide base or thin stalk, rising above the mucous membrane into the lumen of a hollow organ (intestines, stomach, uterus, etc.).

Pathology is a fairly common phenomenon. Most of the tumors do not cause any symptoms and are detected incidentally during an examination. But it is necessary to remember that in almost 95% of cases, adenomatous and villous polyps become malignant within 5–15 years.

Location of polyps

Small intestine

Quite rarely, formations of this type are found in the small intestine. In the medical literature, isolated cases of the development of neoplasms of this localization have been noted. In almost half of the patients in this group, polyps are observed in other parts of the gastrointestinal tract (gastrointestinal tract).

They mainly consist of glandular tissue, but fibromatous and angiomatous can occur. Growths on the inner walls of the small intestine have been identified in adults aged 20 to 60 years.

Localization of polyps in the duodenum is very rare. Almost all patients who consulted a doctor with such a pathology were operated on because there was a suspicion that the neoplasm was malignant.

Such outgrowths can be located in the area of ​​the sphincter of Oddi (in patients with cholecystitis or cholelithiasis) or near the duodenal bulb (in gastritis with high acidity). The disease occurs in both women and men aged 30 to 60 years.

Colon

Most often, polypous formations are located in the large intestine (sigmoid or rectum). They can be either single or multiple. In most cases, they form in adolescence, but sometimes they can also be detected in children (which may indicate a hereditary predisposition).

Multiple or single growths of this localization are observed in 15% of people after 40 years of age. In almost 8 out of 10 people they precede colorectal cancer.

Types of polyps

Neoplasms in the intestine are classified as follows:

Type of polyps	Description
Adenomatous	The growth is an adenoma of glandular tissue. These formations rarely reach large sizes (no more than 1 cm in diameter). In most cases, they have the shape of a mushroom (sometimes they can look like a ball or growth along the mucous membrane), a fairly dense consistency, and a pale pink color. They practically merge with the mucous membrane. Polyps of this type degenerate into a malignant tumor in 1% of cases
Villous	This is one of the types of adenomatous neoplasms. It is formed from epithelial tissues and can reach large sizes (up to 3 cm). In appearance, they resemble knots on a short, dense stem. Since the villous outgrowths are supplied big amount blood vessels, their color can be bright red, which can be seen in the photo. These formations are four times more likely to degenerate into malignant tumors
Glandular-villous	They are large lobular growths with a high degree of epithelial dysplasia. The most dangerous are formations larger than 1 cm and soft to the touch. They are more likely to become malignant
Hyperplastic	They are small growths (up to 0.5 mm in diameter), resembling plaques, located on the mucous membranes of the intestine. In color they practically merge with the surrounding tissues. They degenerate into a malignant form in very rare cases.
Juvenile	This type of neoplasm is detected in most cases in adolescence. Polyps originate from embryonic tissue remains and are large (up to 5 cm in diameter), round or lobulated shiny growths on long stalks

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Causes

The causes of the disease are not fully understood and continue to be actively studied.

Factors contributing to the occurrence of pathology include:

• hereditary predisposition;
• poor nutrition: consumption of large amounts of fried foods, red meat and animal fats with a minimum amount of vegetables and seafood in the diet;
• chronic somatic diseases;
• intestinal infections;
• alcohol abuse and smoking.

Symptoms of polyps in the intestines

The disease may not manifest itself in any way at the initial stages, being asymptomatic. In some cases, growths can only be identified during a routine examination.

The first signs of polyps in the intestines appear if the formation reaches a large size, begins to ulcerate, or is supplemented by inflammatory processes.

The following symptoms may indicate the presence of formations in the large intestine:

• bleeding It can occur as a result of ulceration of the growth, torsion of its legs or damage to blood vessels;
• nagging pain: it may hurt in the lower abdomen or in the sacral area;
• frequent urge to have bowel movements;
• mucus in stool(is an indirect sign of villous intestinal polyps);
• pain in the anus;
• alternating constipation and diarrhea.

Growths located on the walls of the small intestine are very dangerous because they often degenerate into cancer. They can also cause perforation of the intestinal walls, profuse bleeding or intestinal obstruction.

Signs of a polyp in the small intestine:

• dyspeptic symptoms (belching, nausea, flatulence) usually occur at the initial stage of the disease;
• indomitable vomiting, which occurs in cases where the neoplasm is located in the initial parts of the small intestine;
• cramping abdominal pain;
• bleeding.

In 67% of cases, growths located in the duodenum do not cause any symptoms and cannot be identified. But if the tumor reaches a large size, the patient may experience the following symptoms:

• drawing, cramping pain near the navel;
• burping rotten egg;
• feeling of fullness in the stomach;
• frequent nausea.

If the growths block the intestinal lumen, a person experiences cramping abdominal pain, severe vomiting of undigested food, and weakness. The patient's general condition is rapidly deteriorating, so immediate hospitalization is necessary.

Diagnostics

To diagnose polyposis, various methods are used (depending on where exactly the growths are located).

Diagnostic methods:

• ultrasound examination of the abdominal organs;
• esophagogastroduodenoscopy;
• fluoroscopy;
• CT scan.

It is also necessary to do a stool test for occult blood. A referral for examination can be obtained from a gastroenterologist. In some cases, in order to diagnose the disease, the patient must be hospitalized.

Treatment of polyps in the intestines

The only effective treatment for growths is their removal. Conservative therapy is carried out only in the presence of diffuse polyposis (when growths spread to large areas of the intestine) or as a temporary measure before surgery.

Electrocoagulation

If the growth is single, benign and located in the distal parts of the colon, it is removed through a colonoscope using electrocoagulation.

New growths up to 2 cm on a wide base are eliminated using electrical excision. For large and numerous polyps, abdominal surgery is performed.

Enterotomy

To eliminate formations in the small intestine or in the duodenum, enterotomy is indicated. The operation is performed under general anesthesia. The surgeon makes a dissection of the abdominal wall and removes a loop of intestine.

At the next stage, the intestinal wall is cut longitudinally and the formation is eliminated. The wound is then sutured. This operation does not lead to a narrowing of the intestinal lumen, so intestinal function is not disrupted in the future.

Resection of part of the intestine

If there is a suspicion of malignancy of the formation, resection is indicated. The part of the intestine that has an independent blood supply to the mesenteric branch is removed. After such an operation, the patient may experience digestive problems.

Diet in the postoperative period

In order to speed up healing and prevent the formation of new growths, the patient should follow a diet after surgery. He is prohibited from eating spicy, salty and sour foods. It is also necessary to avoid fried and fatty foods. The patient needs to reduce the amount of salt in the diet as much as possible.

Doctors recommend eating food frequently (every 2-3 hours) in small portions. Dishes should be at room temperature. They are prepared by boiling, baking or steaming. The consistency of the dishes should be soft; they must first be crushed by rubbing through a sieve or using a blender.

Particular attention should be paid to fluid intake. You need to drink up to two liters of pure still water or weak black tea per day. You should stop drinking carbonated drinks and alcohol.

Prognosis and prevention

Can a polyp in the intestine disappear on its own? No, such tumors do not resolve; they must be removed surgically.

The prognosis of the disease is favorable if the formation is detected and eliminated in time. The longer the growth exists, the greater the likelihood of it turning into a malignant tumor.

Almost 30% of patients experienced a relapse within several years after removal of tumors (polyps can grow again). People with a history of this disease should have an endoscopic examination every year.

In order to prevent the development of the disease, it is necessary:

• eat right: avoid eating fatty and fried foods, alcohol, carbonated drinks, introduce vegetables, fruits, and seafood into the diet;
• get rid of bad habits;
• treat constipation effectively and promptly;
• lead a healthy lifestyle, play sports, walk in the fresh air.

People who are at risk of developing pathology need to monitor their health especially carefully. If close blood relatives are diagnosed with formations in the intestines, it is necessary to conduct regular examinations.

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- 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. The frequency of occurrence of polyps in different parts of the intestine varies significantly - most of the tumors are located in the colon and rectum, polyps are much less often detected in the small intestine. Duodenal polyps are an 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 lack of a characteristic clinical picture and a general approach to the treatment of polyps is also a 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 for removing 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 make it possible to suspect and identify a polyp at an early stage, before it turns into a malignant neoplasm.

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 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 location were taken for surgery with a 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 form 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 of the 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. The pain syndrome is 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. In the initial stages of the disease, intestinal polyps with this localization may 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 manifest themselves in four groups of symptoms: acute intestinal obstruction (most often associated with intussusception, less often with kinking 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. The asymptomatic course of intestinal polyps is 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 bright that it can imitate 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. Intestinal relaxation with the help of antispasmodics and local administration of contrast through a probe can make the study more accurate. 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 - preferred method surgical intervention, allows you to stop bleeding from the ulcerated mucosa.

When identifying polyps of the small intestine, do not big size enterotomy is performed on the leg

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.

Intestinal polyps are small single or multiple non-malignant tumor-like growths consisting of mucosal cells that appear on the inner surface of the loops of the affected organ.

Both children and adult men and women are susceptible to the development of pathology. Pathology occurs in any segment of the gastrointestinal system. The size of the outgrowths ranges from a few millimeters to 10 centimeters (sometimes more). Most often, polyps of the ascending colon and duodenum are detected. Tissue neoplasms in the small intestine are less commonly diagnosed.

The pathology occurs quite often: it is diagnosed in 9–18 people out of a hundred in the general population, and much more often (40–47%) in the age category of 50–55 years. Typically, intestinal polyps up to 2–3 cm in size do not show any signs and do not bother the patient. But if they are detected, then even the smallest growths must be removed so that they do not degenerate into cancerous formations.

What it is?

Intestinal polyps (ICD 10 code: K62.1) are fleshy growths that form in the cavities of the gastrointestinal tract or other hollow organs. This is a neoplasm (cluster of cells) of insignificant size, attached by a stalk or a wide base to the tissues and protruding into the cavity.

There are cases when polyps appear in entire colonies, covering a large area of ​​the intestine. Minor formations (1–2 mm) are invisible, but with further development they are injured by feces, causing internal bleeding. Large growths can block the intestinal lumen and cause constipation.

This formation can appear regardless of age, and people who have inherited intestinal polyposis are at risk.

Are intestinal polyps cancer or not?

This question arises in many patients who have polyps found in their intestines.

Polyps are benign formations, they are not cancer, but some types can malignize (become malignant) over time. If polyps are detected during a colonoscopy, biopsy material is taken. Laboratory research makes it possible to determine the type of neoplasm, which makes it possible to draw a conclusion about the possibility of malignancy.

Classification

According to the histological structure, the types of polyps in the intestine are determined:

1. Adenomatous appearance with a round and smooth but dense surface. It is usually covered with a vascular network, so it does not stand out. Its size can be large, which increases the risk of developing cancer.
2. Villous appearance. These intestinal polyps grow over a wide area, forming a carpet as they are covered with villi. Of these, 40% can develop into a malignant tumor.
3. The hyperplastic type grows to small sizes, their localization is the wall of the rectum.
4. Hamartomatous appearance - formation occurs with healthy tissue. Their appearance is associated with unusual combinations of cells, but perhaps this is the result of anomalies.
5. The juvenile form occurs in children. It has the appearance of a bunch of grapes hanging on a stem. Doesn't go into oncology.

An identified polyp in the intestine, the signs of which will allow us to determine what type it belongs to, needs to be treated. Depending on the stage of its development, the appropriate method of therapy will be selected.

Causes

Modern medicine does not have clear data on the etiology of intestinal polyposis. However, there are certain theories that suggest the mechanism of development of the disease:

1. Global health problems for the majority of the population associated with environmental degradation. Not noticing the deterioration of health modern people It's hard enough. First of all, this concerns children. The number of babies with severe congenital pathologies is constantly increasing. Many children suffer from diseases that were previously common only in old age. The process of polyp formation is also significantly influenced by factors such as eating foods with chemicals, physical inactivity, lack of fresh air in city living conditions, alcohol abuse, smoking, and poor diet;
2. Chronic inflammation of the intestinal walls. It has been established that polyps cannot begin to form in healthy tissues. Therefore, this assumption regarding the cause of their occurrence seems most obvious. Inflammatory processes occurring in the mucous membrane cause the epithelium to regenerate faster, and this can result in uncontrolled growth. In addition, scientists point to a connection between the process of formation of intestinal polyps and diseases such as dysentery, ulcerative colitis, typhoid fever, enteritis, proctosigmoiditis. The basis for this hypothesis is the disappearance of relapses of polyposis after getting rid of the listed diseases. In addition, constipation and intestinal dyskinesia can provoke the growth of polyps. It turned out that polypous growths are more often found in the part of the intestine where there was fecal stagnation and microtrauma;
3. Genetics. It is believed that family history influences the development of the disease. This is confirmed by the fact that even against the background of absolute health, some children exhibit polypous growths. Scientists explain this fact by a genetic program that causes some parts of the intestine to work differently;
4. Pathologies of the digestive system and blood vessels. The condition of the intestinal mucosa largely depends on the blood vessels. Varicose and diverticular disease, atherosclerosis have a negative effect. Pathologies of the digestive system (stomach ulcer, gastritis, pancreatitis, cholecystitis and others) cannot but affect the health of the intestines;
5. Food allergies, gluten intolerance. While gluten intolerance was a rare problem just a few decades ago, more and more children are now suffering from this form of food allergy. When products containing this protein enter the body, the immune system begins to react violently to it. It perceives gluten as a foreign agent, which leads to damage to the mucous membrane lining the intestines. If an inadequate immune response is ignored, a person faces serious health problems, including intestinal cancer and the development of osteoporosis.
6. Embryonic theory. Scientists hypothesize that those areas of the intestine in which polyp formation occurs were incorrectly formed during intrauterine development. Symptoms of the disease begin to appear somewhat later as a result of the influence of additional negative factors;

In addition to the fact that there are general reasons for the development of polyps in the intestines, the most probable factors for their formation in various sections have been put forward, for example:

• Rarely formed polypous growths inside the duodenum most often result from gastritis with high acidity, cholecystitis or cholelithiasis. The age of the patients ranges from 30 to 60 years;
• Even less often, formations are detected in the cavity of the small intestine. Moreover, they are combined with polyps in other parts of the intestines and in the stomach, and are more often diagnosed in women aged 20 to 60 years. The appearance of growths can be provoked by multiple factors, among which the inflammatory process is in the lead;
• Formations found in the colon are most often the result of negative heredity.

Symptoms and first signs

In the vast majority of cases, the presence of polyps in the intestines does not have any clinical symptoms or specific manifestations. This prevents timely detection and treatment of the disease.

The patient should be alert and consult a doctor if the following signs are present:

1. pain in the abdomen;
2. discomfort that occurs during defecation;
3. blood on the surface and in the stool;
4. mucous discharge during and after bowel movements;
5. difficulties in moving feces, alternating with loose stools;
6. frequent urge to defecate.

• Nonspecific symptoms of colon polyposis (blood in the stool) in adult patients may be mistaken for manifestations of hemorrhoids. Identifying the cause of bleeding in children is much more difficult, since it may not be related to the intestines.

Most patients with colon polyposis are characterized by localization of tumors on the left side of this organ. Having a mushroom-shaped (with a thick or thin stalk) shape, they can reach six centimeters, provoking the development of colitis and diseases of the colon.

A characteristic symptom indicating colon polyposis is the presence of longitudinal stripes of mucus and blood in the stool (the lower the location of the polyp, the brighter the color of the blood and the lesser the degree of its mixing with stool). In every second patient with polyps in the colon, constipation alternates with diarrhea and is combined with painful tenesmus. In addition, patients suffer from abdominal pain, burning and itching in the anal canal and rectum.

Constant diarrhea and bleeding worsen the general condition of patients, causing physical weakness, dizziness, pale skin and severe exhaustion.

1. Rectal polyposis, which does not manifest itself for years, is most often detected during endoscopic examinations in patients over fifty years of age. When inflammation or damage to the integrity of these neoplasms occurs, the clinical picture changes dramatically. Patients experience copious discharge of mucus and blood. In this case, you should immediately contact a proctologist.
2. Polyps localized in the sigmoid colon provoke the occurrence of regular constipation, followed by bouts of causeless diarrhea. Nonspecific symptoms of sigmoid colon polyposis are the presence of a swollen abdomen, belching, as well as the release of blood, pus and mucus during bowel movements.
3. Polyposis of the small intestine, which is extremely rare, can nevertheless lead to the development of intestinal obstruction, profuse bleeding, intestinal volvulus, and disruption of the integrity of its walls. In both adults and children, implantation of one part of the intestine affected by polyps into another can occur. There is a high probability of malignancy of such polyps.

The initial symptoms of small intestinal polyposis include flatulence, nausea, heartburn, belching, a feeling of fullness in the stomach, and pain in the upper abdomen. The patient may experience cramping abdominal pain. Polyps located in the initial parts of the small intestine can provoke uncontrollable vomiting.

Polyps that have settled in the duodenum in 70% of cases do not bother patients in any way for quite a long time. When the tumors reach large sizes, patients experience pain and intestinal obstruction develops; the ulcerated membranes of the polyps begin to bleed.

The nature of the pain varies; They are usually localized in the navel area. In addition to pain, the patient complains of a feeling of fullness in the stomach, constant nausea and rotten belching.

When a polyp of the duodenum occludes the intestinal lumen, the food coma is retained in the stomach, provoking symptoms of intestinal obstruction: the patient experiences cramping pain, vomiting of eaten food, and splashing noise in the abdomen during auscultation.

However, based on the clinical picture alone, which resembles the manifestations of tumors of the bile ducts, small intestine and pyloric region of the stomach, it is impossible to diagnose the presence of duodenal polyps.

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 know about their presence for many years until he is examined or obvious clinical manifestations of the disease 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. The average rate of degeneration of a glandular polyp into cancer is 7–10 years. But experts prefer not to take risks and perform the operation immediately after detecting polypous growths.

With a long course 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 inflammatory diseases of the gastrointestinal tract or unfavorable heredity are recommended to undergo regular preventive examinations by specialists. This will get you started early treatment and get rid of polyps in less traumatic ways.

Diagnostics

To reliably determine the diagnosis, it is important to conduct a whole range of examinations, including laboratory, instrumental and endoscopic research methods.

Intestinal polyps are the area of ​​research of proctologists, endoscopists, gastroenterologists and oncologists.

After studying the patient’s complaints and physical examination, the following manipulations are prescribed:

1. Rectal palpation of the rectum. Using fingers, the nearest parts of the colon are probed and determined possible reasons the appearance of unusual symptoms (hemorrhoids, inflammation, constipation).
2. X-ray. An important study is irrigoscopy (x-ray using contrast). The method allows you to accurately determine pathological growths, vascular components and their volume. The route of administration of contrast is retrograde, that is, by enema into the rectal lumen. The disadvantage of the method is the inability to determine the smallest polyps.
   If the polyps are located in the high parts of the intestine, then the passage of barium through the intestine is examined. To do this, you need to drink the contrast agent. A few hours later, a series of x-rays are taken.
3. Endoscopy. There are two main methods of endoscopic examination of the anorectal space: sigmoidoscopy and colonoscopy.
   The first method allows you to assess the condition of the intestine, the sections of which are located 25 cm higher, take materials for a biopsy, and visually assess the structure of the neoplasm.
   In the second case, the doctor has the opportunity to assess the condition of the intestine over a distance of 1.5 m, take a biopsy sample for histological and cytological examination, immediately remove the pathological growth.

World organization Health Services (WHO) recommends diagnostic colonoscopy for all persons over the age of 55 years, and then every 10 years (in the absence of complaints and symptoms characteristic of intestinal polyps). This recommendation is due to the fact that more than 85% of colon cancer cases are detected in patients over 60 years of age.

The age threshold for the first study is reduced to 45 years if polyposis or intestinal cancer have been identified in the family of first-degree relatives (mother, father, siblings), especially before the age of 45. IN different countries There are standards for including this procedure in the plan of medical examinations of the population. In many European countries Colonoscopy is recommended to be performed annually for all persons over 45 years of age, and the examination plan also includes a stool test for occult blood (Gregersen reaction).

If any complaints arise that may indicate the presence of this disease, colonoscopy is performed as prescribed by the doctor, regardless of the patient’s age. There are frequent cases of detection of benign polyps in children.

How to treat polyps?

Treatment of polyps should begin early. At the same time, the only effective method that allows you to recover from the disease is surgery. Conservative methods are also used for multiple formations that cover the gastrointestinal mucosa. However, wait-and-see tactics are followed for elderly patients who have contraindications to surgery.

Drug therapy in this condition involves prescribing the following drugs:

1. Analgesics and antispasmodics are used for pain (No-shpa).
2. Drugs to improve digestion.
3. Remedies for bloating (Simethicone).
4. Medicines to normalize stool.
5. Immunomodulators and vitamins.

If a person’s polyps have reached large sizes, then they need to be removed surgically.

Surgical intervention

Common surgical techniques:

1. Endoscopic polypectomy. Doctors sometimes combine this option with electrocoagulation of the base of the growth. Since this operation does not cause massive damage, the recovery period is minimal.
2. Removal with a segment of intestine. Prescribed for almost circular tumors, large or multiple growths. Neoplasms are removed along with part of the intestine. If hereditary familial polyposis is diagnosed, then in this case the colon is completely removed.
3. Transanal polypectomy. Polyps are removed using special scissors or a scalpel. Upon completion, the mucous tissues are sutured. Such operations are prescribed only when the polyps are located in close proximity to the anus. The cut-off is carried out under local anesthesia, and for the convenience of the specialist, the anus is spread apart with a rectal speculum.
4. Laser removal. Prescribed for benign large formations with thick or wide bases.
5. Polypectomy through an incision in the intestinal wall. It is prescribed when polyps are large or if they are located in a hard-to-reach area. During the operation, the abdominal cavity is opened. The growth is sometimes excised along with part of the intestinal wall.

Nutrition after removal of an intestinal polyp should be balanced and meet the recommendations of the attending physician. In most cases, you will have to give up meat fats, alcohol and smoking. The diet must contain fresh vegetables, fruits, cereals, fiber, gluten, fish and seafood. Fermented milk products are included in the diet only after consultation with a nutritionist.

Prevention

To reduce the likelihood of polyps forming in the intestines, it is important to follow these tips:

1. Enrich your diet with foods containing coarse fiber. These include apples, pumpkins, beets, squash and cabbage.
2. Avoid eating animal fats. It is better to replace them with vegetable ones.
3. Regularly undergo preventive diagnostics and examination by a doctor.
4. Treat any inflammatory diseases of the stomach and intestines in a timely manner.
5. Avoid drinking strong alcoholic drinks.
6. Stop smoking.
7. Avoid overeating.

To practice traditional treatment polyps can only be obtained after the doctor’s permission, and only if the disease is in its initial form. In general, experts do not recommend self-medicating this pathology. It requires serious long-term therapy.

Polyps are benign formations that are “fleshy” growths of tissue protruding above the mucous membrane of organs. According to many surgeons, polyps in the intestines can be diagnosed in every 10 residents of our country over 40 years of age, subject to a total examination of this age category.

Causes of polyps in the intestines

There is no single theory explaining the appearance of polyps in the intestines. Some scientists are inclined to believe that these tumors appear as a result of disruption of regeneration processes in places of injury to the intestinal wall. Others believe that the cause of the formation of polyps is disturbances during embryonic development. There are many other opinions regarding the nature of this disease.

However, factors have been identified that may increase the likelihood of polyps forming in the intestines:

• male gender (in men the disease is detected more often than in women);
• hereditary predisposition;
• inactive lifestyle and;
• the predominance of carbohydrate and fatty foods in the diet;
• constants and ;

Symptoms of polyps in the intestines

Colon polyps may be accompanied by abdominal pain, stool disorders and false urge to defecate.

In most cases, polyps in the intestines do not manifest themselves in any way, especially small ones, so the pathology is not diagnosed in a timely manner and is not cured.

If there are polyps in the colon, the patient may present the following complaints:

• alternating constipation and diarrhea;
• false urge to defecate (tenesmus);
• discomfort during bowel movements;
• the appearance of blood and mucus in the stool and between periods of bowel movements.

Polyps rarely form in the small and duodenal intestines; symptoms appear when they reach large sizes. And this is due to the fact that neoplasms narrow the intestinal lumen, resulting in:

• feeling of fullness in the stomach;
• pain in the epigastric region;
• belching;
• nausea, sometimes even vomiting.

If the disease is not diagnosed and treated, it can result in high intestinal obstruction.

Diagnosis of polyps in the intestines

It is impossible to establish a diagnosis without special diagnostic procedures; based on complaints and laboratory results, the doctor can only assume the presence of tumors in the intestine. Diagnosis of this disease is carried out by proctologists and endoscopists.

Digital examination of the rectum

This is the first mandatory study that is performed on a patient if there is a suspicion of formations in the intestines. The doctor feels the nearest areas of the rectum; during the study, various pathologies can be identified that may be the “culprit” for the appearance of symptoms.

X-ray methods

- This is an examination of the large intestine using a contrast agent, which is administered retrogradely, that is, using an enema through the rectum. This method allows you to visualize the structural features of the large intestine and identify various formations in it (filling defects). It is often impossible to detect small polyps using this test.

If the presence of polyps or other defects in higher sections is suspected, the passage of barium through the intestines is examined. Before the examination, the patient must drink a solution with a contrast agent. A few hours later, X-rays are taken, in which different parts of the intestine are visualized as the contrast agent passes through.

Endoscopic methods

This is what intestinal polyps look like during colonoscopy.

Sigmoidoscopy is a diagnostic method that allows you to examine the rectum and distal parts of the sigmoid colon, which is about 20-25 cm up from the anus. Using the device, the doctor can:

• visually assess the condition of the intestinal mucosa;
• examine neoplasms, if any;
• take material for subsequent biopsy.

– “gold standard” in the diagnosis of colon diseases. This method allows you to examine the intestine along almost its entire length (up to 1.5 m). Using a colonoscope, your doctor can:

• examine the mucous membrane, identifying tiny polyps measuring only a few mm;
• take material for biopsy;
• remove formations.

Treatment of polyps in the intestines

Radical treatment of this disease is only possible through surgery. It is impossible to get rid of polyps with the help of medications.

Endoscopic removal of polyps on the walls of the large intestine is performed using a sigmoidoscope or colonoscope. Most often, the operation is performed under general anesthesia.

1. When polyps are detected in the rectum, transanal excision is performed; most such operations are performed using local anesthesia. It is recommended to remove formations in this part of the intestine, even if they are small in size and benign in nature, since they are often injured, causing symptoms that are unpleasant for the patient.
2. If it is impossible to remove the formation endoscopically, then removal is performed through an incision in the intestinal wall, this operation is called a colotomy.
3. In case of polyposis, when there are more than a hundred polyps and they are concentrated in one section of the intestine, the affected area is removed, and an anastomosis is performed between the ends of the intestine.

Are intestinal polyps cancer or not?

This question arises in many patients who have polyps found in their intestines.

Polyps are benign formations, they are not cancer, but some types can malignize (become malignant) over time.

If polyps are detected during a colonoscopy, biopsy material is taken. Laboratory research makes it possible to determine the type of neoplasm, which makes it possible to draw a conclusion about the possibility of malignancy.

Adenomatous (glandular) polyps

The likelihood of malignancy of this type of polyps is very high; in 85% of cases, 5-15 years after their discovery, patients are diagnosed with colorectal cancer. The larger the size of such polyps and the greater their number, the higher the likelihood of an unfavorable course of the disease, which is why adenomatous polyps are often called precancer.

For patients whose biopsy results indicate adenomatous polyps, it is recommended that they be removed followed by an annual surveillance colonoscopy. There is evidence that people whose parents were “owners” of polyps of this type (even if it did not develop into intestinal cancer) have a 50% increased risk of developing this pathology.

Also histologically, hyperplastic, inflammatory and hamartomatous polyps are distinguished, which extremely rarely degenerate into cancer. Single small polyps with a low likelihood of malignancy that do not cause any symptoms are usually not removed, and patients are advised to undergo regular examination.

Adenomatous polyps are very prone to malignancy, to avoid which they are removed surgically.

The World Health Organization (WHO) recommends diagnostic colonoscopy for everyone over the age of 55 years, and then every 10 years (if there are no complaints or symptoms characteristic of intestinal polyps). This recommendation is due to the fact that more than 85% of colon cancer cases are detected in patients over 60 years of age.

The age threshold for the first study is reduced to 45 years if polyposis or intestinal cancer have been identified in the family of first-degree relatives (mother, father, siblings), especially before the age of 45.

Different countries have their own standards for including this procedure in the plan of medical examinations of the population. In many European countries, colonoscopy is recommended annually for all persons over 45 years of age, and the examination plan also includes a stool test for occult blood (Gregersen test).

If any complaints arise that may indicate the presence of this disease, colonoscopy is performed as prescribed by the doctor, regardless of the patient’s age. There are frequent cases of detection of benign polyps in children.