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 can be the result of chronic inflammation of the 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 the 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.
| With adenomatous polyps, a lot of mucus appears in the stool, and bleeding. |
| Because of large polyps cramping pain may occur, the person suffers from constipation, symptoms similar to intestinal obstruction, with blood and mucous discharge occurring, and a foreign body is felt in the anus. The pain is most often localized in the lower abdomen. |
| Due to adenomatous polyps, it can develop bowel cancer. |
| Diarrhea and constipation- these are the main signs of the occurrence of polyps, because of them, peristalsis in the intestines is disrupted, most often this happens if the polyps are large in size, because they can reduce the intestinal lumen and because of this, stagnation occurs, and partial intestinal obstruction is formed. |
| If pain appears in the intestinal area, abdomen, this indicates inflammation. |
| Bleeding is one of the dangerous symptoms, it is necessary in such cases urgently consult a doctor, this may indicate a malignant formation. |
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 treatment methods 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 and a 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 types 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 the consumption of alcoholic beverages and 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 true ally in the fight against this disease. There are many methods and recipes that will help you treat your body without even leaving home.
| Take one spoon of crushed chagi(this is a mushroom that most often grows under birch) millennium, St. John's wort, they should be in equal parts and pour boiling water over everything, leave for 20 minutes. Take small doses 20 minutes before meals. |
| Can come to the rescue oak bark, it can be purchased at any pharmacy. To prepare the decoction, take a tablespoon of bark and pour a liter of boiling water, simmer the contents for 10-15 minutes over low heat. Remove from the stove, let the product cool, and then store in a dark place. Take several times a day half an hour before meals, do this for a week, then take a break. Continue alternating until complete recovery. |
| Over time, polyps can transform into malignant tumors; this will help you prevent this. viburnum. Take 3 tablespoons of viburnum berries and pour boiling water over them, when the drink has cooled, strain it through a sieve and drink to treat polyps throughout the day, it is best to do this before meals. |
| Removes intestinal and rectal polyps well mixture of honey and horseradish. Mix them in equal proportions and take one teaspoon of the folk remedy daily on an empty stomach. |
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 likely causes of the appearance and development of polyps:
- Chronic inflammatory processes:
- nonspecific ulcerative colitis;
- Crohn's disease;
- chronic form of dysentery and giardiasis;
- chronic enteritis and colitis;
- membranous colitis.
- Environmental influence.
- Pathologies of blood vessels and organs involved in digestion.
- Genetic abnormalities.
- Allergies.
- Bad habits.
- 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 examinations using special methods are advisable, especially in adults who have crossed the 50-year mark.
Types of intestinal polyps
| Hyperplastic intestinal polyps small in size are more often found in the rectum (in 50% of cases of colon polyps in adults). They are not classified as neoplastic formations. |
| Tubular (tubular) adenomas- formations of a characteristic pink color with a smooth dense surface. |
| Adenomatous polyps- optional precancer. The probability of degeneration of these formations depends on their size and type: with a polyp size of 2 cm, the probability is 30-40%. |
| Hamartomatous intestinal polyps are formed from normal tissues in an unusual combination or with the disproportionate development of any tissue element. Juvenile intestinal polyps are the most characteristic representatives of hamartomatous colon polyps. |
Diagnosis of intestinal polyps
If colonoscopy is not possible, computed tomography is recommended. 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 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 rich in fiber (apples, beets, zucchini, pumpkin, cabbage);
- harmonize a correct, rational diet.
Questions and answers on the topic "Intestinal polyps"
| My daughter was diagnosed with numerous intestinal polyps, and about a hundred have already been removed. Is it possible to remove all polyps throughout the entire intestine without resection? What are the most likely cases under such circumstances? She is only 30 years old. |
| The only treatment for intestinal polyps is their removal. Endoscopic biopsy with polyp removal is the preferred method of surgical intervention to stop bleeding from the ulcerated mucosa. 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. |
| Is it possible to remove a colon polyp with giardiasis? |
| Indications for removal of polyps in the intestines are: the presence of bleeding and copious discharge of mucus from the anal canal; feeling of severe discomfort; constant pain in the lower abdomen; violation of active intestinal motility; development of intestinal obstruction; ulceration of the intestinal mucous membranes. Surgical removal of polyps in the intestines is strictly contraindicated if the patient has: diabetes mellitus; epilepsy; malignant neoplasms; infectious diseases; pacemaker; acute inflammatory process in the area of the intestine subject to surgery, since this increases the likelihood of perforation of the intestinal wall affected by polyps. |
| I am 26 years old. Five days ago, a 0.9*1.5 polyp was removed from the sigmoid colon, plus a total colonoscopy was performed. They were released two hours after the polypectomy. They didn't give any recommendations. The question is, on what days after polypectomy can complications occur? Should I follow a diet? And for how long you can’t lift weights, otherwise I have a small child. |
| Don't lift heavy objects for a week. Follow your diet too. The most important thing is to avoid constipation (regulate this with foods - beets, prunes, etc.). Well, the most important thing is to wait for the results of the histological examination. And there it may be necessary to give other recommendations or even carry out appropriate treatment. |
| My mother (she is 68 years old) was diagnosed with an intestinal polyp. What should we do? Is surgery possible at this age? What are the consequences? |
| Hello, this issue needs to be discussed at an appointment with a proctologist. Polyps are different: some are extremely dangerous, others are not dangerous and require observation; sometimes it is necessary to do an analysis (biopsy) to understand whether the polyp is dangerous or not. Regarding surgery: dangerous polyps are always removed if the person is able to undergo surgery. Even if the operation is dangerous, we must try to prepare the body so that the operation becomes possible. And if the risk of surgery is extremely high, then a decision is made on conservative treatment. Any operation is a risky undertaking, and there is a risk of complications with any operation. But we need to weigh all the risks and decide what is more dangerous: the risk of surgery or the risk of leaving behind a dangerous disease? All these questions should be explained to you by your attending proctologist. |
Polyps formed in the rectal area are benign neoplasms. They grow from the walls of the intestine itself and, as the tumor grows in size, reach the lumen. Experts consider any of the polyps as a potentially malignant formation.
A few words about polyps and whether they need to be removed
Polyps are formations that rise above the level of the mucous membranes as certain growths. They can be spherical, mushroom-shaped or even branched. The color of polyps can also be varied: from gray-red or yellow to dark. Moreover, these formations are always covered with mucus and have a soft consistency.
In the case when there are a number of polyps in the rectal area, experts talk about polyposis. It is necessary to pay attention to the fact that any polyp should be considered precisely as a precancerous condition. At the same time, a formation that exists over a long period of time can change, becoming a malignant formation. We are talking about colorectal cancer, which occurs not only in adults, but also in children.
In order to eliminate such negative consequences, it is strongly recommended to begin treatment of tumors as early as possible. In addition, it is extremely important to establish in time the true reasons why polyps formed.
Remember, the sooner you start treatment, the less likely it is that the condition will develop into cancer!
Reasons for the formation of polyps in the intestine
Clear reasons and algorithms for the formation of polyps have not yet been established.
At the same time, experts rely on certain facts and relationships that indicate dependence on certain factors. Thus, polyps extremely rarely form in healthy tissues. At the same time, it has been established that it is chronic inflammatory diseases that contribute to the natural aging of the epithelium of the mucous membranes of the colon. In addition, the presented process provokes the growth of benign tumors on the mucous membrane.
The list of diseases that provoke such growth includes ulcerative colitis, enteritis, as well as dysentery and typhoid fever. In addition, the list is supplemented by ulcerative proctosigmoiditis. The justification for the fact that it is precisely these problematic conditions of the mucous membrane that are or may be the cause of the formation of rapidly progressing growth may be that after successful therapy for dysentery or ulcerative colitis, previously identified polypous neoplasms are completely excluded.
Quite often, constipation or intestinal dyskinesia turn out to be a kind of launching pad for the formation and growth of polyps.
At the same time, in children, in the overwhelming majority of cases, a completely different situation is identified. The point is that polyps begin to develop on the basis of absolute health.
In connection with this, experts have developed a completely different theory, which implies the existence and emergence of polyps from areas that are genetically programmed in a way that is not necessary. In other words, there is a genetic predisposition. Thus, the causes of polyps in the rectum are and may be different, what can be said about the symptoms of the condition and what are its consequences?
Removing a polyp using a loop
Symptoms of the condition
The symptoms of the condition are aggravated by the fact that in many patients polyps in the rectal area do not appear and are identified exclusively as part of a routine endoscopic examination.
As a rule, the latter are carried out in connection with some other pathology or during the so-called targeted diagnosis of the population.
- Experts pay attention to the following features associated with symptoms:
- in at least 78% of cases, formations are identified in people who have reached the age of 50 years;
- Activation of the inflammatory state or damage to the integrity of the polyp can cause the release of excessive amounts of substances such as mucus or blood. This will be indicated by the occurrence of diarrhea mixed with mucus or blood itself.
With more common polyposis, experts note that the condition is accompanied by bleeding, mucus formation, or increased bowel movements. In addition, the patient gradually develops anemia and progresses, as well as exhaustion. Polyps that are located in the outlet area of the rectum, especially the pedunculated ones, may fall out when trying to have a bowel movement.
In addition, they can cause bleeding and even experience pinching in the sphincter area.
What complications can develop if polyps in the rectum are not removed in a timely manner and how exactly prevention is carried out will be discussed further. I would like to draw your attention to the fact that if even minimally alarming symptoms occur, you need to consult a specialist, bypassing the stage of self-treatment or using traditional recipes.
Consequences and preventive measures
In fact, there can be a lot of complications due to a polyp or, moreover, rectal polyposis. We are talking, first of all, about malignant degeneration and inflammatory diseases of this part of the intestine. In addition, cracks in the rectal area and paraproctitis can be identified.
A total deterioration of the immune condition, frequent stomach upsets and even colds are likely.
It is very simple to avoid such complications, which significantly aggravate all life processes and, in particular, the functioning of the gastrointestinal tract - you just need to follow the basic recommendations of a specialist. They concern not only treatment, but also prevention. It is this that makes it possible, in the long term, to exclude the appearance of a single polyp or polyposis.
It is also necessary to remember to comply with certain measures, in particular, the presence of coarse fiber in the menu.
We are talking about products such as cabbage, beets, turnips, as well as zucchini, apples or pumpkin. They optimize intestinal activity, minimizing the likelihood of polyp formation. Next, I would like to draw attention to the preferable use of vegetable fats.
Experts call another preventive measure limited or completely absent consumption of alcoholic beverages, including beer. All of them contribute to the formation of tumors in the intestinal area and other formations that can be detrimental to the entire gastrointestinal tract system.
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HOW TO SIGNIFICANTLY REDUCE THE RISK OF CANCER?
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1.Can cancer be prevented?
The occurrence of a disease such as cancer depends on many factors. No person can ensure complete safety for himself. But everyone can significantly reduce the chances of developing a malignant tumor.
2.How does smoking affect the development of cancer?
Absolutely, categorically forbid yourself from smoking. Everyone is already tired of this truth. But quitting smoking reduces the risk of developing all types of cancer. Smoking is associated with 30% of deaths from cancer. In Russia, lung tumors kill more people than tumors of all other organs.
Eliminating tobacco from your life is the best prevention. Even if you smoke not a pack a day, but only half a day, the risk of lung cancer is already reduced by 27%, as the American Medical Association found.
3.Does excess weight affect the development of cancer? In Russia, WHO associates 26% of all cancer cases with obesity.
4.Do exercise help reduce the risk of cancer?
Spend at least half an hour a week training. Sport is on the same level as proper nutrition when it comes to cancer prevention. In the United States, a third of all deaths are attributed to the fact that patients did not follow any diet or pay attention to physical exercise. The American Cancer Society recommends exercising 150 minutes a week at a moderate pace or half as much but at a vigorous pace. However, a study published in the journal Nutrition and Cancer in 2010 shows that even 30 minutes can reduce the risk of breast cancer (which affects one in eight women worldwide) by 35%.
5.How does alcohol affect cancer cells?
Less alcohol! Alcohol has been blamed for causing tumors of the mouth, larynx, liver, rectum and mammary glands. Ethyl alcohol breaks down in the body to acetaldehyde, which is then converted into acetic acid under the action of enzymes. Acetaldehyde is a strong carcinogen. Alcohol is especially harmful for women, as it stimulates the production of estrogens - hormones that affect the growth of breast tissue. Excess estrogen leads to the formation of breast tumors, which means that every extra sip of alcohol increases the risk of getting sick.
6.Which cabbage helps fight cancer?
Love broccoli. Vegetables not only contribute to a healthy diet, but they also help fight cancer. This is also why recommendations for healthy eating contain the rule: half of the daily diet should be vegetables and fruits. Particularly useful are cruciferous vegetables, which contain glucosinolates - substances that, when processed, acquire anti-cancer properties. These vegetables include cabbage: regular cabbage, Brussels sprouts and broccoli.
7. Red meat affects which organ cancer?
The more vegetables you eat, the less red meat you put on your plate. Research has confirmed that people who eat more than 500g of red meat per week have a higher risk of developing colorectal cancer.
8.Which of the proposed remedies protect against skin cancer?
Stock up on sunscreen! Women aged 18–36 are especially susceptible to melanoma, the most dangerous form of skin cancer. In Russia, in just 10 years, the incidence of melanoma has increased by 26%, world statistics show an even greater increase. Both tanning equipment and sun rays are blamed for this. The danger can be minimized with a simple tube of sunscreen. A 2010 study in the Journal of Clinical Oncology confirmed that people who regularly apply a special cream have half the incidence of melanoma than those who neglect such cosmetics.
You need to choose a cream with a protection factor of SPF 15, apply it even in winter and even in cloudy weather (the procedure should turn into the same habit as brushing your teeth), and also not expose it to the sun's rays from 10 a.m. to 4 p.m.
9. Do you think stress affects the development of cancer?
Stress itself does not cause cancer, but it weakens the entire body and creates conditions for the development of this disease. Research has shown that constant worry alters the activity of immune cells responsible for triggering the fight-and-flight mechanism. As a result, a large amount of cortisol, monocytes and neutrophils, which are responsible for inflammatory processes, constantly circulate in the blood. And as already mentioned, chronic inflammatory processes can lead to the formation of cancer cells.
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Removal of intestinal polyps is a surgical operation that consists of eliminating these benign tumors that attach to the intestinal walls and grow deep into the intestinal lumen.
Having a habit of growing in any part of the large or small intestine, polyps, differing in size and structure, can be discrete and multiple in nature.
Polyps of a discrete nature are distinguished by a single arrangement of several benign neoplasms located far from each other.
If there are hundreds of such neoplasms, they speak of the multiple nature of the polyps. If their number significantly exceeds this indicator, the patient is diagnosed with diffuse polyposis. It is in this case that the risk of their malignancy is greatest.
Indications and contraindications for surgery
Indications for removal are:
- the presence of bleeding and copious discharge of mucus from the anal canal;
- feeling of severe discomfort;
- constant pain in the lower abdomen;
- violation of active intestinal motility;
- development ;
- ulceration of the intestinal mucous membranes.
Surgical removal of intestinal polyps is strictly contraindicated if the patient has:
- diabetes mellitus;
- infectious diseases;
- pacemaker;
- acute inflammatory process in the area of the intestine subject to surgery, since this increases the likelihood of perforation of the intestinal wall affected by polyps.
Preparation
Since most intestinal polyps can be removed during the procedure of colonoscopy and sigmoidoscopy, the algorithm for preparing for surgery comes down to an identical set of bowel cleansing measures performed before these diagnostic studies.
In clinical practice, the following options for preparing for a colonoscopy procedure are most often used:
- 48 hours before the procedure, the patient is prescribed a strict slag-free diet. In the afternoon before surgery, the patient must take castor oil. One cleansing enema at home is performed in the evening and three (at half-hour intervals) in the morning before a colonoscopy. Since the procedure is usually scheduled for the first half of the day, eating is contraindicated. A few hours before surgery, the patient can drink a cup of weak tea or a glass of juice.
- The second preparation option, which is extremely popular these days in clinics all over the world, is based on the method of cleansing the intestines using the drug Fortrans.
To prepare the medicine, one sachet of powder is dissolved in 1000 ml of water. The prepared solution is taken in a glass every twenty minutes in the evening hours on the eve of the scheduled operation. For patients who are freed from the need to follow a slag-free diet and perform cleansing enemas, this method of preparation is more attractive. The big disadvantage of this option for colon cleansing is that not every patient is able to drink such an amount of medicine in such a short time. In some patients, taking Fortrans can provoke attacks of nausea and vomiting, a feeling of discomfort and heaviness in the abdominal cavity. Typically, such symptoms are typical for patients suffering from concomitant diseases. A large number of complaints are forcing doctors to look for new regimens for taking the drug Fortrans.
- The most common options are:
- It is proposed to divide the entire prepared solution into two equal parts, take one half in the morning, and the second in the afternoon hours of the day preceding the operation. On the day of surgery, the patient must drink another liter of medicinal solution.
According to the second option, the patient takes two liters of the diluted drug in the afternoon of the day preceding the procedure for removing polyps. He takes another liter of medicine on the morning of the operating day. According to reviews, it is this option of intestinal cleansing that is most easily tolerated by patients; In addition, with it there are significantly fewer side effects than with all the methods described above.
The use of Fortrans cannot help patients suffering from severe forms of heart failure and erosive and ulcerative lesions of the intestines, in which taking such an amount of fluid is simply contraindicated.
In these cases, the osmotic laxative Forlax is used to cleanse the intestines, which is used to relieve constipation in adult patients. The great advantage of this drug is that one serving dissolves in just a glass of water.
In some cases, a scheme is used where the patient is prescribed to take two sachets of Forlax in the morning and the same amount in the evening. Thanks to these actions, it is possible to relieve the proximal intestine. To cleanse its other parts, a light enema is performed.
Sometimes, instead of an enema, it is practiced to take half the dose of the drug on the eve of surgery. No complications have been reported in medical practice after cleansing the intestines with Forlax.
Another advantage of using Forlax is the absence of sugar in its composition, which makes it possible for diabetics and patients who have contraindications to taking galactose to take it.
Methods for removing polyps in the intestines
Conservative treatment of polyps, due to its insignificant effectiveness, is used only in the presence of serious contraindications to surgical intervention or for temporary relief of symptoms.During surgery, each detected polyp is removed, followed by histological examination to identify cancer cells.
According to experts, timely surgery to remove polyps is the leading preventive measure to prevent colorectal cancer.
In modern medical practice, the most popular operations are:
- endoscopic polypectomy with electrocoagulation of the removed tumor;
- transanal excision of the polyp;
- removal of benign neoplasms using colotomy.
Very often, polyps in the intestines are removed during the diagnostic procedure of colonoscopy. In this case, the diagnostic procedure is easily transformed into a therapeutic one.
Sometimes even malignant polyps that have a stalk and lack a network of venous and lymphatic vessels are removed in this way, but only if the degeneration affected only the head of the tumor.
Endoscopic polypectomy
This type of operation is used in relation to benign neoplasms localized in the middle sections of the intestine. Classified as a minimally invasive intraluminal surgical procedure, endoscopic removal of intestinal polyps is most often performed using local anesthesia.
Video about endoscopic removal of intestinal polyps:
During the operation, several stages are clearly visible:
- first, an endoscope is inserted into the patient’s intestine to the location of the polyp;
- a lead plate (passive electrode) is bandaged to the patient’s lower back;
- Having fixed the endoscope at the level of the polyp to be removed, a special endoloop is inserted into its biopsy channel, performing the function of a second electrode, and it is thrown onto the base of the benign neoplasm;
- the loop is gradually tightened and a high frequency current is applied to it;
- as a result of a two-second exposure to current, the area covered by the hot loop is charred, leading to reliable sealing of the ends of the cut vessels;
- after this, the specialist controls the hemostasis process;
- if necessary, take measures for additional electrocoagulation of the base of the removed polyp;
- the severed polyp is removed from the patient's body.
Large tumors are removed by biting, since a burn of the intestinal wall that is too deep can lead to perforation and an explosion of intestinal gases. To remove large polyps, biopsy forceps are used instead of an endoloop.
Pinching off parts from the head of the tumor is carried out in several stages. The tactics of gradual removal are also used in case of multiple polyps with a cluster of tumors.
The operation of endoscopic polypectomy can be performed either by a qualified endoscopist or a proctologist who has the skills to perform both diagnostic and surgical therapeutic colonoscopy.
For endoscopic removal of large (over two centimeters) neoplasms, villous or multiple polyps, a control endoscopy procedure is performed after a year. If there is no recurrence of polyposis, it is recommended to monitor the condition of the intestines using colonoscopy once every three years.
Laparoscopy
Laparoscopic operations are used for benign neoplasms of large (over two centimeters) sizes.Unlike classical operations that require large incisions, they are performed through small punctures of the abdominal wall using special laparoscopic surgical instruments.
Operations of this type require the use of general anesthesia and a fairly long rehabilitation period.
Laparotomy
If it is impossible to remove polyps using endoscopic polypectomy (usually this applies to polyps that have a wide base), a laparotomy (with opening of the abdominal cavity) operation is performed to excise them through an incision in the wall of the affected intestine.
To remove such polyps and fleecy neoplasms on thick stalks, colotomy is also used - an operation that requires access through the abdominal wall. The sigmoid colon affected by polyposis is removed through an incision in the lower iliac region or an inferomedial incision.
Having determined by touch the location of the polyp, soft pulp is applied to both ends of the extracted intestine and, after making a longitudinal incision in the intestinal wall, the neoplasm is excised along with part of the adjacent mucous membrane tissue (after excision, sutures are placed on them). For suturing the intestinal wall, a suture in two rows is used, and for the abdominal wall, a blind layer-by-layer suture is used.
Bowel resection
Intestinal resection is an operation to eliminate polyps, involving the need to cut the abdominal wall and remove part of the intestine affected by multiple tumors. This method is used specifically in relation to the accumulation of polyps localized in a certain area of the intestine.
If this collection is concentrated in the upper segment of the rectum, anterior resection is performed. During surgery, it is this part of the rectum that is to be removed, along with the lower segment of the sigmoid colon located above it. At the final stage of the operation, the ends of both intestines are sutured.
If the accumulation of tumors is concentrated in the very center of the rectum, a low anterior resection is performed.
Localization of polyps in the lower segment of the rectum is an indication for transanal excision performed through the anal canal. Full recovery for a patient who has undergone bowel resection requires at least four weeks.
Complications
Polypectomy surgery can lead to a number of complications, the most common of which are:- Bleeding. The likelihood of occurrence remains for ten days after removal of polyps. Bleeding from the anus, which developed the very next day after polypectomy, indicates insufficient efficiency of coagulation of the base of the removed polyp. Bleeding that occurs a few days after surgery is most often caused by the rejection of a blood clot that has formed at the ends of the cut blood vessels. The intensity of both early and late bleeding can be either insignificant or significant enough to threaten the patient's life. In this case, emergency surgical intervention is necessary, carried out using endoscopic instruments and consisting of cauterization (coagulation) of the bleeding blood vessels. If it is not possible to stop the bleeding using coagulation, specialists resort to laparotomy - an operation that requires opening the abdominal cavity.
- Damage (perforation) of the intestinal walls. This complication can occur both during and after surgery. The formation of a hole in the intestinal wall is a consequence of a deep burn resulting from cauterization of a removed polyp. Through this hole, the contents of the intestine can enter the abdominal cavity, giving impetus to the process of infection. To eliminate this complication, a laparotomy (an incision in the abdominal wall) is performed, followed by suturing the opening that appears and applying it (it is necessary in order to temporarily exclude the injured area of the intestine from the passage of feces). After the repaired defect has completely healed (usually after 8-16 weeks), the colostomy is removed.
- Cases of recurrence of benign neoplasms. After surgery to excise polyps, 15% of patients remain at risk of their recurrence within the next two years.
Recovery in the postoperative period
The most important component of the postoperative period for a patient who has undergone surgery to remove polyps in the intestine is careful adherence to a gentle diet that helps restore the motor and evacuation functions of the intestine.
The therapeutic diet of the operated patient consists of three stages:
- The first stage begins immediately after the operation and continues for three days after it. During the first 24 hours after surgery, the patient is completely prohibited from eating and drinking. After this period, he is allowed to quench his thirst with a small (no more than 50 ml) amount of water, and a little later - drink a little vegetable broth and compote. After twelve hours, the patient is offered some rice water, meat broth or jelly. All restrictions are aimed at minimizing the motor activity of the intestine and reducing its excretory functions, since digestive enzymes and bile released during the digestion of food can have a negative impact on the condition of sutures and injured tissues.
- After 72 hours after surgery In the patient's diet, carefully monitoring his condition, slimy soups, thin porridges (from rice, millet and oatmeal), and soufflé from lean meat are introduced. If after eating a particular dish the patient experiences pain or increased gas formation, it is removed from the diet. The goal of this stage of the therapeutic diet is to normalize stool and gradually increase the load on the intestines.
- Two weeks after the operation, the third stage of a gentle diet begins(lasting at least four months). Eating foods rich in coarse plant fibers is detrimental to the operated patient. His diet should consist of broths, vegetable and cereal soups, pureed porridges, dietary pates and soufflés.
The following are completely excluded from the patient’s diet:
- all types of spices, hot seasonings, sauces and salt;
- sour, salty, peppery and spicy foods;
- mushrooms (in any form);
- fatty fish and meats;
- raw fruits and vegetables;
- canned foods;
- too hot or cold food;
- freshly baked bread. Instead of fresh bread, which causes fermentation processes in the intestines, the patient is recommended to eat crackers. For the same reason, he should avoid eating legumes, asparagus and nuts.
The preferred methods of cooking food should be boiling, baking and steaming. Fruit compotes and teas, herbal infusions, milk and kefir will be useful for drinking.
A recovering patient should eat food (at least six times a day) at the same hours, in very small portions: this will improve intestinal motor functions, and the load will not be too significant.
Growths on the mucous membrane are polyps. This pathology is very common. Some types have a high chance of developing into cancer. There is no conservative treatment for polyps, so radical methods may be the only way out. Do polyps need to be removed? How is this done? And to whom is surgery contraindicated? We will answer these and other questions in detail in the prepared material.
The following types are considered the most dangerous:
- Adenomatous. The polyp tissue is glandular. It is prone to hyperplasia (rapid growth) and metaplasia (transformation). Such polyps can not only become cancerous in the future, but also grow to a size of several centimeters, which will impede bowel function.
- A villous polyp most often does not occur alone. Many formations cover a large area of the inner lining of the intestine. They have a high probability of malignancy and disrupt the normal functioning of the organ.
- Diffuse polyposis. If a normal polyposis is considered to be an accumulation of 10 to 100 formations, then the diffuse condition is characterized by an even larger number of up to several thousand growths. This pathology is very dangerous and can turn into a cancerous tumor.
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Expert opinion
Olga Yurievna Kovalchuk
Doctor, expert
Attention! A large polyp can completely block the intestinal lumen and thereby lead to its obstruction. If the situation is not corrected, death is possible.
The main danger of having such polyps is that they do not give any symptoms until very serious problems occur.
Is treatment possible with medications?
There is no drug that has proven effectiveness in the treatment of polyps. However, tablets, injections and other forms of conservative methods are used for some cases:
- If an inflammatory process is detected on the intestinal mucosa.
- There is an infection not only of this organ, but also of the body as a whole.
- When observation is indicated, drugs that enhance immunity and general strengthening are prescribed.
- The patient’s life can be made easier by symptomatic treatment of polyps, which will relieve the unpleasant manifestations of the disease.
Contraindications for surgery
Surgery is not always possible; there are a number of restrictions even if the polyp needs to be removed.
Temporary:
- Menstruation period in women.
- Infection.
- Inflammation.
- History of epilepsy.
- Diabetes.
- Presence of a pacemaker in the body.
There may be other contraindications; as a rule, this is due to the patient’s serious condition due to chronic diseases.
Types of surgery
Treatment of polyps by eliminating them - polypectomy can be carried out in different ways. The choice is made by the doctor based on the specifics of the particular case.
Preparation
Before the operation, the patient needs to go through a preparatory stage, during which it is necessary:
- Tell your doctor about any medications you have recently taken.
- Drink 3–3.5 liters of water per day, which precede the removal process.
- Switch to liquid and semi-liquid foods during this period.
- 12 hours before surgery, eat nothing at all.
- Complete an enema cleansing procedure before surgery.
Endoscopic method
Direct separation of the polyp from the mucous membrane is carried out in the following ways:
- Electrocoagulation. A special loop is put on the polyp and, using a current, it is cut off at the base. The thick stem of the formation will have to be treated with a special preparation. The removed fragment is sent for histology to determine the severity of the disease.
- Laser treatment. This method is used to burn out the polyp. The method is convenient because the healing time is significantly reduced. However, there is no material left for histology. Such treatment is carried out in paid clinics, and it will cost several thousand rubles, depending on the complexity of the situation. The laser is not used in the blind and colonic region of the intestine due to the very thin wall.
- Excision with special forceps is used for large growths on which it is impossible to throw a loop.
This operation does not require hospitalization of the patient. How long it will last depends on the location of the polyps and the complexity of the process. Upon completion, the patient can return to normal life with some dietary restrictions.
Laparoscopy
This method is used for difficult-to-reach locations of large polyps. An endoscopic instrument is inserted through a puncture in the abdomen. Otherwise the procedure is similar to the previous one.
Transanal operation
Surgery to remove a polyp in the rectum and anal area is performed using a rectal speculum without the use of endoscopic instruments. Anesthesia can be either local or general, depending on the situation.
Colotomy
This is an open operation through an incision in the peritoneum. Recommended for the elimination of large formations in the sigmoid colon and for resection - removal of part of the intestine affected by villous polyposis. The abdominal procedure is performed under general anesthesia. Duration depends on many factors within 2-4 hours. The patient should remain in a hospital setting during the postoperative period until recovery and undesirable consequences are eliminated.
Segmental resection of the large intestine is used in cases of cancer.
Complications after surgery
The endoscopic method rarely leads to anything dangerous. The patient is monitored for 2 or more years with regular examinations.
Abdominal surgeries do not always go smoothly; the following adverse consequences are possible:
- Internal bleeding from the wound. The risk exists in the first 10 days after removal.
- Blood clot formation.
- General anesthesia can damage the heart and lungs.
- Disruption of the gastrointestinal tract.
- Wound infection.
- Damage to the organ wall.
Therefore, after abdominal surgery under general anesthesia, the patient remains in intensive care under the special supervision of medical staff. During this period, he needs a proper return to a normal diet.
Prohibited products:
- Whole vegetables and fruits without heat treatment.
- Fresh bread, cabbage, legumes, yeast baked goods.
- Sausages, smoked meats.
- Soda and juices from packages.
- Ingredients with a high content of acids.
- Spices, hot, salty dishes.
- Mushrooms in any form.
- Sauces, marinades.
- Home and industrially canned food.
- Fried and fatty foods.
- Hot and cold food.
- Tonic drinks. Coffee, strong tea, energy drinks.
- Alcohol.
Food should be crushed as much as possible, warm in a small volume and often. An additional condition is sufficient water consumption. From compliance
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Can cancer be prevented?