Health Topics for Digestive System

James A. Clifton Center for Digestive Diseases

Cancers of the Digestive System

Liver Failure Clinic

Liver Service

Rectal polyps

Rectal polyps are small growths that project from the lining of the rectum or colon. Although they are not cancerous, they have the potential to become cancer. While most polyps do not become cancerous, most cancers of the colon start with polyps. This is why polyps should be removed and the entire colon checked for more polyps.

Most polyps are found in people over 50 who have no other symptoms. Polyps do not usually cause any symptoms. Undetected blood loss and resulting anemia may occur. A large polyp may form an ulcer, which usually causes bloody stools. Polyps may develop after a flare-up of colitis.

Polyps tend to run in families. There are a few inherited conditions in which many polyps appear at an early age. In these conditions, cancer almost always develops, so the standard treatment is to remove the entire colon. The conditions are rare and account for less than 1 percent of all colon and rectal cancers.

Cancer screening tests are important to identify polyps and signs of cancer in the colon. The tests for examining the colon include a fecal occult blood test, a colonoscopy, flexible sigmoidoscopy, or barium x-ray. A fecal occult blood test is a quick sampling of some stool to check for blood. Even though the healthcare provider may do a quick sample in the office, the best way for the fecal occult blood test to be done is a take-home multiple test with samples of stool from 3 different days sent to the provider. A colonoscopy is a visual check of the colon with a long flexible instrument through which the doctor can look at the lining of the colon and remove polyps. A sigmoidoscopy is a flexible tube with a light that allows direct viewing of the lining of the lower one-third of the colon. A barium x-ray combines a barium enema with x-rays of the colon.

For all men and women 50 years of age or older, who are at average risk of colon cancer, the American Cancer Society recommends the following screening tests for colon cancer:

• fecal occult blood test every year OR
• flexible sigmoidoscopy every 5 years OR
• fecal occult blood test every year with a flexible sigmoidoscopy every 5 years OR
• colonoscopy every 10 years OR
• double contrast barium enema every 5 years

Of the first three options, the American Cancer Society recommends the third option, of the fecal occult blood test every year and the flexible sigmoidoscopy every 5 years. If the fecal occult blood test is positive then a colonoscopy would be done instead of the sigmoidoscopy. The take-home multiple sample method of fecal occult blood test is the one that should be done.

Anyone who has a polyp removed that is cancerous needs to have another colonoscopy within 3 years. This is important because once a person has one polyp, they are more likely to have another polyp later.

If any of these tests (except colonoscopy) are positive, they should be followed up with a colonoscopy. Anyone who has a relative in the immediate family who has had colon cancer, or has a history of polyps is considered at higher risk. These higher risk people need to have the tests more often as discussed with their healthcare provider.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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