What Is a Rectal Polyp?

Rectal polyps generally refer to the protruding lesions of the rectal mucosal surface protruding to the intestinal cavity. Rectal polyps are mostly distributed at the lower end of the rectum, are round, have slender pedicles, and are mostly composed of mucous membranes and glands, which are connected to the intestinal wall. There are also polyps that are broad-based and sessile. Most are single and few are multiple. Rectal polyps can be divided into inflammatory, proliferative, adenoma and hamartoma polyps. Adenomatous polyps can be malignant, but are rare in children. Rectal polyps are a common cause of blood in the stool of children. Some polyps grow close to the anal canal and can prolapse at the anus after the stool.

Basic Information

Causes of rectal polyps

The etiology is still unclear. Adenomatous polyps may be associated with abnormal expression of genes caused by environmental factors; proliferative polyps or inflammatory polyps are associated with infection and injury.

Clinical manifestations of rectal polyps

Blood in the stool

Painless blood in the stool is the main clinical manifestation of rectal polyps. Polyp has less bleeding in the blood of the stool. When the defecation causes the polyp to fall off due to squeezing, and the polyp is large in volume and low in position, a large amount of blood in the stool can occur. Blood in the stool is characterized by blood in the stool without bleeding.

2. Prolapse

When the polyp is large or large, the intestinal mucosa is pulled due to gravity, which gradually separates from the muscular layer and prolapses downward. Defecation movement and bowel movement stimulation can relax the mucosal layer around the pedicle and can cause rectal prolapse.

3. Intestinal irritation

Intestinal peristaltic symptoms such as abdominal discomfort, abdominal pain, diarrhea, pus and bloody stools, and post-emergency symptoms can occur when bowel movements pull the polyps.

Rectal polyps

1. Digital rectal examination can touch round masses as soft as the size of soybean grains, which can move without tenderness. Polyps that are higher or smaller are not easily found by digital rectal examination.

2. Proctoscopy: Adenomatous polyps are red and shiny with round surface mucosa; inflammatory polyp pedicles are long red; proliferative polyps are mostly mound-like raised nodules.

3. Barium enema examination can show filling defects.

4. Histopathological examination can determine the nature of polyps.

Rectal polyps diagnosis

The pedicled polyps in the lower position are prolapsed during defecation and can be diagnosed by visual inspection. If there is painless blood in the stool, it can also be diagnosed by touching the active soft mass or seeing polyps through digital diagnosis. If no lesions are found in the above examination, the sigmoid colon, fiber colonoscopy (or electronic colonoscopy) examination or gas-barium enema angiography should be performed to determine its position, number, size, character and range. At the same time, a pathological examination was performed to determine whether there was cancer.

Rectal Polyps Treatment

Except for small mound-like proliferative hyperplastic polyps, which can be regularly checked and closely observed, surgical treatment is generally required.

Electrocautery

Small polyps with smooth mucosa and no tendency to malignant can be burned directly, and pedicled polyps can be burned with a ferrule at the root of the pedicle.

2. Ligation

For a polyp with a diameter of about 1 cm, a rubber band is placed on the base of the pedicle with a ligation device to gradually fall off the ischemia.

3. Surgical resection

Those with thick pedicles or broad-based polyps with suspected malignant changes and larger polyps 6 to 7 cm away from the anus can be sutured and resected through the anus at the root of the polyp under anesthesia. Those who cannot be removed by the above method can be transabdominal or transsacral Remove the polyps. At present, hospitals with conditions can also use transanal endoscopic microsurgery (TEM), which combines three techniques of endoscopy, laparoscopy and microsurgery, to remove wide-based pedicled rectal polyps, minimally invasive and skinless. The incision is well-exposed and accurate. It can remove higher rectal polyps and obtain high-quality surgical specimens.

Rectal polyp prevention

1. Develop good eating habits, eat more fresh vegetables and fruits, increase the content of dietary fiber, reduce the opportunity and time for toxic and harmful substances to contact the intestinal wall, and try to eat less fried, smoked and pickled foods.

2. Develop a good lifestyle, increase physical exercise, and thus improve the body's immunity.

3. People with a family history of colorectal polyps and a history of polyps should be checked regularly in order to detect polyps early and deal with them in a timely manner.