Colorectal Adenoma: Symptoms, Causes, and Treatment
A colorectal adenoma is a benign tumour that develops from the glandular cells lining the colon or rectum. These growths, also known as adenomatous polyps, can progress to become cancerous over time if left untreated. While most adenomas remain non-cancerous, their removal during screening significantly reduces the risk of colorectal cancer development.
This article explores the signs, risk factors, and treatment options for identifying and managing colorectal adenomas.
Symptoms of Colorectal Adenoma
The presence of colorectal adenomas may manifest through various physical signs that warrant medical attention.
Blood in Stool: Blood appears in the stool or on toilet paper after bowel movements, ranging from bright red to dark in colour.
Unexpected Bowel Changes: Alternating periods of constipation and diarrhoea occur, along with changes in stool consistency.
Persistent Stomach Discomfort: Persistent cramping or pain in the lower abdomen develops, often accompanied by bloating.
Unexplained Fatigue: Ongoing bleeding from adenomas can lead to anaemia, causing fatigue and weakness.
What Causes Colorectal Adenomas?
Several factors contribute to the development of colorectal adenomas, affecting both their formation and growth rate.
Age: The likelihood of developing adenomas increases after age 50, with higher prevalence in older populations.
Family History: Individuals with first-degree relatives affected by colorectal adenomas face an elevated risk.
Lifestyle Factors: Diets high in processed meats and low in fibre, combined with physical inactivity, increase adenoma formation risk.
Genetic Conditions: Inherited syndromes like FAP (Familial Adenomatous Polyposis) predispose individuals to adenoma development.
Types of Adenomas
Colorectal adenomas present in distinct forms, each with specific characteristics that influence their management approach.
Tubular Adenomas
These account for most adenomas, featuring tube-like glands within their structure. They typically grow slowly and have a lower risk of becoming cancerous. The appearance is often small and mushroom-shaped.
Villous Adenomas
These adenomas contain finger-like projections and tend to be larger and flatter in shape. They carry a higher risk of developing into cancer and often require more extensive removal procedures.
Tubulovillous Adenomas
These combine features of both tubular and villous types. Their cancer risk falls between that of tubular and villous adenomas, and their size varies considerably.
Diagnostic Methods
Complete Colon Examination
This procedure allows direct visualisation of the entire colon using a flexible scope. The doctor can identify, photograph, and remove adenomas during the same procedure. The process typically takes 30-60 minutes under sedation.
Virtual Colon Scanning
This imaging technique creates detailed cross-sectional images of the colon. It serves as an alternative for patients who cannot undergo traditional colonoscopy but require a separate procedure for polyp removal.
Partial Colon Examination
This examination inspects the lower third of the colon. The procedure takes about 15 minutes and typically requires minimal preparation compared to a full colonoscopy.
Treatment Options
Treatment options are selected based on factors such as adenoma size, type, location, and quantity.
Non-Surgical Treatment
Polypectomy
This outpatient procedure removes adenomas during a colonoscopy using specialised tools such as snares or forceps. It is a straightforward and minimally invasive method, allowing patients to return home the same day with minimal recovery time.
Endoscopic Mucosal Resection (EMR)
For larger or complex adenomas, fluid is injected beneath the lesion to lift it, enabling removal in sections. This technique preserves surrounding healthy tissue and reduces the risks associated with more invasive treatments.
Surgical Treatment
Laparoscopic Colectomy
A minimally invasive procedure involving several small incisions to remove affected sections of the colon. This approach typically results in shorter hospital stays, quicker recovery, and reduced post-operative discomfort compared to traditional open surgery.
Open Colectomy
A more extensive surgical method performed through a larger abdominal incision. This is often chosen for complicated cases where direct access to the colon is needed or when other methods are unsuitable. It allows surgeons to address challenging or widespread conditions effectively.
Prevention and Management
Regular screening beginning at age 45 for average-risk individuals helps detect adenomas early. A diet rich in vegetables, fruits, and whole grains, combined with regular physical activity, supports prevention.
After adenoma removal, patients require follow-up colonoscopies at intervals determined by their risk factors and findings from previous examinations. Smoking cessation and limiting alcohol consumption further reduce risk.
Conclusion
Managing colorectal adenomas requires a comprehensive approach involving regular screening, prompt treatment, and lifestyle modifications. Early detection through screening programmes provides the best opportunity for successful treatment and prevention of complications.
Schedule a consultation today to explore suitable treatment approaches tailored to your specific condition.