A rectal polyp is an abnormal tissue growth that develops in the rectum, which is the final section of the large intestine before it connects to the anus. Rectal polyps are common, especially as people age. Most are harmless, but some polyps can eventually turn cancerous if not removed. Consulting the Best Gastroenterologist in Mumbai can help determine if a rectal polyp excision is needed to remove polyps that develop in the rectum.
Causes of Rectal Polyps
There are various causes and types of rectal polyps. The most common varieties include:
- Hyperplastic polyps – Comprise about 80% of all rectal polyps. Slow growing and usually harmless.
- Adenomatous polyps – Also called adenomas. Can develop into cancer over time, especially if >1cm.
- Inflammatory polyps – Form as a result of ongoing colitis or inflammatory bowel disease.
- Hamartomatous polyps – Caused by an overgrowth of normal tissue. Low cancer risk.
Symptoms of Rectal Polyps
Small polyps often produce no signs or symptoms. Larger polyps may cause:
- Rectal bleeding – Fresh blood in stool or on toilet paper is the most common symptom.
- Mucus discharge – Excess mucus from the rectum.
- Change in bowel habits – Constipation, diarrhea, or feeling like bowels don’t empty completely.
- Bowel obstruction – Large polyps can partially block stool passage.
- Rectal pain – Some patients experience discomfort, fullness or pain.
Diagnosing Rectal Polyps
If polyp symptoms are present, the following tests can help diagnose rectal polyps:
- Digital rectal exam – The doctor feels inside the rectum for abnormalities.
- Anoscopy – A small scope examines the lower rectum and anus.
- Flexible sigmoidoscopy – Views the sigmoid colon and rectum using a flexible lit scope. Can biopsy polyps.
- Colonoscopy – Views entire colon and rectum. Polyps can be removed during this test.
- CT colonography – This imaging test visualizes the colon and rectum. Helps identify larger polyps.
- Biopsy – Removal of a polyp sample for laboratory analysis. Determines if cancerous.
Deciding Which Polyps to Remove
Not all polyps require removal. The gastroenterologist will assess factors like the polyp’s size, shape, type and location to determine management. In general:
- Polyps <5mm – Usually safe to leave alone and monitor with follow-up colonoscopies.
- Polyps 5-10mm – Removal often recommended, depending on type and risk factors.
- Polyps >10mm – Almost always removed due to increased cancer risk.
- Pedunculated polyps – Easier to remove and tend to have lower malignancy rates.
- Sessile polyps – Higher chance of developing into cancer compared to pedunculated.
- Villous adenomas – More likely to become cancerous than other adenomas.
- Dysplastic polyps – Removal is advised due to precancerous changes.
Rectal Polyp Excision Procedures
If polyp removal is indicated, common techniques include:
Colonoscopy Polypectomy
- The most common method. Done during a screening or diagnostic colonoscopy.
- A wire loop at the end of the scope cuts the polyp off the intestinal wall.
- Electrocautery can prevent bleeding from the excision site.
- Retrieved polyps sent for biopsy.
Transanal Endoscopic Microsurgery
- Uses a special scope inserted through the anus to resect rectal lesions.
- Lets the surgeon view the polyp directly rather than through the colonoscope tube.
- Works well for large sessile polyps not amenable to conventional colonoscopic removal.
Transanal Excision
- Rectal polyps can be directly cut out through the anal opening without colonoscopy.
- Local anesthesia used. Stay in hospital not always required.
- Used for smaller, low-lying polyps that can be easily reached.
Surgery
- Full rectal surgery may be done if the polyp appears cancerous or surgery is needed to remove all of it.
- Portions of the rectum may be resected depending on size and position of the polyp.
Recovery and Follow-Up Care
- Mild discomfort, bleeding and bowel changes are common after polyp removal.
- Most patients can resume normal activities in 1-3 days.
- Follow-up colonoscopy is advised to check for new polyp growth, usually in 3-5 years.
- More frequent colonoscopy may be recommended for large or dysplastic polyps.
Rectal polyps are common but those at risk for becoming cancer should be removed. Various endoscopic and surgical techniques allow for safe and effective polyp excision. Appropriate follow-up and surveillance are key to preventing recurrences. The typical rectal polyp excision cost in Mumbai ranges from ₹20,000 – ₹40,000 depending on the technique used and medical fees. Insurance usually covers a portion of the costs when the procedure is medically necessary.
