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Your search term(s) "polyps" returned 20 results.
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Adenoma-Adenocarcinoma (Excluding Adenomatous Polyposis). IN: Wexner, S.; Stollman, N., eds. New York, NY: Informa Healthcare USA. 2007. pp 477-516.
This chapter about adenoma and adenocarcinoma is from a comprehensive text that offers chapters about each of the major colonic disorders. Each chapter is coauthored by at least one surgeon and one gastroenterologist to reflect the in-depth collaboration between these fields that is required for managing diseases of the colon. In this chapter, the authors discuss epidemiology, specific environmental associations, other risk factors, the pathogenesis of colonic neoplasms, screening for colorectal neoplasia, chemoprevention, clinical presentation and diagnosis, adenomatous polyps, colorectal cancer (CRC) staging, the surgical management of colon cancer, surgical resection, chemotherapy for CRC, and postoperative surveillance for CRC. The authors stress that through the identification and removal of adenomatous colorectal polyps, opportunities exist not just for early detection but also for prevention of CRC. Most CRCs develop in previously benign adenomas. Surgery remains the mainstay of curative therapy. The authors note that, unfortunately, neither screening nor chemoprevention is at present widely used in the general population. The chapter includes black-and-white illustrations and concludes with an extensive list of references. 8 figures. 9 tables. 249 references.
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Colon Polyps: What You Need to Know. Polipos En El Colon: Lo Que Usted Debe Saber. Bethesda, MD: National Digestive Diseases Information Clearinghouse. 2007. 4 p.
This fact sheet familiarizes readers with colon polyps, small clumps of extra tissue that grow inside the large intestine, also called the colon. Most polyps are benign, which means they are not cancerous. Written in a question-and-answer format, the fact sheet covers the risk factors for colon polyps, the symptoms of colon polyps, how to know if one should be tested for colon polyps, treatment options, and how to contact the National Digestive Diseases Information Clearinghouse (NIDDK) for more information. This fact sheet is from the NIDDK Awareness and Prevention Series. The fact sheet is presented in English and Spanish (2 pages each).
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Colonic Polyps in Children and Adolescents. Canadian Journal of Gastroenterology. 21(4): 233-239. April 2007.
This review article considers colonic polyps in children and adolescents, covering isolated juvenile polyps, juvenile polyposis syndrome (JPS), familial adenomatous polyposis (FAP), attenuated familial adenomatous polyposis (AFAP), and mutY homologue (MYH)-associated polyposis (MAP). The author notes that colonic polyps most commonly present with rectal bleeding in children; juvenile refers to the histological type of polyp and not the patient’s age at onset of the polyp. Adolescents and adults with multiple juvenile polyps are at a significant risk of intestinal cancer. Both adult and pediatric gastroenterologists must try to determine the risk of colorectal cancer in people with juvenile polyposis syndrome. AFAP can occur either by a mutation at the extreme ends of the adenomatous polyposis coli gene or by biallelic mutations in the MYH gene. The identification of MYH-associated polyposis as an autosomal recessive condition has important implications for screening and management strategies. The authors conclude with a brief discussion about compliance with surveillance recommendations and future directions. 5 figures. 2 tables. 47 references.
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Gastrointestinal Polyposes: Clinical, Pathological and Molecular Features. Gastroenterology Clinics of North America. 36(4): 927-946. December 2007.
This article on neoplastic precursor lesions related to the development of cancer in patients with inflammatory bowel disease (IBD) is from a special issue of Gastroenterology Clinics of North America that focuses on the pathology and clinical relevance of neoplastic precursor lesions of the gastrointestinal tract, liver, and pancreaticobiliary system. The author focuses mainly on noninflammatory epithelial polyposes, particularly the diagnostically important morphological and molecular features of the more recently recognized or more poorly understood conditions. These include familial adenomatous polyposis, attenuated familial adenomatous polyposis, Lynch syndrome, flat adenomas, MUTYH-associated polyposis, multiple adenomas, Peutz-Jegher syndrome, Cowden and Bannayan-Riley-Ruvalcaba syndromes, juvenile polyposis, hereditary mixed polyposis syndrome, hyperplastic polyposis, and colorectal polyposis. The author concludes that the diagnosis of some forms of polyposis is straightforward; others may easily be confused with each other. The number and type of polyps are of utmost importance in achieving an accurate diagnosis, which in turn depends on adequate polyp sampling and knowledge of the morphology of each type. 5 figures. 1 table. 108 references.
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Hyperplastic and Serrated Polyps of the Colorectum. Gastroenterology Clinics of North America. 36(4): 947-968. December 2007.
This article on hyperplastic and serrated polyps of the colorectum is from a special issue of Gastroenterology Clinics of North America that focuses on the pathology and clinical relevance of neoplastic precursor lesions of the gastrointestinal tract, liver, and pancreaticobiliary system. The author notes that the serrated polyp pathway is different from the traditional adenoma-carcinoma sequence. The serrated polyp pathway begins with a hyperplastic polyp, or precursor serrated aberrant crypt focus, and has the potential to end as a colonic adenocarcinoma. The author describes the markers for this pathway, the molecular process, and other serrated pathways. The author concludes by calling for clinical studies to determine the natural history of serrated neoplasia and provide evidence-based guidance for risk assessment and surveillance of patients with various serrated polyp precursors. 5 figures. 100 references.
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New Post-Polypectomy Surveillance Guidelines. Practical Gastroenterology. 31(8): 30, 35-42. August 2007.
People found to have adenomatous polyps usually undergo polypectomy and then are placed into a surveillance program of periodic colonoscopy to remove missed synchronous and new metachronous adenomas and cancers. This article reviews new postpolypectomy surveillance guidelines issued by the United States Multi-Society Task Force on Colorectal Cancer and the American Cancer Society (USM-STF/ACS). The author outlines how this set of guidelines differs from earlier guidelines: They offer a consensus statement that strengthens the guidelines, they specifically examine predictors of advanced adenomas and incorporate them into the guidelines, and they emphasize the quality of baseline colonoscopy and its impact on detection of postpolypectomy colorectal cancer. The author maintains that risk stratification can reduce the intensity of follow-up evaluation in a substantial proportion of these patients, so limited colonoscopy resources could be shifted from surveillance to screening and diagnosis. The article includes the recommendations, addition surveillance considerations, and a discussion of their implications for clinical practice. 8 tables. 67 references.
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Other Benign and Malignant Colonic Tumors. IN: Wexner, S.; Stollman, N., eds. Diseases of the Colon. . New York, NY: Informa Healthcare USA. 2007. pp 517-542.
This chapter about benign and malignant colonic tumors is from a comprehensive text that offers chapters about each of the major colonic disorders. Each chapter is coauthored by at least one surgeon and one gastroenterologist to reflect the in-depth collaboration between these fields that is required for managing diseases of the colon. In this chapter, the authors discuss lipoma, colorectal lymphoma, leiomyomas, and carcinoids; adenocarcinoma is covered in a previous chapter. For each type, the authors consider epidemiology, presentation, pathogenesis and risk factors, diagnostic approaches, patient management, and expected outcome. Lipomas are the most common, benign, nonepithelial tumors found in the colon. Colorectal lymphoma is less common than primary lymphoma in the stomach and small bowel. The diagnosis of colorectal lymphoma is usually made at laparotomy. Leiomyomas are thought to be of smooth muscle origin and are rare colonic lesions; they are usually asymptomatic and discovered incidentally. Carcinoid tumors are those with malignant potential, and both rectal and colonic carcinoids are extremely rare. The chapter includes black-and-white illustrations and photographs and concludes with an extensive list of references. 3 figures. 5 tables. 193 references.
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Pharmacological Prevention of Colorectal Cancer. Practical Gastroenterology. 31(10): 20-30, 35-36. October 2007.
This article reviews the current status of the pharmacological prevention of colorectal cancer (CRC). The authors note that CRC tends to develop through a multistep process that occurs over a period of years, permitting many opportunities for intervention and cancer prevention. The authors briefly discuss the natural history of adenomatous polyps and CRC, as well as the identification of individuals at risk for CRC, and address the use of chemoprevention. Chemoprevention involves the long-term use of nutritional or pharmaceutical agents that can delay, prevent, or even reverse the process of CRC development. The authors discuss the use of nonsteroidal anti-inflammatory drugs (NSAIDs) as well as a new group of agents, the nitric-oxide-releasing NSAIDs (NO-NSAIDs). Other drugs discussed include HMG-CoA reductase inhibitors (statins), ursodeoxycholic acid, difluromethaylornitine (DMFO), and hormone replacement therapy (HRT). They note that, at present, the only approved drug for chemoprevention of CRC is celecoxib and that is indicated only in high-risk patients with familial adenomatous polyposis (FAP). Screening methods and surveillance continue to be the standard of care for high-risk patients with a history of CRC or adenomatous polyps and for the general population based on age. 64 references.
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Post-Polypectomy Surveillance: Who and How. Practical Gastroenterology. 31(7): 19-25. July 2007.
The most common neoplastic lesions found during screening tests are colorectal adenomas; their presence indicates a possible increased risk for future colorectal neoplasia. This article considers the guidelines for postpolypectomy surveillance of these patients. The author notes that high-quality baseline colonoscopy with excellent preparation, adequate examination, and complete polypectomy will reduce miss rates and should be the basis of any program of follow-up. Findings at baseline colonoscopy can be used to predict future risk and thus recommended surveillance intervals. High-risk adenomas justify a surveillance interval of 3 years; for those with one or two tubular adenomas, an interval of 5 to 10 years is adequate. Hyperplastic polyps warrant only an average-risk screening program. The author concludes that the implementation of these guidelines could free up procedures to support screening programs. 1 figure. 1 table. 11 references.
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Adenomatous Polyps. Riviera Beach, FL: AmeriPath, Inc. 2004. 2 p.
This fact sheet helps readers understand adenomatous polyps, abnormal noncancerous (benign) growths that may be precursor lesions to colorectal cancer. The fact sheet reviews the risk factors for adenomatous polyps; the types of diagnostic tests that may be used to diagnose polyps; the treatment options, notably colonoscopy; methods to help prevent colon cancer, including monitoring one's bowel habits and including dietary fiber in one's regular plan of eating; and recommended questions to ask of one's physician. The fact sheet concludes with a list of sources of additional information, primarily the web site addresses of professional and voluntary organizations. 1 figure.
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Hyperplastic Polyps. Riviera Beach, FL: AmeriPath, Inc. 2004. 2 p.
This fact sheet helps readers understand hyperplastic polyps, abnormal growths rising from the lining of the large intestine (colon) and protruding into the intestinal canal (lumen). Polyps are usually classified into two types: adenomatous polyps (adenomas) and hyperplastic polyps. Adenomas are the precursor lesions for colorectal carcinoma (colon cancer). The more common hyperplastic polyps are benign and, in most cases, not considered to be premalignant. The fact sheet reviews the types of diagnostic tests that may be used to diagnose polyps; the treatment options, notably colonoscopy; methods to help prevent colon cancer, including monitoring one's bowel habits and including dietary fiber in one's regular plan of eating; and recommended questions to ask of one's physician. The fact sheet concludes with a list of sources of additional information, primarily the web site addresses of professional and voluntary organizations. 1 figure.
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Neoplastic and Nonneoplastic Polyps of the Colon and Rectum. In: Textbook of Gastroenterology. 4th ed. [2-volume set]. Hagerstown, MD: Lippincott Williams and Wilkins. 2003. p. 1883-1913.
A polyp is any protrusion above the mucosal surface. Polypoid lesions of the large bowel are normally classified into three main subgroups: epithelial polyps, subclassified into neoplastic polyps (consisting of adenomas or carcinomas) and nonneoplastic polyps; and submucosal lesions (which produce a polypoid appearance). This chapter on polyps of the colon and rectum is from a comprehensive gastroenterology textbook that provides an encyclopedic discussion of virtually all the disease states encountered in a gastroenterology practice. The authors of this chapter discuss epidemiology, etiology and pathogenesis, the adenoma-carcinoma sequence, primary prevention, the signs and symptoms of polyps, morphologic and clinical features of neoplastic polyps and of nonneoplastic polyps, screening for adenomas, diagnosis of adenomas, natural history, therapy, follow up for metachronous adenomas and cancers, and the impact of polypectomy on cancer incidence and mortality. The chapter is illustrated with black-and-white reproductions of imaging studies and drawings. 17 figures. 8 tables. 480 references.
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Polyposis Syndromes. In: Textbook of Gastroenterology. 4th ed. [2-volume set]. Hagerstown, MD: Lippincott Williams and Wilkins. 2003. p. 1914-1939.
The polyposis syndromes are a group of conditions in which multiple gastrointestinal (GI) polyps occur in the lumen of the gut. Most of these syndromes are inherited, and most exhibit an increased risk for colon cancer. Many benign and malignant extraintestinal manifestations are also observed. Cancer prevention is often possible with proper management of patients and their families. Recent elucidation of their genetic and molecular etiologies has contributed immensely to the understanding of cancer pathogenesis and cell biology. This chapter on polyposis syndromes is from a comprehensive gastroenterology textbook that provides an encyclopedic discussion of virtually all the disease states encountered in a gastroenterology practice. The authors of this chapter cover familial adenomatous polyposis, syndromes with hamartomatous polyps, polyposis syndromes with neural polyp histology, polyposis syndromes of uncertain etiology, polyposis syndromes with inflammatory polyps, polyposis conditions arising from lymphoid tissue, and miscellaneous noninherited polyposis syndromes. The chapter is illustrated with black-and-white reproductions of imaging studies and photographs. 5 figures. 9 tables. 319 references.
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What I Need to Know About Colon Polyps. Bethesda, MD: National Digestive Diseases Information Clearinghouse, 2003. 20 p.
This brochure explains colon polyps, their causes, and how they can be managed. Written in nontechnical language, the brochure covers a definition of polyps, the typical symptoms of polyps, the risk factors and causes of polyps, how to know when to consult a health care provider, diagnostic tests to confirm the condition or determine the cause of the problem, treatment options, and how to prevent their occurrence or recurrence. A polyp is extra tissue that grows inside the colon; most polyps are not harmful. Symptoms may include constipation or diarrhea for more than a week, or blood on the underwear, on toilet paper, or in the stool. Many polyps do not cause symptoms. Doctors remove all polyps and test them for cancer. Readers who have symptoms, who are 50 years old or older, or who have someone in their family with polyps or colon cancer are encouraged to get tested for polyps. The booklet includes a summary of the information presented, a glossary of related terms, a list of resources where readers can get more information, and a list of acknowledgements. A final section briefly describes the goals and work of the National Digestive Diseases Information Clearinghouse (NDDIC). The brochure is illustrated with line drawings designed to clarify the concepts discussed in the text. 7 figures.
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Colonic Polyps and Polyposis Syndromes. In: Feldman, M.; Friedman, L.S.; Sleisenger, M.H. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 7th ed. [2-volume set]. St. Louis, MO: Saunders. 2002. p. 2175-2214.
A gastrointestinal (GI) polyp is a discrete mass of tissue that protrudes into the lumen of the bowel. Because of this protrusion into the bowel lumen and the stresses of the fecal stream to which they are subject, polyps may cause symptoms. Symptomatic polyps are uncommon; the greatest concern with polyps is their potential to become malignant. This chapter on colonic polyps and polyposis syndromes is from a comprehensive and authoritative textbook that covers disorders of the gastrointestinal tract, biliary tree, pancreas, and liver, as well as the related topics of nutrition and peritoneal disorders. Topics include neoplastic polyps (adenomatous and malignant polyps), non-neoplastic polyps, mucosal polyps, juvenile polyps, Peutz-Heghers polyps, inflammatory polyps (pseudopolyps), submucosal lesions, inherited polyposis syndromes, and noninherited gastrointestinal polyposis syndromes. The chapter includes a mini-outline with page citations, illustrations, and extensive references. 19 figures. 15 tables. 345 references.
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Gallbladder Polyps: Epidemiology, Natural History and Management. Canadian Journal of Gastroenterology. 16(3): 187-194. March 2002.
This article discusses polypoid lesions of the gallbladder, which affect approximately 5 percent of the adult population. Most affected individuals are asymptomatic, and their gallbladder polyps are detected during abdominal ultrasound performed for unrelated conditions. Although the majority of gallbladder polyps are benign, most commonly cholesterol polyps, malignant transformation (to cancer) is a concern. The differentiation between benign and malignant lesions can be challenging. Several features, including patient age, polyp size and number, and rapid growth of polyps, are important discriminating features between benign and malignant polyps. Based on the evidence highlighted in this article, the authors recommend resection in symptomatic patients, as well as in asymptomatic individuals over 50 years of age, or those whose polyps are solitary, greater than 10 millimeters in diameter, or associated with gallstones or polyp growth on serial ultrasonography. New imaging techniques, including endoscopic ultrasound and enhanced computed tomography (CT scan), may aid in the differential diagnosis of these lesions and permit better patient management. A brief patient care algorithm is provided. 3 figures. 3 tables. 66 references.
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Polypoid Diseases. In: Corman, M.L.; Allison, S.I.; Kuehne, J.P. Handbook of Colon and Rectal Surgery. Philadelphia, PA: Lippincott Williams and Wilkins. 2002. p.381-422.
This chapter on polypoid diseases is from a handbook that addresses the entire range of diseases affecting the colon, rectum, and anus. The authors discuss a number of benign polypoid conditions that are commonly observed in the practice of general and colon and rectal surgeons. A polyp is a well-circumscribed projection above the surface epithelium. Three types of polyps are discussed in this chapter: hyperplastic (metaplastic), hamartomatous, and adenomatous. For each type, the authors review clinical appearance, symptoms, histology, diagnosis and management. The chapter also covers genetics, molecular mechanisms of carcinogenesis (development of cancer), colonoscopy and polypectomy, the management of benign (non-cancerous) rectal tumors, and polyp follow-up.
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Polyposis Syndromes: Pediatric Implications. Gastrointestinal Endoscopy Clinics of North America. 11(4): 659-682. October 2001.
Polyposis syndromes have been managed in the past by geneticists and adult gastroenterologists, but now increasingly fall into the practice of the pediatric gastroenterologist. Gastrointestinal polyps in children most commonly present with rectal bleeding, but of more concern, may have potential for malignant change. This article reviews the polyposis syndromes, their malignant potential, and their management algorithms. Topics include histopathologic classification of gastrointestinal polyps, clinical management, juvenile polyp, juvenile polyposis syndrome, Peutz-Jeghers syndrome (PJS), familial adenomatous polyposis, desmoid disease, other polyposis syndrome, and the role of the polyposis registries. The author also discusses the genetics of these syndromes and future advances. Children and adolescents with a polyposis syndrome are faced with the immediate complications of the polyps, such as intussusception or bleeding, plus the extraintestinal manifestations and the long-term risk of malignancy. Because the conditions are rare, an individual clinician may only see a child with polyposis every few years. The approach to care of these families should be multidisciplinary, involving a polyposis registry, a pediatric gastroenterologist, colorectal surgeon, pathologist, geneticist, and specialist nurses, all of whom should be familiar with the varied presentations and problems faced by these patients. 11 figures. 2 tables. 84 references.
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Comparison of Colonoscopy and Double-Contrast Barium Enema for Surveillance After Polypectomy. New England Journal of Medicine. 342(24): 1766-1772. June 15, 2000.
After patients have undergone colonoscopic polypectomy, it is uncertain whether colonoscopic examination or a barium enema is the better method of surveillance. This article reports on a study undertaken as part of the National Polyp Study, in which the authors offered colonoscopic examination and double contrast barium enema for surveillance to patients with newly diagnosed adenomatous polyps. A total of 973 patients underwent one or more colonoscopic examinations for surveillance. In the case of 580 of these patients, the authors performed 862 paired colonoscopic examinations and barium enema examinations that met the requirements of the protocol. The findings on barium enema were positive in 222 (26 percent) of the paired examinations, including 94 of the 242 colonoscopic examinations in which one or more adenomas were detected (rate of detection, 39 percent). The proportion of examinations in which adenomatous polyps were detected by barium enema was significantly related to the size of the adenomas; the rate was 32 percent for colonoscopic examinations in which the largest adenomas detected were 0.5 cm or less, 53 percent for those in which the largest adenomas detected were 0.6 to 1.0 cm, and 48 percent for those in which the largest adenomas detected exceeded 1.0 cm. Among the 139 paired examinations with positive results on barium enema and negative results on colonoscopic examination in the same location, 19 additional polyps, 12 of which were adenomas, were detected on colonoscopic reexamination. The authors conclude that, in patients who have undergone colonoscopic polypectomy, colonoscopic examination is a more effective method of surveillance than double contrast barium enema. 5 tables. 23 references.
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End of Barium Enemas? (editorial). New England Journal of Medicine. 342(24): 1823-1824. June 15, 2000.
This editorial comments on an article published in the same journal describing the use of barium enema versus colonoscopy for diagnostic uses. The editorial author notes that whether or not colonoscopy is a better way to examine the colon, it has been replacing barium enemas in recent years. The appeal of endoscopic technology, the ability to detect and remove lesions during a single procedure, and the influence of the gastroenterology community have been persuasive. In the research article on the accuracy of barium enema versus colonoscopy, barium enema did not fare well, especially in the identification of small polyps. The commentary author discusses the generalization of results, the problem of translating the procedures to typical clinical practice (rather than the research procedures, which were performed by a hand picked group of top technicians), and the recent finding that some colorectal cancers may arise from flat adenomas. The author concludes that the ability of barium enema to detect clinically important polyps is not good enough to use this method for the surveillance of patients who are increased risk for polyps or for a diagnostic evaluation of the colon. Barium enema may still have a role in screening (where expectations regarding the accuracy of findings are not as high) but it is unclear exactly what this role should be. 9 references.
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