Probably, each of us experiences unpleasant sensations bordering on fear upon hearing the diagnosis of “malignant tumor”. All over the world, scientists are struggling with the clue where it comes from and how to treat it with a 100% guarantee, but alas, the results are disappointing. The diagnosis of "adenomatous polyp" does not sound so gloomy, and few people who are not related to medicine can explain what it is. Meanwhile, this ailment is considered a precancerous condition, therefore it is extremely dangerous. Those who have it, you need to take action immediately to maintain health, and possibly their lives.
Polyp Characterization
At its core, polyps in the human body are an area of the mucous membrane that has grown for whatever reason. That is, they can appear in any organ covered with mucous membranes. According to medical statistics, an adenomatous polyp, otherwise called an adenoma and representing a benign tumor, causes a lot of troubles. The definition of “benign” means that at some point in the body cells suddenly began to uncontrollably divide, but so far they fully or partially retain the functions of the affected organ or tissue and do not give metastases. It is this important sign that gives a chance to completely cure them. Therefore, an adenomatous polyp is not yet a sentence. However, without action, most benign tumors become malignant. So, polyps, whose dimensions reached only 1 cm, contain with high probability invasive cancer cells, that is, those that are already metastasizing. True, the small size of the growth does not give a 100% guarantee of safety, since there are cases when the cancer has developed from a single polyp villus.
Classification
Mucous membranes in humans are multilayered and, depending on the organ that they cover, have different epithelium in structure. The adenoma grows on those mucous membranes, the epithelium of which is represented by the glandular structure, that is, it includes many glands. Based on this, polyps can appear in the stomach, in the gall bladder, in the intestine, in the organs of the genitourinary system.
In addition to the location, there are a number of classification criteria:
1. By the type of base: on the legs (stem) or on a wide platform (sessile). It is believed that a sedentary adenomatous polyp launches metastases faster. The photo above shows what a large sessile polyp looks like on the intestinal wall.
2. In size: small, medium, large. As long as adenomas are less than 1 cm, they are least likely to become malignant. Conversely, among adenomas more than 1 cm, about 13% have cancer cells, and more than 2 cm the probability of degeneration into cancer is already 51%.
3. In appearance: spherical, oval, mushroom-shaped, dense, soft.
4. By localization: single, nesting, multiple. The latter degenerate into cancer about 2 times more often.
Morphological features
The adenomatous polyp of the intestine, stomach, and absolutely all organs is arranged differently, which greatly affects the prognosis of recovery. They are as follows:
1. Irony. They consist of many glands and connective tissue rich in blood vessels. They are divided into benign, with signs of atypia (cells lose their shape, their nuclei become denser) and with malignancy (atypical cells and glands are immersed in the muscle and submucosal layers of the epidermis, that is, in fact, are preparing for metastasis).
2. Villous. These polyps are externally velvety, similar to the heads of cauliflower, often have a rough surface. The probability of malignancy is higher than 60%.
3. Ferruginous-villous.
4. Hyperplastic. Very small, soft, maintain the normal structure of the mucosa.
5. Juvenile. Do not malign, consist of cystic glands and dense stroma.
6. Fibrous. In the stroma, there are many significantly dilated vessels, which is why they resemble inflammatory infiltration.
7. False.
Reasons for the appearance
Why polyps begin to grow, while there are no exact answers. Some scientists believe that they appear in people in old age, while others refute this. Statistics say that in young children, the chance of detecting adenomas is 28%, in people under 30 years old - 30%, and in older people over 70 years old - only 12.8%. The maximum number of detection of adenomas occurs at the age of 40-50 years.
That is, an adenomatous polyp of the rectum or other organ can appear in a person of any age, even in infants (there is a case of diagnosing a stem polyp in a 2-month-old baby in the stomach). The most likely reasons scientists include:
- pathology in embryonic development;
- heredity (in children whose parents have encountered an adenoma, the likelihood of getting it is also about 2 times higher);
- inflammatory processes in the digestive tract (gastritis, colitis, dysentery, problems with bowel movements and others);
- improper nutrition;
- violation of the regeneration of the mucous membranes of the stomach and intestines after the effects.
Adenomatous polyp of the stomach
This organ is in first place for predisposition to the appearance of adenomas. According to one of the classifications based on morphological characters, the following types of stomach polyps are diagnosed:
- tubular;
- papillary;
- mixed (papillotubular).
They are located unevenly in the stomach. So, in its upper third of 2241 examined patients polyps were found in 2.1%, in the middle third these figures reached 17%, and in the lower third there were already 66.8% of pathologies.
The development of malignant tumors in the stomach occurs according to such a simplified scheme: normal epithelium - the formation of a polyp - its development into a carcinoma - cancer. More often, a similar scenario develops in two years, a maximum of three, but there are isolated cases when people lived with polyposis for about 20 years.
The causes of adenomas in the stomach are common - heredity, pathologies in the development at the embryo level, inflammatory diseases, mainly gastritis, junk food, alcoholism, chronic gastrointestinal diseases. Also, according to scientists, various neuropsychic disorders contribute to the growth of mucous membranes in the stomach.
Symptoms
There is no single clinical picture indicating that an adenomatous polyp has grown in the stomach. Symptoms in each patient are always individual. Of the most common, we can distinguish:
- pain syndrome (up to 88.6%);
- the feeling that the stomach is already full, even after consuming minimal amounts of food;
- decreased appetite;
- belching;
- nausea;
- increased salivation;
- flatulence;
- heartburn;
- an unpleasant aftertaste in the oral cavity.
Pain often appears after eating and lasts a couple of hours, then subside.
In addition to the symptoms characteristic of polyps, patients have common signs that there are problems in the body. This fatigue, weakness, sometimes fever, insomnia, headache, causeless depression.
There are extragastric signs by which it is possible to suspect the presence of polyposis, especially if it is hereditary. These are spots on the skin (around the lips, nose, on the cheeks, chest, palms, back, stomach, neck) in the form of freckles, in any weather and in any season they do not change their appearance.
Diagnostics
An adenomatous polyp in any organ is almost impossible to detect without hardware diagnostics. For the stomach, it includes:
- ultrasound;
- X-ray with a thick liquid of barium (effective in about 4.6% of cases);
- gastroscopy;
- fibrogastroscopy;
- biopsy;
- gastrolaparoscopy.
No less important are laboratory tests of gastric juice, blood, and reactions to occult blood in the contents of the stomach.
The maximum result is obtained by several methods at once.
Adenomatous colon polyp
This ailment is in the second “honorable” place after polyposis of the stomach. According to statistics, polyps in the colon are recorded with such a frequency:
- women - 46%;
- men - 53%.
The dependence of the development of the disease on age is as follows:
- patients from 41 to 60 years old - 56%;
- from 31 to 40 years old - 23%;
- from 14 to 30 years - 10%.
The degeneration of polyps into a malignant tumor has some dependence on their number. So, if there are 5 or more of these formations in the rectum, they develop into cancer in 100% of cases.
In the colon, polyps are also unevenly distributed. So, in the ascending part, 13% of all cases are recorded, in the transverse colon part - 13.5%, in the sigmoid part and rectum - 73.5%. The causes of polyps in the intestines are about the same as when they occur in the stomach, but doctors give priority to inflammatory diseases. So, among 455 examined patients who found polyps, 30% suffered from chronic ailments (colitis, proctosigmoiditis and others), and 16.4% suffered from dysentery. A large role belongs to malnutrition. For this reason, colitis is detected in more than 50% of cases.
Symptoms and diagnosis of polyps in the intestine
There are no characteristic signs only for intestinal polyposis. Often for a long time, patients generally do not feel signs that their adenomatous polyp has begun to grow. The most characteristic symptoms of the disease:
- blood in the feces (89%);
- with the development of the disease bleeding is possible with or after bowel movements;
- diarrhea or constipation (55.2%);
- pain in the peritoneum;
- burning and / or itching in the anus (up to 65%);
- anemia (7%);
- nausea;
- heartburn;
- headache;
- belching;
- flatulence;
- Pain in the rectum, extending to the lower back and sacrum.
Diagnostics includes palpation, ultrasound, radiography, sigmoidoscopy, contact beta radiometry, colonoscopy, fibrocolonoscopy, and laboratory tests.
Polyps in the gallbladder
Adenomatous polyp of the gallbladder is a rare disease that occurs in less than 1% of all patients with polyposis. According to statistics, more often the disease affects people after 45 years. The gallbladder is a very small organ, in adults it is only up to 14 cm long and up to 5 cm wide. In structure, it resembles a sac with thin walls, a wider body, a narrowing neck and a very narrow part, from which the bile duct originates. The most difficult situation is the location of polyps in the neck or duct. At the same time, the exit of bile into the intestine is blocked, and patients have yellowness of the skin and eye proteins. In addition to this symptom, there are other signs that the polyp may have grown in the bile:
- aching pains;
- renal colic;
- nausea (especially in the morning);
- bitterness in the mouth;
- digestion disorder.
The causes of the disease can be inflammation of the bile and its mucous membranes, improper metabolism, poor nutrition, and heredity.
Diagnosis is by ultrasound, ultrasonography. The treatment is mainly surgical, consisting in the removal of the gallbladder. Only in certain cases, the doctor can prescribe instead of surgery, taking medications - "Ursosan" or "Ursofalk."
Treatment
Depending on the location, size and other characteristics, the doctor prescribes treatment for an adenomatous polyp. If it is found in the stomach, only surgical treatment is possible, since no medication will cause the polyp to grow back. Pills only briefly improve the overall picture, but do not reduce the risk of a neoplasm degenerating into cancer. If a single polyp is detected, only it is removed, and if multiple growths are detected, a stomach resection is performed.
Another treatment option is polypectomy with an endoscope. It is indicated for stem polyps from 0.5 cm in size and consists in their removal using a metal loop. In some cases, it is performed on an outpatient basis. A biopsy after this operation is required. The same methods of treating polyps in the small and colon. In the rectum, if an adenoma is detected at a distance of 10 cm from the anus, it may be excised under local anesthesia.
Small growths are removed using electrocoagulation.
Among modern treatment methods, if indicated, removal of polyps by laser, electric pulses or radio waves may be suggested.
In any case, after exposure, a strict diet is attributed to the patient.
There is an opinion that benign polyps in the colon can be cured with celandine enemas, which need to be done 25-30 per course. The solution is prepared as follows: twist 50 grams of green leaves and stems in a meat grinder, pour 300 ml of boiling water, wait until it cools, strain. 2 hours before the enema, the treatment is done with a cleansing. The patient's celandine solution should be kept up to 1.5 hours, and children - up to 30 minutes. Procedures are carried out every other day.
Important: in many patients this method did not justify itself, and they had to perform operations to remove polyps that grew into malignant tumors.