Colonic polyps

Last reviewed: 19 Apr 2022
Last updated: 23 Jan 2018

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • FHx
More key diagnostic factors

Other diagnostic factors

  • rectal bleeding
  • mucus discharge
  • tenesmus
  • change in bowel habit
  • signs of anaemia
  • fatigue
Other diagnostic factors

Risk factors

  • increasing age
  • FHx
  • previous history of polyps
  • male gender
  • acromegaly
More risk factors

Diagnostic investigations

1st investigations to order

  • colonoscopy
  • flexible sigmoidoscopy
  • double-contrast barium enema (DCBE)
  • virtual colonoscopy/CT colonography
  • chromoendoscopy
  • narrow band imaging (NBI)
More 1st investigations to order

Investigations to consider

  • histology
  • i-Scan endoscopic image enhancement technology
More investigations to consider

Emerging tests

  • autofluorescence
  • cap-assisted colonoscopy

Treatment algorithm

INITIAL

obstruction through intussusception

ACUTE

detected during colonoscopic examination or screening

familial adenomatous polyposis

Peutz-Jeghers syndrome

Contributors

Authors

George Malietzis, MBBS, MRCS

Clinical Lecturer

Department of Surgery and Cancer

Imperial College

London

UK

Disclosures

GM declares that he has no competing interests.

John T. Jenkins, MD

Consultant Colorectal Surgeon

Department of Coloproctology

St. Mark's Hospital

London

UK

Disclosures

JTJ declares that he has no competing interests.

Acknowledgements

Dr George Malietzis and Dr John T. Jenkins would like to gratefully acknowledge Dr Phil Tozer, a previous contributor to this monograph. PT declares that he has no competing interests.

Peer reviewers

John Anderson, FRCS

Consultant Colorectal Surgeon

Glasgow Royal Infirmary

Glasgow

UK

Disclosures

JA declares that he has no competing interests.

Sharon Stein, MD

Assistant Professor of Surgery

Division of Colon and Rectal Surgery

University Hospital Case Medical Center

Cleveland

OH

Disclosures

SS received a fee for educational courses on laparoscopic surgery, paid for in part by Covidien, Olympus, and Applied Medical.

  • Colonic polyps images
  • Differentials

    • Colorectal cancer
    • Haemorrhoids
    • Anal fissure
    More Differentials
  • Guidelines

    • NCCN clinical practice guidelines in oncology: colorectal cancer screening
    • Evidence-based clinical practice guidelines for management of colorectal polyps
    More Guidelines
  • Patient leaflets

    Bowel cancer: what is it?

    Bowel cancer: what treatments work?

    More Patient leaflets
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer