Colon Polyps - Diagnosis

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Were your colon polyps diagnosed during a colonoscopy? What was the outcome?

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How are colon polyps diagnosed?

There are several means to diagnose colon polyps.

Endoscopic colonoscopy

Endoscopic colonoscopy involves the use of a colonoscope, a flexible tube approximately five feet in length with a light and camera at the end and a hollow channel through which instruments can be passed. The colonoscope is passed via the anus into the colon and then through the colon until the proximal end of the colon - the cecum - is reached. On withdrawal of the colonoscope, the lining of the colon is observed for polyps and other abnormalities. These may be biopsied or removed using electro-cautery and then examined under the microscope. Colonoscopy identifies 95% of polyps, small and large, though occasionally polyps are missed if they are small, hidden by folds in the colon's lining, are flat or the colonoscopy is hurried.

Virtual colonoscopy

Virtual colonoscopy involves the use of either computerized tomography (CT) or magnetic resonance imaging (MRI). The colon is filled with either a liquid contrast agent or air, and CT or MRI is performed. Computerized reconstruction of either the CT or MRI images provides a virtual image that mimics the view obtained by a colonoscope. Virtual colonoscopy is very good at finding polyps but not as good as colonoscopy; it can miss polyps less than one centimeter in size, although the need to identify these smaller polyps is debated since they infrequently are malignant. MRI has an advantage over CT because of it does not expose the patient to radiation. It is more expensive, however, and there is less experience with MRI than with CT. The problem with both CT and MRI virtual colonoscopy is that if a polyp is found that should be removed, colonoscopy then must be done at a later time to remove it.

Barium enema

Barium enema is an older method of diagnosing colon polyps. During a barium enema, the colon is filled with barium, and multiple X-rays of the colon are taken as the patient changes position. Barium enema is a good way to diagnose polyps and is relatively inexpensive; however, it can easily miss small polyps and exposes patients to radiation. Moreover, the skills and experience necessary to do a barium enema properly have declined among radiologists because barium enemas are less frequently ordered now that colonoscopy and virtual colonoscopy are available. Finally, like virtual colonoscopy, if polyps are found, a colonoscopy must be done to remove the polyp.

Flexible sigmoidoscopy

Flexible sigmoidoscopy uses a shortened version of a colonoscope, approximately three feet in length. It is able to examine only the distal third to one-half of the colon. Like the colonoscope, it can be used to identify, biopsy, and remove polyps without exposure to radiation. For screening purposes, since the sigmoidoscope cannot examine the entire colon, it usually is combined with either less frequent colonoscopy or frequent stool occult blood tests to identify polyps beyond its reach.

Return to Colon Polyps

See what others are saying

Comment from: Distressed, 45-54 Female (Patient) Published: February 10

After 8 years of first nausea, then came intense pain, pain so bad it put me on the ground, I first was taken to the hospital, where they said I was having female problems. So the rounds of tests began, all female parts related tests, of course there was nothing wrong, I knew this, but was told by doctors that I was having female problems or that it was in my head. I had a biopsy done by a gynecologist and was told there was nothing there. I was put on medication for depression as it kept getting worse. Finally after 8 years of getting worse and worse, I went to the restroom and lost about 1/2 cup blood, I thought I had started menstruating after 10 years of not, but that was not the case. I started losing a great amount of blood on a daily basis. Finally after blacking out at work I was taken again to the hospital and was told to get a colonoscopy, I was not totally put out so kept waking up during the procedure. But the doctor diagnosed ulcerative proctitis. I was put on medication and it helped somewhat, but then the bleeding became intense and I was blacking out again. I went back in for a second colonoscopy and the doctor found and removed several polyps, the diagnosis stayed the same and I was prescribed two types of medications. I've been in and out of remission, now I am not; I am bleeding again and losing white and bloody clumps of tissue like substance. I called immediately for help (my original doctor retired), after calling 3 doctors I got one who will see me in 3 weeks, I don't know what's going to happen. I'm scared big time, the pain is at times unbearable, I'm at my wits end, and it would be nice to find a doctor that not only likes taking my money but one that wants to help me; I doubt bleeding and losing clumps of tissue is normal.

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Comment from: rdmbjm75, 65-74 Female (Patient) Published: March 26

I am a 69 year old female who had one pre-cancerous polyp found in the ascending colon removed when I was 35 after experiencing recurring unexplained diarrhea. Repeated colonoscopy the following year and no additional polyps were found. I have had routine colonoscopy every five years since and have been polyp free. I went in last Friday for my current routine colonoscopy and the doctor found "many" (his words) 3mm polyps in the sigmoid colon. He resected and retrieved them and I am still waiting for the results. I also had an endoscopy done last Friday and they discovered I have developed a hiatal hernia in my esophagus. No history of colon cancer in my family but my mother died from cancer of the lymph glands and my half-brother (my mother"s son) had bladder cancer.

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