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What are the signs and symptoms of colon polyps?

Ninety-five percent of colon polyps do not cause symptoms or signs, and are discovered during screening or surveillance colonoscopy.

When symptoms or signs occur they may include:

  • Red blood mixed in with or on the surface of the stool
  • Black stools if the polyp is bleeding substantially and is located in the proximal colon (cecum and ascending colon)
  • Iron deficiency anemia if the bleeding has been slow and occurring over a prolonged period of time.
  • Weakness, light-headedness, fainting, pale skin, and rapid heart rate due to iron deficiency anemia
  • The presence of invisible (occult) blood in stool that is tested when screening for colon cancer at visits to a doctor's office (Because of the tendency of polyps to bleed slowly, intermittently and in small amounts, occult blood testing of stool often is used to screen for colon cancer.)
  • Rarely diarrhea when large villous polyps secrete fluid into the intestine
  • Rarely constipation if the polyp is very large and obstructs the colon
  • Rarely intussusception, a condition in which a polyp drags the portion of the colon to which it is attached into the more distal colon (i.e., telescopes into the more distal colon) and leads to obstruction of the colon. This can cause all of the signs and symptoms of intestinal obstruction including abdominal pain and distention, nausea and vomiting.

How common are colon polyps?

Colon polyps are very common. They increase in prevalence as people age; by age 60, one-third or more of people will have at least one polyp. If a person has a colon polyp, he or she is more likely to have additional polyps elsewhere in the colon and is more likely to form new polyps at a later time. In a small subset of patients with colon polyps, there is a familial, genetic abnormality that causes patients and other members of their families to develop larger numbers of polyps, to develop them at an early age, and to more frequently have them become cancerous.

Why are colon polyps important?

Colon polyps are important because they may give rise to colon cancer. The type of polyp predicts who is more likely to develop further polyps and colon cancer. Polyps cause other problems (to be discussed), but it is the deadly nature of colon cancer that is of most concern.

Benign polyps become malignant polyps (cancer) with further mutations and changes in the cells' genetic material (genes). The cells begin to divide and reproduce uncontrollably, sometimes giving rise to a larger polyp. Initially, the increasingly, genetically abnormal cells are limited to the layer of cells that line the inside of the colon. The cells then then develop the ability to invade deeper into the wall of the colon. Individual cells also develop the ability to break off from the polyp and spread into lymph channels through the wall of the colon to the local lymph nodes and then throughout the body, a process referred to as metastasis although this is unusual unless the cancer has invaded into the wall of the colon.

The transition from benign to malignant polyp can be seen under the microscope. In the earlier phase of the transition, called low-grade dysplasia (dysplasia=abnormal formation), the cells and their relationships to one another become abnormal. When the cells and their relationships become even more abnormal, it is termed high-grade dysplasia. High-grade dysplasia is of greater concern because the cells are clearly cancerous although they are limited to the innermost lining of the colon; with rare exceptions, they have not yet developed the abilities to invade and metastasize (spread to other parts of the body). If they are not removed, invasion and metastasis may occur.

Return to Colon Polyps

See what others are saying

Comment from: LS650, 45-54 Male (Patient) Published: January 03

I had a FIT (fecal immunochemical´┐Żtest) as part of a routine physical when I turned 50. Despite no obvious symptoms, my FIT was abnormal. I underwent a colonoscopy and the doctor found three polyps, with one about a centimeter wide. Just waiting for the biopsy results now. If I'd waited until I'd had obvious symptoms, it could have been a different story.

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Comment from: Bud21901, Male (Patient) Published: December 21

I started to see blood in 2015. I ignored it. In 2016 it got way worse. Blood, and bowel movements were horrible. I would have to pull off the road because I would get dizzy or feel faint. I would still ignore the symptoms. In my mind I didn't want my wife or kids to know I was vulnerable or weak, and not capable of providing. I finally scheduled a routine checkup, and let to doctor know. He scheduled me to a surgeon. I told the wife I had an issue and it was accepted. All this worrying for nothing. I went in, and they cut a 7 cm and a 2 cm polyp out, and I am back to work Monday. I feel amazing! I have been sick for over a year and refused to believe it. It became normal to be sick! There are millions of men out there living paycheck to paycheck just like me. They feel it's there duty to provide, and they will do it at all costs. Guys, get checked yearly, and if you feel like something is wrong don't ignore it. It's just not worth it. I was sick for 2 years, and made excuses the entire time. We are not invincible, and a few days' pay is worth making you feel 100 percent.

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Comment from: sam, 55-64 Female (Patient) Published: November 01

I had a colonoscopy 18 months ago and have put on 10 kg from my breasts down and around my stomach. I am eating the correct foods (really almost all the time). I wonder if I should go for another colonoscopy as my doctor says that there are certain foods that collect in the colon polyps and hence the weight gain. I'm getting very depressed about this weight gain!

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