Probably, each of us experiences discomfort, bordering on fear, upon hearing the diagnosis of a malignant tumor. All over the world, scientists are struggling to figure out where it comes from and how to treat it with a 100% guarantee, but alas, so far the results are disappointing. The diagnosis of "adenomatous polyp" does not sound so bleak, and few non-medical people can explain what it is. Meanwhile, this disease is considered a precancerous condition, therefore it is extremely dangerous. Those found to have it need to take immediate action to save their he alth and possibly their lives.
Characteristics of polyps
At its core, polyps in the human body are an area of the mucous membrane that has grown for some reason. That is, they can appear in any organ covered with mucous. According to medical statistics, an adenomatous polyp, otherwise called an adenoma, causes a lot of trouble and is a benign tumor. The definition of "benign" means that in some placebodies suddenly began to divide cells uncontrollably, 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 feature that gives a chance to cure them completely. Therefore, an adenomatous polyp is not yet a sentence. However, without action, most benign tumors become malignant. So, polyps, the size of which has reached only 1 cm, contain with a 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 cancer developed from a single villus of a polyp.
Classification
The mucous membranes in humans are multi-layered and, depending on the organ they cover, have epithelium of different structure. Adenoma grows on those mucous membranes, the epithelium of which is represented by a glandular structure, that is, it includes many glands. Based on this, polyps can appear in the stomach, in the gallbladder, in the intestines, in the organs of the genitourinary system.
Besides the location, there are a number of their classification criteria:
1. According to the type of base: on legs (stem) or on a wide platform (sitting). It is believed that a sessile adenomatous polyp starts metastases faster. The photo above shows what a large sessile polyp looks like on the intestinal wall.
2. Size: small, medium, large. As long as adenomas are less than 1 cm, they are the least likely to become cancerous. Conversely, among adenomas larger than 1 cm, approximately 13% havecancer cells, and more than 2 cm the probability of degeneration into cancer is already 51%.
3. Appearance: spherical, oval, mushroom-shaped, dense, soft.
4. By localization: single, nesting, multiple. The latter are reborn into cancer about 2 times more often.
Morphological features
Adenomatous polyp of the intestine, stomach, absolutely all organs are arranged differently, which greatly affects the prognosis of recovery. They are:
1. glandular. 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 thicken) and with malingation (atypical cells and glands sink into the muscular and submucosal layers of the epidermis, that is, in fact, they are preparing for metastasis).
2. Villous. These polyps are velvety in appearance, similar to cauliflower heads, and often have a rough surface. The probability of malinga they have above 60%.
3. Glandular-villous.
4. Hyperplastic. Very small, soft, retain the normal structure of the mucosa.
5. Juvenile. Do not malingate, consist of cystic glands and dense stroma.
6. Fibrous. In the stroma, they have many significantly dilated vessels, which is why they resemble inflammatory infiltration.
7. False.
Reasons for appearance
Why polyps begin to grow, there are no exact answers yet. Some scientists believe that they appear in people in old age, othersrefute. Statistics say that in young children the chance of detecting adenomas is 28%, in people under 30 years old - 30%, and in the elderly over 70 years old - only 12.8%. The maximum number of adenoma detections occurs at the age of 40-50 years.
That is, an adenomatous polyp of the rectum or another organ can appear in a person of any age, even in infants (there is a known case of diagnosing a stem polyp in a 2-month-old baby in the stomach). The most likely reasons scientists include:
- pathologies in embryonic development;
- heredity (children whose parents have experienced adenoma are also about 2 times more likely to get it);
- inflammatory processes in the digestive tract (gastritis, colitis, dysentery, problems with defecation and others);
- malnutrition;
- violation of the regeneration of the mucous membranes of the stomach and intestines after exposure.
Adenomatous polyp of stomach
This organ is in first place in terms of predisposition to the appearance of adenomas. According to one of the classifications based on morphological features, the following types of gastric polyps are diagnosed:
- tubular;
- papillary;
- mixed (papillotubular).
They are unevenly distributed 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 simplifiedscheme: normal epithelium - formation of a polyp - its development into carcinoma - cancer. More often, such a 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, developmental pathologies at the embryonic level, inflammatory diseases, mainly gastritis, junk food, alcoholism, chronic gastrointestinal diseases. Also, according to scientists, various neuropsychiatric 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. The symptoms of each patient are always individual. Of the most common, we can distinguish:
- pain syndrome (up to 88.6%);
- feeling that the stomach is already full, even after consuming minimal amounts of food;
- loss of appetite;
- burp;
- nausea;
- increased salivation;
- flatulence;
- heartburn;
- bad taste in mouth.
Pains often appear after eating and last a couple of hours, then subside.
In addition to the symptoms characteristic of polyps, patients have general signs that there are problems in the body. These are fatigue, weakness, sometimes fever, insomnia, headache, causeless depression.
There are extra-gastric signs that suggest polyposis, especially if it is hereditary. These are spots on the skin (around the lips, nose, cheeks,chest, palms, back, stomach, neck) in the form of freckles, which do not change their appearance in any weather and in any season.
Diagnosis
Adenomatous polyp in any organ is almost impossible to detect without hardware diagnostics. For stomach it includes:
- Ultrasound;
- x-ray with a thick liquid of barium (effectively 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.
Maximum results are obtained by examinations by several methods at once.
Adenomatous colon polyp
This disease is in the second "honorable" place after gastric polyposis. According to statistics, polyps in the colon are recorded with the following 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 old - 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.
Polyps are also unevenly distributed in the colon. Thus, 13% of all cases are recorded in the ascending part, 13.5% in the transverse colon, andsigmoid 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 had polyps, 30% suffered from chronic ailments (colitis, proctosigmoiditis and others), and 16.4% had dysentery. An important role belongs to irrational nutrition. For this reason, colitis is found in more than 50% of cases.
Symptoms and diagnosis of polyps in the intestines
There are no characteristic signs only for intestinal polyposis. Often for a long time, patients do not feel any signs at all that an adenomatous polyp has begun to grow in them. The most characteristic symptoms of the disease:
- blood in stool (89%);
- with the development of the disease, bleeding is possible during or after defecation;
- diarrhea or constipation (55.2%);
- pain in the peritoneum;
- burning and/or itching in the anus (up to 65%);
- anemia (7%);
- nausea;
- heartburn;
- headaches;
- burp;
- flatulence;
- pain in the rectum, radiating to the lower back and sacrum.
Diagnosis includes palpation, ultrasound, radiography, sigmoidoscopy, contact beta radiometry, colonoscopy, fibrocolonoscopy, 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. ByAccording 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 tapering neck and a very narrow part, from which the bile duct originates. The most severe situation is the location of polyps in the neck or duct. At the same time, the exit of bile into the intestines is blocked, and in patients, yellowness of the skin and whites of the eyes appears. In addition to this symptom, there are other signs that a polyp may have grown in the gall:
- aching pains;
- renal colic;
- nausea (especially in the morning);
- bitterness in the mouth;
- indigestion.
The causes of the disease can be inflammation of the gallbladder and its mucosa, improper metabolism, poor nutrition, heredity.
Diagnosis is carried out using ultrasound, ultrasonography. The treatment is mainly surgical, consisting in the removal of the gallbladder. Only in some cases, the doctor may prescribe medication instead of surgery - "Ursosana" or "Ursofalk".
Treatment
Depending on the location, size and other characteristics, the doctor prescribes the treatment of an adenomatous polyp. If it is found in the stomach, only surgical treatment is possible, since no medication will make the polyp grow back. Tablets only briefly improve the overall picture, but do not reduce the risk of neoplasm degeneration into cancer. Upon detectiona single polyp is removed only, and if multiple growths are found, gastric resection.
Another method of treatment is polypectomy using an endoscope. It is indicated for stem polyps from 0.5 cm in size and consists in their removal with a metal loop. In some cases, it is performed on an outpatient basis. A biopsy after this operation is required. The same methods of treatment of polyps in the small intestine and colon. In the rectum, if an adenoma is found at a distance of up to 10 cm from the anus, it may be excised under local anesthesia.
Small growths are removed by electrocoagulation.
Among modern treatments, according to indications, removal of polyps with a laser, electrical impulses or radio waves can be offered.
In any case, after exposure, the patient is assigned a strict diet.
It is believed that benign polyps in the colon can be cured with celandine enemas, which should 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 down, strain. 2 hours before a healing enema, a cleansing enema is done. The patient should keep a solution of celandine in himself for up to 1.5 hours, and children - up to 30 minutes. Procedures are carried out every other day.
Important: for many patients, this method did not justify itself, and they had to undergo surgery to remove polyps that had developed into malignant tumors.
