What are polyps? |

Causes and Symptoms

The causes of polyps vary depending on the location of the polyp growth in the body. Symptoms are also site dependent.

Nasal polyps consist of inflamed tissue in the mucous membrane lining of the nose or sinuses. Causes of nasal polyps may be allergies, chronic infection, cystic fibrosis, and asthma. They usually develop around the ethnoid sinuses (inside the top of the nose) and may block the airway, resulting in difficulty breathing or shortness of breath because of obstruction. Breathing through the mouth, anosmia (loss of the sense of smell), and a runny nose are common symptoms.

Vocal cord polyps are caused by mechanical injury, such as shouting, and usually occur on one vocal cord. Polyps are not to be confused with vocal cord nodules, which are generally caused by chronic abuse such as singing. Symptoms include hoarseness and a breathy or raspy voice.

Gastric polyps are rare and are usually discovered by accident, such as during an upper gastrointestinal endoscopy (a viewing of the interior of the stomach). Causes include
Helicobacter pylori (H. pylori) infection and chronic gastritis (inflammation of the stomach) caused by an autoimmune response. Gastric polyps usually do not cause symptoms; if symptoms do occur, they may include nausea, vomiting, abdominal pain, bleeding, or a feeling of fullness after eating even small amounts.

Colorectal polyps grow on the lining (mucous membrane) of the colon (also known as the large intestine) or rectum and may be caused by abnormal cell growth, heredity (family history or inherited disorder), or inflammatory diseases such as ulcerative colitis or Crohn’s disease. Small polyps do not usually cause symptoms. If symptoms do occur, then they may include blood in a bowel movement, rectal bleeding, fatigue due to anemia from loss of blood, or pain.

Uterine polyps develop in the lining of the uterus and are caused by an overgrowth of endometrial cells. Occasionally, uterine polyps may slip through the cervix into the vagina, resulting in cervical polyps. The exact cause of uterine and cervical polyps is unknown, but may be related to the estrogen hormone level, chronic inflammation or clogged blood vessels in the cervix. Symptoms may include bleeding, heavy or irregular menstrual periods, or a white or yellow discharge of mucus (leukorrhea), or there may be no symptoms.

Treatment and Therapy

The treatment for polyps varies by site. The most common treatments are medication and removal (polypectomy), either surgically or during colonoscopy/sigmoidoscopy (intestines), colposcopy (vagina and cervix), or some other endoscopic procedure (throat, stomach, small bowel). Biopsy of the polyp may be done to determine if it is malignant (cancerous) or benign (not cancerous).

It is possible to prevent some polyps. Controlling allergies and managing chronic sinusitis may prevent nasal polyps. Vocal cord polyps are directly related to injury from yelling, so reducing or eliminating such abuse may lessen the potential for development. Stomach polyps caused by H. pylori may be controlled by treating the underlying bacteria, and controlling gastritis may diminish the occurrence.

The goal of treatment for nasal polyps is to reduce the size of the polyp or to remove it. Because nasal polyps may occur in response to allergies or chronic sinusitis, medications such as corticosteroids (a drug that reduces inflammation), antihistamines, and antibiotics (a drug to fight infection) may be effective in shrinking the size of the polyp. If the polyp is in the sinus cavity, then endoscopic surgery using a small camera and tube inserted into the sinus allows the physician to remove the polyp.

Vocal cord polyps usually require surgical removal to restore the normal speaking voice. Voice therapy with a speech pathologist may be needed to prevent future occurrences. Stomach polyps require biopsy and, if there is concern, surgical removal. Medications to treat gastritis, including antibiotics, may be used. Routine colonoscopy and flexible sigmoidoscopy are recommended for routine cancer screening, and if a colorectal polyp is seen during the procedure, it is removed. If colorectal polyps are causing symptoms, then surgical removal either through colonoscopy or removal of a portion of the intestine may be needed. Uterine polyps may be watched, medications may be used to shrink them, or surgery may be used to remove them; if the polyps are cancerous, then a hysterectomy (removal of the uterus) is usually necessary.

Perspective and Prospects

Polyps are usually benign (not cancerous), but they can become malignant (cancerous) over time or in certain areas. Risk factors include age, obesity, family history, poor overall health (including allergies and chronic infections), stomach ulcer, infection, and inherited disorders such as cystic fibrosis or familial adenomatous polyposis. Prevention and screening, routine visits to the physician for health maintenance, and good health behaviors are important to prevent, recognize, or manage polyps. Prompt treatment is indicated if polyps cause symptoms or if a biopsy demonstrates malignant cells.

Bibliography

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