Colon Polyp

[Frank74]

Thank you for taking my question.  I am a 31 year old male.  I recently had a colonoscopy due to symptoms which include mild-occasional rectal bleeding (on toilet tissue and sometimes appearing on and/or mixed with stool, bright red appearance), excessive gas, and occasional abdominal pain. These symptoms have lasted for around six months.  

     My previous abdominal related medical history is significant for a non-specific form of inflammatory bowel disease at 20-23 years of age for which I treated with sulfasalizine for two years.  That condition went in to remission at 22-23 years of age and has not returned.  In addition, I had my appendix removed in March 2006.  I have had two abdominal CT scans in the past year both of which were essentially clean.  

      The report from the colonoscopy indicates that the colon and rectal surgeon performing the procedure located and removed one polyp.  The polyp is described as a 1cm semi-sessile polyp of the ascending colon just above the ileocecal valve.  The biopsy report, which is lacking for detail, states in its diagnosis section "Fragments of tubulo-villous adenomatous polyp, 211.3."  Accordingly, as reported to me by my physician, the biopsy report indicates that the polyp was benign.

     1.  How rare is it to have a polyp at my age? (no familial history of CC, other than maternal uncle with rectal cancer at 60 years of age)?

     2.  What are the chances that cancer could have been present in my polyp but not recognized on biopsy?

     3.  Would it be worthwhile to attempt to have the biopsy slides sent to a large academic hospital for a second review?  

     4.  How likely is it that the surgeon performing the scope missed other polyps?

     5.  How soon should I have a follow-up colonoscopy?; How long does it take for polyps to grow?    

        Thanks.

[Kevin Pho, MD]

To answer your questions:
1) Although possible, polyps at such a young age are relatively uncommon.

2) The biopsy should rule out cancer, but if there continues to be concern, another opinion can be considered.

3) This option can certainly be considered if the diagnosis is in doubt.

4) Although possible, a colonoscopy is normally pretty thorough for the evaluation of colon polyps.

5) Polyps are generally slow growing - over the course of years.   Repeat colonoscopy for a tubulo-villous polyp would be in 3 years - sooner depending on the size.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[tim26]

A related discussion, stool culture to test for polyps? was started.