RECTAL POLYP
An outgrowth of tissue from the lining of the intestine is referred to as an intestinal polyp. A polyp of the colon or large intestine occurs in about 1-2% of children. The most common type of polyp encountered in Pediatric gastroenterology practice is the hamartoma or juvenile polyp accounting for more than 95% of cases. Juvenile polyps are most frequently diagnosed in the first 10 years of life with a peak age of diagnosis between two to five years. The term ‘juvenile’ refers to the type of polyp and not the age of onset. Most harmless polyps are single and are found in the last 20 cm of the colon.
The most frequent and sole presentation is small amount painless rectal bleeding (bright red blood). It is not associated with pain or discomfort. Bleeding per rectum can be intermittent and tends to recur over weeks or months. Other less common presentations include a prolapsing rectal mass, mucopurulent stools or symptoms of iron-deficiency anemia due to chronic blood loss (weakness, fatigue, pallor, or headache). Colon polyps rarely lose significant amounts of blood unless they are pulled off the colon wall at their stalk by the normal movement of the colon. Larger polyps in the small intestine or colon can sometimes become a lead point for intussusception (telescoping of bowel in nearby bowel) leading to blockage.
A colonoscopy is recommended whenever a colonic polyp is suspected. In colonoscopy, mucosal lining of the entire colon is examined with a narrow flexible instrument (colonoscope), mounted with a video camera and attached to a monitor. When a polyp is found, the Pediatric gastroenterologist uses a special grasping instrument (snare) that goes inside the colonoscope in a channel and cautery to remove the polyp (Polypectomy). The polyp is sent to the histo-pathologist, who will examine it under the microscope to determine the type of polyp. If a child is found to have a single juvenile polyp, he or she does not need to have a follow up colonoscopy as these polyps generally do not recur.
Dr. Deepak Goel
Dr. Deepak Goyal, a Pediatric Gastroenterologist with extensive post-MD experience of more than 15 years that includes super-specialty training in ‘Pediatric Hepatology & Gastroenterology’ (MCI-recognized) at SGPGIMS, Lucknow, has managed various kinds of complicated Pediatric Gastroenterology, Hepatology & Liver Transplant Cases.
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