8 Symptoms of Colon Polyps
While colorectal cancer polyps often have no symptoms—especially in the early stages—there are some warning signs to be on the lookout for...plus one common myth about polyps.
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“Not all colon polyps are cancerous but all colon cancer starts as a polyp which is why everyone needs to know about them and be screened regularly for them,” says Fola May, MD, a gastroenterologist and associate professor of medicine, David Geffen School of Medicine at UCLA and the director of Fight Colorectal Cancer. “And colorectal cancer is the second-leading cancer killer of men and women combined.”
Yikes! OK, we’re listening…but what are polyps, exactly? Colon polyps are growths that occur on the inner lining of the large intestine (colon), or the rectum (which comprises the last six inches of the G.I. system before the body expels solid waste). Polyps vary in size and shape, ranging from small, flat bumps to larger, mushroom-shaped growths.
Polyps are quite common: It’s estimated that 15% to 40% of adults have them, and people who have them generally have more than one,” adds Dr. May.
Polyps can be benign (noncancerous) or malignant (cancerous). Only a percentage of polyps will become cancerous—and of those that do, they generally take years to turn cancerous.
One major problem? “Early polyps often look like a small pimple,” Dr. Mays says—so small that if you had one, you almost certainly wouldn’t know it. “You will most likely not be able to feel symptoms or see signs of a polyp,” Dr. May says. “Most polyps and early-stage colorectal cancers do not cause symptoms that you can see or feel.” The only way to diagnose and remove polyps is with a colonoscopy, which is why it’s important to start getting cancer screens regularly starting at age 45.
“Since it is difficult to tell during colonoscopy which polyps have the potential to become cancerous, the goal of the procedure is to remove them all,” she explains.
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Types of colon polyps
There are the three types of polyps:
Adenomatous polyps: These are the most common type and the most likely to become cancer. They may be described as tubular, villous, or tubulovillous polyp, which are the different growth patterns of the polyp.
Hyperplastic polyp and inflammatory polyp: These are common but usually not cancerous. If yours is rather large, your doctor may recommend getting a colonoscopy more often than the standard every 10 years.
Sessile serrated polyps and traditional serrated adenomas: These have a higher risk of being cancerous. Sessile are broad and flat polyps, while serrated polyps have a “saw-tooth” appearance.
Symptoms of colon polyps
Dr. May emphasizes that most people experience no symptoms of polyps, especially at the early stages—but adds that as they grow larger, they may cause some symptoms. If you experience any of these symptoms they may indicate colon polyps, colorectal cancer, or some other gastrointestinal issue and they warrant a call to your doctor.
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Blood in your stool or rectal bleeding
If you see bright red blood in your poop, in the toilet after defecating, or on the toilet paper after wiping, it may be bleeding from an irritated polyp. This is the most common symptom of larger colon polyps.
Polyps, particularly those that have gotten large, can cause bleeding. Over time this blood loss can lead to anemia, or a low red blood cell count. You may feel tired, or your doctor may notice it in a routine blood test.
New diarrhea or constipation
Any new changes in bowel movements that last longer than a week are cause for concern, says Dr. May. These can include diarrhea or constipation or a change in the consistency and shape of the stool. “Pencil shaped stool—long, narrow poop—is a sign of colorectal cancer, especially if it happens suddenly,” she says.
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Unexplained weight loss
Losing weight without trying is one of the hallmark signs that colon polyps have progressed into later-stage colorectal cancer. As they grow larger, they can block nutrient absorption in the colon, causing unexplained weight loss.
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Abdominal pain or discomfort
On its own, this symptom can have many causes…but if you feel consistent cramping or pain in your abdomen along with other symptoms on this list, it may indicate colon polyps. This can range from mild discomfort to severe pain.
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Fatigue and weakness
Anemia brought on by polyps often causes fatigue, exhaustion, and a feeling of overall weakness. If you experience this symptom along with others on this list—particularly rectal bleeding—call your doc right away.
Shortness of breath
Feeling always out of breath or like you can’t catch your breath during normal activities is another side effect of the anemia due to blood loss.
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You can’t feel them
There is a common myth that if the polyp gets large you will be able to feel it either through palpitating your stomach area or by inserting your fingers into your rectum. This isn’t true, and you won’t be able to feel polyps from the outside, says Dr. May.
If you do feel a lump it’s more likely to be a hernia, hemorrhoids, or your normal internal organs. (This is more of a non-symptom—but the myth is so common we wanted to include it here!)
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Fola May, MD, a gastroenterologist and associate professor of medicine, David Geffen School of Medicine at UCLA and the director of Fight Colorectal Cancer.
National Institutes of Health: "Definition & Facts for Colon Polyps"
American Cancer Society: "All About Colorectal Cancer"