Rectal polyps

　　Rectal polyps refer to protruding nodular lesions on the surface of the rectal mucosa into the intestinal lumen, including adenomas (including villous adenomas), juvenile polyps, inflammatory polyps, and polyposis. From a pathological perspective, their contents vary, some are benign tumors, and some are the consequences of inflammatory hyperplasia. However, as they appear similar to the naked eye, the general and vague name 'polyp' has been traditionally used. The rectum is a common location for polyps, and due to their ease of detection and treatment, they are highly valued. In recent years, it has been believed that colorectal cancer originates from polyps, and early removal of polyps can reduce the incidence of cancer. Therefore, as a precancerous lesion, polyps have received more attention. What are the causes of rectal polyps?

　　1. Dietary Factors

　　Dietary factors are related to the formation of rectal polyps. Patients, especially the interaction between bacteria and bile acids, are many times the basis for the formation of adenomatous polyps.

　　2. Genetic Factors

　　It is generally believed that the formation of polyps is closely related to gene mutations and genetic factors. Current research indicates that mutated genes can be inherited from parents to their offspring, with equal genetic opportunities for both males and females, without gender differences.

　　3. Inflammatory Stimulation

　　Long-term inflammation stimulation of the rectal mucosa can cause the formation of intestinal mucosal polyps. This is due to the inflammation, congestion, edema, erosion, and ulceration of the intestinal mucosa, which, after healing, lead to the gradual contraction of scars, forming polyps. Also, due to chronic inflammation stimulation, gland obstruction, and mucus retention, the disease occurs.

　　4. Stimulation and Mechanical Injury by Fecal Foreign Bodies

　　Long-term stimulation of the intestinal mucosal epithelium by coarse fecal matter and foreign bodies, as well as damage to the rectal mucosa caused by other reasons, can cause abnormal cell proliferation and the formation of polyps.

　　Rectal polyps have little effect on the human body at first, but if rectal polyps are allowed to develop, the harm is great. The harm of rectal polyps is reflected in the following aspects:

　　1. Rectal Polyp Malignancy

　　Many solitary polyp patients do not pay attention to it at the beginning, and it is possible to transform into multiple polyps. Multiple polyps have a very high chance of malignant transformation!

　　2. Rectal Polyp Intussusception

　　Sometimes, larger rectal polyps can also cause intussusception, leading to intestinal obstruction and abdominal pain.

　　3. Rectal Polyp Prolapse

　　When rectal polyps are large or numerous, due to gravity, they pull on the intestinal mucosa, causing it to gradually separate from the muscular layer and prolapse downward. The action of defecation and intestinal peristalsis stimulation can relax the mucosal layer around the pedicle base, possibly leading to rectal prolapse.

　　Experts remind us that early detection, early diagnosis, and early treatment of rectal polyps are important. Early treatment has a better prognosis, while late treatment usually requires surgery, causing greater harm to the body. Therefore, attention should be paid to examinations and treatments.

　　Polyps are excessive lumps on the human tissue, accounting for about 45~70% of benign tumors in the digestive tract. The rectal polyps referred to here are new growths on the rectal mucosa, which are often caused by chronic stimulation of feces and are common benign tumors. Most rectal polyps are pedunculated round or elliptical masses that can protrude into the intestinal lumen and move up and down. The majority of the pedicle is elongated due to the intestinal mucosa due to intestinal peristalsis or fecal traction. Most are solitary, with multiple occurrences being rare. It should not be called polyps when referring to the mucosal surface bulges caused by myomas in muscles and fats, to avoid mistaking tumors for polyps.

　　Symptoms of rectal polyps

　　1. Protrusion: When the pedicle of the rectal polyp is long, it is often prolapsed out of the anus. The polyp may sometimes only protrude from the anal orifice, or part of the pedicle may also protrude out. If the polyp is large, it must be manually retracted after protrusion, and it may occasionally become incarcerated outside the anus. High-positioned polyps often cannot be prolapsed.

　　2. Hematochezia: It is fresh blood, covering the surface of the stool without mixing with it. The pedunculated polyps at the lower end of the rectum may fall out of the anus during defecation.

　　3. When polyps are complicated with ulceration and infection, there may be mucus and blood stools and a feeling of urgency to defecate.

　　4. General symptoms: Those with a large number of polyps and a long course of disease may have symptoms such as anemia, emaciation, and other systemic weakness. Those with excessive mucus excretion may have hypokalemia arrhythmia or weakness in the limbs, easy fatigue, etc.

　　Rectal polyps are a common clinical disease, and their incidence increases with age, with more males than females. To prevent rectal polyps, it is advisable to start with daily life and diet.

　　1. Maintain optimism

　　Maintain a good mental attitude to cope with stress, combine work and rest, and do not overwork. It can be seen that stress is an important factor in the induction of cancer. Traditional Chinese medicine believes that stress leads to overwork and physical weakness, causing a decrease in immune function, endocrine disorders, and metabolic disorders in the body, leading to the deposition of acidic substances in the body; stress can also lead to mental tension, causing qi stagnation and blood stasis, internal fire, and other symptoms.

　　2. Regular life

　　Live a regular life, and for those with irregular living habits, such as staying up all night singing karaoke, playing Mahjong, not returning home at night, and other irregular lifestyles, these can worsen the acidification of the body and are prone to intestinal polyps. Develop good living habits to maintain an alkaline constitution, so that cell proliferation is promoted, and mutation diseases are kept away from oneself.

　　3. Good living habits

　　Develop good living habits, quit smoking, and limit alcohol consumption. Smoking, according to the World Health Organization's prediction, if people stop smoking, cancer rates in the world will decrease by one-third after five years; secondly, do not overindulge in alcohol. Both smoke and alcohol are highly acidic substances, and long-term smokers and drinkers are prone to an acidic constitution.

　　4. Light diet

　　Do not eat too much salty and spicy food. Do not eat over-hot, over-cold, expired, or spoiled food; for the elderly, the weak, or those with hereditary genetic diseases, eat some cancer-preventive foods and alkaline foods with high alkaline content appropriately to maintain a good mental state.

　　5. Green food

　　Avoid consuming contaminated foods such as polluted water, crops, poultry, fish eggs, and moldy food. Consume more green organic foods and prevent diseases from entering through the mouth.

　　6. Exercise the body

　　Strengthen physical exercise, enhance physical fitness, and exercise more often in the sunshine. Sweating can help expel acidic substances from the body, preventing the formation of an acidic constitution.

　　In our daily lives, we should try to avoid various triggering factors and reduce the incidence of diseases to the lowest limit, improving our quality of life.

　　With the rapid development of society and the increase in intellectual labor, in recent years, anorectal diseases have only increased and not decreased, seriously affecting the quality of life of patients, especially white-collar women. The most common anorectal disease in women is rectal polyps. Just like normal diseases, the earlier the treatment for rectal polyps, the better. Otherwise, the condition may worsen. Then what kind of examinations should be done for rectal polyps in the hospital?

　　1. Rectal palpation

　　Used for polyps in the middle and lower rectum, rectal polyps can be felt as soft, smooth, and movable nodules by finger palpation. About 70% of patients can palpate soft, bean-sized round masses that can move and are not tender. And for rectal polyps located higher or smaller polyps, rectal palpation is not easy to find, and other auxiliary examinations are needed.

　　2. Electronic anorectal endoscopy

　　For more precise diagnosis, hyperplastic polyps often present as nodular protuberances. Adenomatous polyps are round with pale and glossy mucosal surfaces. Villous papillary adenomas are lobulated, resembling cauliflower, and are soft like sponge-like large polyps. Inflammatory polyps have long pedicles and red in color. It solves the problems of missed and misdiagnosis in anorectal disease detection.

　　3. Sigmoidoscopy or fiberoptic endoscopy

　　If multiple polyps are found, routine diagnosis and examination of various lesions in the large bowel lumen, sigmoidoscopy or fiberoptic endoscopy should be performed to exclude multiple polyps and colorectal polyposis. Polyps without pedicles and broad bases should be considered as pre-malignant lesions and should be examined by pathological sectioning as soon as possible. It is a relatively painless examination. Rectal polyps often grow on the posterior wall of the lower rectum (accounting for about 70%), with solitary polyps accounting for 90%, most of which have pedicles 2-5 cm long and can be moved. Polyps without pedicles account for about 10%, and are generally rare. What kind of examination should be done for rectal polyps? Papillary polyps are often solitary, with a few being multiple, broad bases, without pedicles or short pedicles, with fine, long villous protuberances on the surface, and are prone to malignant transformation. Standard biopsy forceps are equipped with fiberoptic endoscopy, which helps to discover early lesions in the colon.

　　Rectal polyps are generally benign tumors, but multiple rectal polyps are more common in young and middle-aged adults, with a clear family hereditary tendency and a high risk of malignant transformation. Therefore, patients with rectal polyps should pay attention to diet and nutrition to prevent the occurrence of malignant transformation of rectal polyps.

　　Firstly, foods suitable for rectal polyps

　　1. High energy and high protein should be consumed to compensate for the nutritional expenditure caused by long-term diarrhea. The supply amount can be gradually increased according to the patient's tolerance for digestion and absorption. Generally, the energy supply is 40 kcal per kilogram of body weight per day. Protein is 1.5 grams per kilogram of body weight per day, with 50% being high-quality protein.

　　2. Ensure an adequate intake of vitamins and inorganic salts to compensate for the nutritional loss caused by diarrhea.

　　3. Eat in small, frequent meals: To alleviate the burden on the intestines, supplement nutrient intake by eating in small, frequent meals.

　　Secondly, foods that are not suitable for rectal polyps

　　1. It is not advisable to eat spicy, sour, and刺激性食物.

　　2. Eat less greasy food and more fiber-rich fruits and vegetables.

　　3. Limit fats and dietary fiber: Patients with rectal polyps accompanied by diarrhea often have poor fat absorption, and severe cases are accompanied by fatty diarrhea. Therefore, the amount of dietary fat should be limited, and low-fat foods and cooking methods should be used. For those with fatty diarrhea, medium-chain triglyceride oils can be used. Avoid eating foods that are high in irritants and fiber, such as spicy foods, sweet potatoes, radishes, celery, raw vegetables, fruits, and刺激性 spices such as scallions, ginger, garlic, and coarse grains, dried beans, etc.

　　Among the many factors that cause colorectal cancer, intestinal polyps are one of the common causes that should not be ignored. Although polyps have a tendency to become cancerous, not all of them will become cancerous. However, once rectal polyps are contracted, timely treatment is necessary to prevent the possibility of cancerous transformation. The following editor introduces four treatment methods for rectal polyps, hoping to be helpful to everyone.

　　1. Laparotomy

　　If the rectal polyp is too high to be treated with the above methods, it needs to be removed by laparotomy under epidural anesthesia, cutting the anterior wall of the rectum to remove the polyp. If it has become cancerous, it should be treated according to rectal cancer. For familial polyposis with multiple polyps, the retention of the rectum can be determined according to the distribution of rectal polyps; rectal resection or rectal mucosal stripping can be performed, and ileorectal anastomosis can be performed through the rectal seromuscular sheath, etc.

　　2. Electrocautery Removal

　　For those who cannot be removed through the anus within the scope of the rectoscope, the polyp can be removed by electrocautery by套住蒂部 with a snare device. Rectal polyps require pathological examination, and electrocautery treatment for wide-base polyps is not safe.

　　3. Minimally Invasive Therapy

　　The treatment of rectal polyps can adopt the minimally invasive HCPT surgery therapy. Compared with the above traditional surgical therapies, its advantages are basically painless, less trauma, quick postoperative recovery, accurate positioning, safe and reliable, and it is also the most popular treatment method among patients at present.

　　4. Transanal Resection

　　The rectal polyp can be removed from the anal canal, the anus is widened with an anoscope or dilator, the polyp is clamped with a forceps, tied off at the base with a silk thread, and the polyp is removed. After the wide base polyp is treated and removed, the mucosal wound should be sutured.

　　This is an introduction to the treatment methods of rectal polyps. Experts remind patients that rectal polyps are extremely harmful to the human body, and once this disease is contracted, it needs to be treated promptly.