17462 Serrated Polyps

Overview

Serrated polyps are growths that form on the inner lining of the large bowel (colon). They get their name because, under a microscope, their edges look like the jagged teeth of a saw. Most serrated polyps are harmless, but some types can change into bowel cancer over many years if left in place.

Yes. Serrated polyps are one of the most common types of polyps found in the large bowel, and their detection has increased as more people take part in bowel screening.

They affect both men and women, and become more common with age. People with a family history of bowel polyps or bowel cancer, or who smoke, may be at higher risk.

Symptoms

Common symptoms

• Most serrated polyps cause no symptoms at all.
• Bleeding from the back passage (rectal bleeding).
• A change in bowel habits lasting more than a few weeks.

Symptoms in children

• Serrated polyps are very rare in children. If a child develops any bowel polyp, it is usually a different type. Possible signs can include blood in the stool or persistent changes in bowel habit, and these should always be checked by a doctor.

Symptoms in older adults

• Serrated polyps in older adults often have no symptoms, which is why screening is so important. If they do cause symptoms, you may notice blood in your stool, a lasting change in bowel habits, or signs of anaemia such as tiredness and pale skin.

Causes

Main causes

• The exact cause is not fully understood, but serrated polyps start when cells in the lining of the bowel grow abnormally.
• Some serrated polyps have small changes in the DNA of the bowel cells that make them more likely to develop into cancer over many years.
• Inherited gene changes may play a role in some families.

Risk factors

• Being over the age of 50.
• Having a family history of bowel polyps or bowel cancer.
• Having had polyps in the past.
• Smoking.
• Being overweight or having an inactive lifestyle.

When to see a doctor

See a doctor urgently if:

• See your GP if you have blood in your stool, black or tarry stools, or a sudden change in your bowel habits that lasts more than a few weeks.

Book a routine appointment if:

• If you are due for routine bowel cancer screening, or if you have a family history of bowel polyps or bowel cancer, talk to your doctor about when screening should start.

Diagnosis

Serrated polyps are usually diagnosed during a colonoscopy, which is a test that uses a thin, flexible tube with a small camera to look inside the large bowel. If a polyp is found, it is almost always removed during the same procedure and sent to a laboratory for analysis under a microscope.

Tests that may be done

• Colonoscopy – the most common way to detect and remove polyps.
• Flexible sigmoidoscopy – a test that looks at the lower part of the bowel.
• Computed tomography (CT) colonography – a special X-ray that can show polyps without using a telescope inside the bowel.
• Biopsy – a small sample of the polyp is taken and examined by a pathologist to confirm the type.

What to expect at your appointment

Before a colonoscopy, you will be asked to use laxative drinks to clear your bowel. The procedure usually takes about 20–30 minutes, and you will likely be sedated so you feel relaxed and comfortable. If a polyp is found, it is removed during the test. You can usually go home the same day, but you will need someone to take you home if you have had sedation.

Treatment

Treatment for serrated polyps starts with removing them. Most polyps can be taken out completely during a colonoscopy, and no further treatment is needed. After that, your doctor will tell you when you need another check to make sure no new polyps have developed.

Self-care at home

• There are no home treatments that can remove polyps, but you can help your bowel health by eating a high-fibre diet with plenty of vegetables and fruits.
• Drink enough fluids and take gentle exercise most days.
• Avoid smoking and limit alcohol to stay as healthy as possible.

Medical treatments

There are no medicines used to treat serrated polyps themselves. Instead, the main 'treatment' is physical removal during a colonoscopy. If you have other conditions such as anaemia, your doctor may recommend appropriate measures, but no medications for polyps are prescribed.

When is surgery considered?

Surgery is rarely needed. It may be considered if a polyp is very large, cannot be safely removed during a colonoscopy, or contains cancer cells. In those situations, the affected part of the bowel may be removed by a surgeon.

Living with this condition

Once a serrated polyp has been removed, there are usually no daily restrictions. You should follow the arranged follow-up plan, which may mean a repeat colonoscopy in a few years. Keep a note of your test dates and results.

Lifestyle tips

• Stay physically active – aim for at least 30 minutes of moderate activity on most days.
• Maintain a healthy body weight.
• Avoid smoking and limit alcohol.
• Eat a balanced diet rich in vegetables, fruits, and whole grains.

Diet and exercise

A diet high in fibre from whole foods, with plenty of vegetables and fruits, and low in red and processed meats may reduce the risk of bowel problems. Regular exercise helps digestion and supports overall health.

Mental health and emotional wellbeing

Hearing that you have a polyp can be worrying, but it is important to remember that most serrated polyps are not cancer. If you feel anxious about your diagnosis or your risk of bowel cancer, talk to your doctor. Anxiety is common, and there is no need to face it alone.

Prevention

You cannot always prevent serrated polyps, but healthy habits such as not smoking, staying active, and eating a balanced diet may lower your risk. The best way to prevent a polyp from becoming a problem is to take part in bowel screening and have it removed if it is found.

Vaccines

There is currently no vaccine for serrated polyps or bowel cancer.

Screening programmes

Bowel cancer screening is offered from around age 50–60 depending on where you live. It usually involves a simple stool test that checks for tiny amounts of blood. If the test result is abnormal, you may be offered a colonoscopy. If you have risk factors like a family history, your doctor may recommend screening earlier or more often.

Complications

If left untreated

• Some types of serrated polyps can slowly grow and develop into bowel cancer over several years.
• A polyp could, rarely, cause bleeding that leads to anaemia.
• A very large polyp could partially block the bowel, but this is uncommon.

Long-term outlook

The outlook is excellent. Most serrated polyps are harmless, and removing them during a colonoscopy takes away the risk of them becoming cancer. If you follow your doctor's advice about follow-up checks, your chances of developing bowel cancer remain very low.

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