Bowel Polyps

Overview

A bowel polyp is a small growth, like a mushroom-shaped lump, on the inner lining of your bowel (large intestine) or rectum. Most polyps are harmless, but some can turn into bowel cancer over many years. That is why doctors usually advise removing them when found.

Yes. Bowel polyps are very common, especially in people over 50. Most are only found during screening tests.

Anyone can develop bowel polyps, but they are more common in older adults, people with a family history of polyps or bowel cancer, and people with certain health conditions.

Symptoms

Common symptoms

• Bowel polyps usually cause no symptoms at all.
• Sometimes, you may see blood in your stool or on toilet paper.
• You might have a change in your normal bowel habit (such as diarrhoea or constipation) that lasts more than a few weeks.

Symptoms in children

• Bowel polyps are uncommon in children. When they happen, they may cause painless bleeding from the bottom, or a polyp may stick out from the anus (a juvenile polyp).

Symptoms in older adults

• In older adults, the same signs apply. Because polyps get more common with age, any new bleeding or change in bowel habit should be checked.

Causes

Main causes

• The exact cause of bowel polyps is not fully understood. They happen when cells in the lining of the bowel divide and grow too much. This growth is linked to age, genetics, and in some cases to lifestyle or inflammation.

Risk factors

• Age over 50.
• Being male (slightly higher risk).
• A family history of bowel polyps or bowel cancer.
• Having an inflammatory bowel disease such as Crohn's disease or ulcerative colitis.
• A diet high in red or processed meat and low in fibre.
• Smoking and heavy alcohol use.
• Being overweight or not physically active.

When to see a doctor

See a doctor urgently if:

• If you have fresh blood or darker blood mixed with your stool, see a doctor urgently (usually the same day).
• If your bowel habits have changed and lasted more than 3 weeks.
• If you are losing weight without trying or feel extremely tired.

Book a routine appointment if:

• At routine check-ups, ask your doctor about screening if you are 50 or older, or if you have risk factors such as a family history of bowel cancer.

Diagnosis

Bowel polyps are most often found during a screening test or when a doctor investigates symptoms. The best way to look at the whole large bowel is a colonoscopy – a long, flexible tube with a tiny camera. If a polyp is found, it can usually be removed at the same time.

Tests that may be done

• Stool test for hidden blood (e.g., faecal immunochemical test or FIT) – looks for small amounts of blood you cannot see.
• Colonoscopy – a camera test to look inside your whole large bowel.
• Flexible sigmoidoscopy – a camera test to look at only the lower part of your bowel.
• Virtual colonoscopy (CT colonography) – a CT scan that shows images of your bowel from outside.

What to expect at your appointment

Before a colonoscopy, you will need to empty your bowel. You will get a special drink to help clear the bowel, and you will be given sedation or pain relief to keep you comfortable. The test usually takes about 30 minutes. You can usually go home the same day.

Treatment

Treatment for bowel polyps usually means removing them. This is done during a colonoscopy, using a wire loop that cuts the polyp off (polypectomy). If a polyp is too large to remove safely during colonoscopy, you may need surgery. After removal, the polyp is sent to a lab to check if it is harmless or has precancerous changes.

Self-care at home

• After a polyp is removed, follow your doctor's advice about rest and activity for a short time.
• Drink plenty of fluids and eat normally unless your doctor tells you otherwise.
• Watch for signs of bleeding, pain, or fever and report them to your doctor.

Medical treatments

There is no medicine that makes polyps disappear. Sometimes, if you cannot have surgery or a procedure, your doctor will monitor the polyp with regular tests instead. If a polyp becomes cancer, it is treated the same as early bowel cancer – usually by removal, sometimes with additional therapy, depending on the stage and your general health.

When is surgery considered?

Surgery is only needed for polyps that are too large to remove during a colonoscopy or for polyps that contain cancer. The operation usually removes the small part of the bowel containing the polyp. This is generally a keyhole procedure.

Living with this condition

After a polyp is found, you will need follow-up to check your bowel again. Your doctor will tell you how often based on the number, size, and type of polyps you had. Most people need another colonoscopy in 1 to 3 years. Between scopes, keep track of any symptoms.

Lifestyle tips

• Eat a high-fibre diet with lots of vegetables, fruits, and wholegrains.
• Limit red and processed meats.
• Keep active and try to stay a healthy weight.
• Stop smoking and limit alcohol.

Diet and exercise

Aim for at least 30 minutes of moderate activity on most days. Increase fibre gradually to avoid bloating. Choose water or unsweetened drinks, and limit sugary snacks.

Mental health and emotional wellbeing

Waiting for tests or being told you have a polyp can feel worrying, especially because of the word 'cancer'. But remember that most polyps are benign and removing them prevents problems. If you feel anxious, talk to your healthcare team – they are used to reassuring people. You can also speak with a trained counsellor.

Prevention

There is no guaranteed way to prevent polyps, but screening helps find and remove them early. A healthy lifestyle may lower your risk. The most important thing is to ask your doctor about screening when you are eligible.

Vaccines

There are no vaccines for bowel polyps.

Screening programmes

Bowel screening tests are offered free in many countries, including the UK. If you are age 45–50 or above, talk to your GP about which screening test is right for you.

Complications

If left untreated

• Some polyps can slowly turn into bowel cancer over 5–15 years.
• Large polyps may bleed and cause anaemia.
• Rarely, a polyp can block the bowel, causing severe pain and constipation.

Long-term outlook

The outlook for bowel polyps is very good. Because most polyps are harmless, and removing them is straightforward and safe, the main risk is not simply having the polyp – it is leaving it alone long enough to change. So if your doctor recommends removal, it is a wise and effective step to protect your future health.

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