The anal polyp is a precancer tumoral formation of a mucous rectum. Long time proceeds asymptomatically. It can be shown by bloody or mucous allocations, considerable bleedings are sometimes observed; locks or ponosa, false desires, feeling of a foreign matter or incomplete depletion of intestines. The diagnosis is made on the basis of a manual research, an anoskopiya, a rektoromanoskopiya or a kolonoskopiya, a radiological research with contrasting, biopsies. Treatment includes low-invasive surgical techniques: electrothermic coagulation and radio wave therapy.
The anal polyp represents the good-quality new growth coming from the mucous anorektalny area. Polipozny outgrowths can be single and multiple, settle down separately and groups; to be connected with mucous by means of a leg or the wide basis. A tumor form fungoid, branching, spherical or oval. The size varies from prosyany grain to hazelnut (2-3 cm in the diameter). Pathology meets in all age categories, since children's age. Polyps happen a ferruterous origin (meet most often), hyper plastic or fleecy. Pathological process, as a rule, proceeds asymptomatically until significant increase in a tumor or loss of a polyp outside at the expense of a long leg.
Reasons and risk factors
The new growth practically never arises on healthy and not changed a mucous rectum. Usually emergence of polyps is preceded by the postponed inflammatory diseases (chronic colitis, ulcer colitis, a typhoid, ulcer proktosigmoidit, dysentery). As also contributing factors serve chronic locks or ponosa, violations of motility of intestines (dyskinesia), the lowered acidity of gastric juice. At children, unlike adults, polyps can appear on not changed mucous membrane, against the background of full health. It is caused by anomalies of development of a rectum owing to violations of an embryogenesis. Also the assumption of a virus origin of polyps is made.
On morphological accessory allocate the adenomatozny, fleecy, fibrous and mixed polyps. Most often tumors in the form of adenoma meet; they do not differ by the form from a mucous membrane (have gentle-pink color and the normal vascular drawing), represent dense new growths, smooth to the touch. Fleecy polyps fasten the wide basis, have spongy structure and easily bleed. Fibrous tumors most often have a leg and quite often can grow from gemorroidalny knot. Because of growth of a soyedinitelnotkanny leg polyps can drop out of a rectum outside.
Symptoms of an anal polyp
Manifestations of polyps depend on their arrangement, a look and the sizes. For many years pathological process can not have an effect up to significant increase in a tumor or its loss outside. The symptomatology of a disease is not specific, can be similar to many pathological processes of digestive tract. There can initially be a feeling of discomfort in the field of an anus, feeling of incomplete depletion of intestines or existence of a foreign matter in anorektalny area.
Most often the disease is followed by bleedings: at a new growth arrangement in disteel department of a rectum emergence of a strip of fresh blood on a surface of kalovy masses is noted. At higher arrangement of polyps of allocation have mucous or bloody and mucous character. Long existence of an anal polyp with frequent bleedings from it can lead to development of post-hemorrhagic anemia. Work of intestines is, as a rule, not broken. Only at the impressive sizes of polyps there can be locks or ponosa, and also symptoms of irritation of intestines – false desires (tenezm).
Diagnostics and difdiagnostika
First of all, consultation of the proctologist with carrying out a manual rectal research is required. The patient adopts the knee and elbow provision. The doctor at the same time investigates all walls of the anal channel and nizhneampulyarny department of a rectum. It allows to reveal polyps, the accompanying states (hemorrhoids, anal cracks and so forth), and also to define a condition of a sphincter and its tone. With the same purpose also the anoskopiya is carried out. From tool methods of a research in need of an exception of multiple polyps of a rectum and other departments of a large intestine apply a rektoromanoskopiya or a kolonoskopiya with a possibility of carrying out an endoscopic biopsy mucous and the subsequent morphological research of bioptat. In the absence of a possibility of performing endoscopy appoint an irrigoskopiya with double contrasting or a barium passage X-ray analysis on a large intestine.
Differential diagnostics of true anal polyps is carried out with false polyps or pseudo-polyps. The last consist of the granulyatsionny fabric which is result of inflammatory diseases of a thick gut. Pseudo-polyps have the irregular polygonal shape, easily bleed, most often have no leg, settle down against the background of the inflamed mucous membrane. Anal polyps also should be distinguished from a papillit - hypertrophied nipples in the anal channel. The last represent an eminence of a mucous membrane in rectum bosoms. At children it is necessary to distinguish displays of ulcer colitis and a polyp. Difficulties are connected with similar symptomatology of these two pathologies (bleeding and mucous allocations).
Treatment of an anal polyp
Treatment of educations consists in their endoscopic excision. Low-invasive techniques, such as electrothermic coagulation and radio wave therapy are applied. Electrothermic coagulation is carried out after preliminary preparation similar to that that is carried out before an endoscopic research of a thick gut (cleaning enemas in the evening, on the eve of operation and in two hours prior to intervention). Also the presurgical drug treatment including resolvents can be appointed (if takes place to be sharp inflammatory process). Manipulation is carried out with use of the endoscope. In the presence at a leg polyp the last is captured as it is possible closer to the basis. Removal of a polyp by means of the given current, is carried out within several seconds (2-3 sec.). If the tumor is fixed by the wide basis, then it is clamped, slightly delaying a new growth on themselves.
At the big sizes of a polyp it is liquidated parts, with an interval of stages of intervention in 2-3 weeks. Makes the greatest difficulty of removal polyposes on all extent mucous - in the latter case carry out a resection of a mucous rectum or a sigmoidektomiya within healthy fabrics from the subsequent kolorektoplastiky. Restoration after operation can take of 3-5 days and up to 2-3 weeks during which the patient keeps to a bed rest and a besshlakovy diet.
Forecast and prevention
The forecast after performance of expeditious removal of polyps quite favorable (except for cases when it is made removals of the whole site of a straight line, and sometimes and a sigmovidny gut). For patients the dispensary observation including endoscopic inspection each 1,5-2 months after intervention and then at least, than once a year is established. Timely removal of anal polyps is some kind of prevention of development of a colorectal cancer (especially in the presence of symptoms of anemia and threat of an ozlokachestvleniye). The prevention of development of polyps is medical examination and inspection of all categories of the citizens having these or those violations of work of a large intestine.