A polyp is the growth of epithelial cells from the mucous membrane of an organ. In most cases, it is a benign mass that rises above the surface of the mucosa.
A characteristic feature of polyps is the appearance of these formations: they can attach to the mucous membrane of an organ with a wide base or come in a mushroom shape. Sizes range from a few millimeters to several centimeters. Often reach gigantic proportions.
Glandular polyp (adenomatous polyp, adenoma) is a pathological formation of glandular cells with inclusions of atypical elements. It is an education that can degenerate into malignant under certain circumstances.
Glandular polyp - symptoms
The glandular polyp, the signs of which, first of all, are the morphological structure, shape and size, has:
• spherical;
• mushroom-shaped;
• branchy form.
It consists of a network of branching glands and is most often located on the mucous membrane:
• uterus;
• stomach;
• intestines.
The size of the tumor is an important factor, because malignancy (malignant degeneration) directly depends on the size of the polyp. Malignancy can occur in the following cases:
• if the polyp size is 1.5 cm - in 2% of cases or less;
• with a diameter of 1.5 - 2.0 cm - in 2 - 10%;
• more than 2.5 - 3.0 cm - malignancy of more than 10%.
It is believed that the type of polyp plays a role in further degeneration: education on a broad basis often becomes malignant.
The glandular polyp, the signs of which are also multiplicity and prevalence, is divided into polyposis:
• single;
• multiple (group and scattered adenomas);
• diffuse (family).
The number of growths formed, as well as the size, have prognostic value:
• malignancy of single formations occurs in 1 - 4% of cases;
• multiple malignant in 20% of cases;
• diffuse polyposis can occupy the entire surface of the organ without leaving unaffected areas; their malignancy occurs in 80% - 100%.
Glandular polyp - causes
The glandular polyp is an acquired pathology. The risk of this formation in humans increases with age.
Glandular polyp, the causes of which are:
• genetic predisposition;
• hormonal disorders;
• endocrine diseases;
• long-term trauma to the mucosa of a particular organ,
nevertheless, in more than 50% of all cases there are close relatives: the presence of chromosomal aberrations in many cases of this pathology has been studied and proved. These are violations in the structure of some chromosomes that make up the genes responsible for the development of polyps.
The localization of the polyp in a particular organ is explained by a number of factors and reasons contributing to its occurrence in this particular place.
Glandular polyp - causes it in the digestive system
Polyps of the gastrointestinal tract are most often found in the stomach and intestines (in the rectum and colon). In addition to heredity, the development of adenoma in the stomach can be triggered by prolonged use of proton pump inhibitors (PPIs). The risk factors for the formation of polyps in the digestive system include:
• stagnation of intestinal contents in connection with the use of a large amount of fats and proteins, leading to a decrease in peristalsis and intensification of the processes of decay and fermentation, and, accordingly, to the development of intoxication;
• imbalance of microflora, causing a violation of local immunity and a sharp decrease in the differentiation and regeneration of epithelial cells of the digestive system;
• the presence of chronic diseases and a violation of the production of bile acids, which can cause mutations in the cells of the mucosa.
Causes of the uterine polyp
The glandular endometrial polyp can be caused by the following reasons:
• inflammatory process during the formation of the body, which subsequently caused a violation of the menstrual cycle and reproductive function;
• hormonal dysfunction during menopause;
• chronic mucosal injury due to a long-used intrauterine device;
• operation (curettage or probing of the uterine cavity);
• mastopathy.
In addition to the above specific risk factors, there are more general ones:
• hypovitaminosis C and E;
• reduced immunity;
• concomitant diseases of the intestine (Crohn’s disease, colitis), uterus (inflammatory nature - myoma, endometriosis, as well as cervical erosion), sexually transmitted infections;
• diseases of the endocrine system (pathology of the thyroid gland with impaired hormone production and diabetes);
• excess weight;
• frequent stresses.
Glandular polyp - the first symptoms
It is believed that with a glandular polyp, the first symptoms develop 5 to 6 years after the appearance of the formation. Until this time, polyps, if present, do not manifest themselves clinically. They can become an accidental find during the examination, or they are almost asymptomatic.
With a glandular polyp, the first symptoms occur when the size of the adenoma is more than 2.0 cm. A typical location of the glandular polyp in the digestive tract is the stomach, colon and rectum (part of the intestine).
Adenoma of the stomach is formed in the fundus, it does not cause any subjective sensations and is, at best, a find on EFGDS.
In the colon, the glandular tumor looks like a mushroom on a long stalk. Malignant in 1% of cases, but over time it grows with villi, mutates, and the ability to degenerate into a malignant formation increases significantly.
When it is localized in the digestive organs, when large sizes are reached, the following can occur:
• pain in the stomach or in the anus;
• gastrointestinal bleeding (black stools or vomiting of coffee grounds; scarlet blood or mucus may be present during bowel movements);
• stool disorders (constipation or diarrhea);
• frequent, sometimes painful urges to defecate;
• anal itching.
When a polyp reaches a huge size, intestinal obstruction occurs, with their inflammation in the rectum, paraproctitis develops, often cracks.
If the polyp develops in the endometrium, it is asymptomatic for a long time. Only upon reaching the huge size of the glandular polyp, the first symptoms can become:
• aching abdominal pain radiating to the perineum or lower back;
• unpleasant or painful sexual intercourse;
• infertility;
• irregularities of the menstrual cycle (irregularity, heavy or scanty bleeding, ongoing discharge between cycles, etc.);
• metrorrhagia.
Often there is a germination of a polyp from the cervix to the vagina.
Of the complications, in addition to the germination of the polyp, the following often occur:
• bleeding,
• malignancy;
• with uterine polyps - infertility;
• relapse.
Glandular polyp - treatment
If a glandular polyp is detected, conservative treatment is ineffective. Radical surgery is needed.
In the presence of a polyp of the digestive system, the following methods are used:
• polypectomy by the endoscopic method in the stomach with further coagulation of the bed of the removed polyp;
• transanal removal in the presence of a glandular polyp in the rectum;
• in complex cases - colonotomy or resection of a part of the intestine with a polyp.
If a glandular polyp is found in the uterus, the treatment consists of:
• the use of hormonal drugs;
• removal of polyps by the endoscopic method;
• ovarian resection in case of hormone-dependent pathology;
• hysterectomy with appendages with menopause or with a massive common process.
Prognosis after treatment of glandular polyp
Relapses occur in 30 - 50% of cases in the range from 1.5 to 6 months after successful treatment. In this case, malignancy of the adenoma often occurs after its relapse. Therefore, without fail, the first inspection should occur in 1.5 - 2 months, in the subsequent - every 3 - 6 months during the first. In the future, you need to visit a doctor twice a year.
Glandular polyp - prevention
There is no specific prophylaxis. Self-medication is unacceptable.
With a glandular polyp, general prevention consists in annual professional examinations and immediate medical attention for the slightest symptoms of concern. Routine examinations play a crucial role in preventing the disease and help to avoid serious complications and consequences.
It is necessary to strive for a healthy lifestyle, eat right, treat chronic diseases in a timely manner, prevent abortion - use contraception.
