Polyp is a medical term for outgrowth of mucosa, which grows into a hollow organ. Typical issue is the case of polyps of the digestive tract (especially polyps of the colon and stomach), endometrial polyps, nasal polyps, gallbladder polyps and urinary bladder polyps. The polyps may have different causes and different clinical significance from banal to very dangerous. According to the appearance, we divide the polyps into pedunculated (they have a neck) and sessile polyps.


The polyps may grow as a result of mucosal irritation by chronic inflammation. In more other cases, the polyps may result from an excessive cell multiplication in benign and malignant tumors. Increased occurrence of polyps may be part of certain genetic syndromes that are caused by an inherited genetic mutation (for example the familial adenomatous polyposis).


Generally, the polyps can be divided into tumorous and non-tumorous and the tumorous are further distinguished to be benign or malignant. The important fact is that many benign tumor polyps can gradually transform into malignant ones (typical example is the majority of cases of the colon cancer).


The polyps may be asymptomatic, or they cause local symptoms occurring due to their growth. Large nasal polyps can cause problems with breathing through the nose. Digestive tract polyps, polyps of the urinary bladder and uterus may cause bleeding (blood in urine, blood in stool, gynecological bleeding) and a variety of nonspecific symptoms. Intestinal polyps have been reported to cause intestinal obstruction.


The majority of polyp is usually found using endoscopic methods (upper GI endoscopy, colonoscopy with chromoendoscopy, hysteroscopy and cystoscopy) or using imaging techniques (ultrasound of the abdomen finds polyps of the gallbladder, urinary bladder polyps or uterine polyps). The endoscopy has ad advantage to directly visualize the polyp to evaluate its size, anatomical location and probable attributes and it also allows us to take a sample for histological examination, or complete removal of the polypous tissue.


Histological examination is essential as it can determine the nature of the polyp. However, a small tissue sample may be inaccurate as it may not show the histological architectonic of the whole polyp. Therefore, complete removal of the entire polyp with subsequent histological examination is preferable.


The situation is challenging in the polyps of the gallbladder as there is no endoscopic method to examine them. Therefore, the doctors may evaluate every case individually. Less risky cases can be regularly monitored, while cholecystectomy (surgical removal of the gallbladder) is performed in high-risk patients.


As mentioned above, the only therapeutic option is to completely remove the polyp tissue. Most polyps can be removed using endoscopic instruments (mostly classical polypectomy), some large intestinal polyps or polyps of the gallbladder must be removed surgically. Inherited syndromes with a high occurrence of polyps usually require a special approach, for example the complete removal of large intestine in people with some forms of familial adenomatous polyposis.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources