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Approach to the patient with colonic polyps

Dennis J Ahnen, MD
Finlay A Macrae, MD
Section Editor
Paul Rutgeerts, MD, PhD, FRCP
Deputy Editor
Shilpa Grover, MD, MPH


A polyp of the colon refers to a protuberance into the lumen from the normally flat colonic mucosa. Polyps are usually asymptomatic but may ulcerate and bleed, cause tenesmus if in the rectum, and, when very large, produce intestinal obstruction. Colonic polyps are usually classified as non-neoplastic, hamartomatous, neoplastic (adenomas and carcinomas), serrated (which can be neoplastic or non-neoplastic), and submucosal (which can be neoplastic or non-neoplastic).

The different types of benign polyps that develop sporadically and their management will be reviewed here. Colon cancer screening in the average risk individual, surveillance after colorectal cancer resection, and screening in individuals with colorectal polyposis syndromes are discussed separately. (See "Screening for colorectal cancer: Strategies in patients at average risk" and "Screening for colorectal cancer in patients with a family history of colorectal cancer" and "Surveillance after colorectal cancer resection" and "Clinical manifestations and diagnosis of familial adenomatous polyposis" and "Peutz-Jeghers syndrome: Epidemiology, clinical manifestations, and diagnosis".)


The non-neoplastic colonic polyps may be grouped into several distinct categories:




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