How Do I Treat Polyps?

Question: I had a colonoscopy and had a polyp removed, plus I have diverticulitis (3) pockets. What can I do to prevent polyps and what can I do to prevent or treat diverticulitis?

Dr. Hibberd's Answer:

We have no definitive prevention for polyps. Polyps are acquired solid tissue growths that project inside our bowel wall. In part, they are determined by your genetic background. There are no pharmaceutical agents available to effectively treat or prevent polyps. Polyps must be surgically removed, usually via scope during a colonoscopy. Open procedures are not necessary to remove polyps.

Malignant degeneration of polyps is believed to be our prime source of colon malignancy. We now screen (i.e. by colonoscopy ) those at higher risk for polyps and remove all colon polyps for this reason. A colonoscopy is recommended for all over 50 years of age and earlier for those with family history of malignancy, prior malignancy elsewhere (especially uterine), inflammatory bowel disorders, and those with recurrent abdominal pain or rectal bleeding.

Diverticulae are weakened areas of bowel wall that look like small mini balloons on the outer surface of our bowel wall. Sometimes the neck of these balloons becomes obstructed, allowing the contents of the ballooned area to set up a localized inflammatory process. Since this blockage predisposes us to inflammation, bacterial invasion and infection often follows. The local infection of ballooned area is called diverticulitis. This is similar to appendicitis, but in a different area.

High fiber diets appear to be effective in managing patients with diverticulae. The old guard warning of avoiding nuts, seeded fruits and vegetables is total trash and has not been proven in any studies, yet there are many who still believe in avoiding these when you have diverticulitis. Remember, our bowel wall is very elastic. High fiber is beneficial to bowel function, and may indeed be protective from the development of diverticulae. Remember that though diverticulitis is an infection of these diverticulae, most people with diverticulae never realize they are present until their bowel is imaged (by scope, virtual colonoscopy, or contrasted barium enema).

The presence of diverticulae bears no known health risk for malignancy. One caveat however: we know that malignancies often set themselves up in areas of chronic inflammation, so the avoidance and treatment of chronically inflammed areas of our bodies should always be a priority. So have your polyps removed and use a high fiber diet to keep any diverticulae you may have quiescent.