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Daniel Nelson, MD
Daniel Nelson, MD, Doctor (MD)
Category: Health
Satisfied Customers: 258
Experience:  Licensed MD. Mayo Clinic Rochester trained physician in Internal Medicine - Critical Care Medicine.
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Can you tell me anything about cecum or cecal polyps that ...

Customer Question

Can you tell me anything about cecum or cecal polyps that grow feelers. Evidently this makes it harder to remove the polyp during a colonoscopy.
Submitted: 6 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 6 years ago.

Greetings.

There are usually four type of polyps in large intestine (cecum is part of large intestine);

1) Inflammatory, 2) hyperplastic, 3) tubular adenoma, and 4) villous adenoma. Please read the link for the further details;

http://www.gihealth.com/html/education/colonpolyps.html

http://www.mayoclinic.com/health/colon-polyps/DS00511

Please feel free for your follow up questions.

Dr. Arun

Customer: replied 6 years ago.
I know what a polyp is and I specifically wanted an answer to the fact that they grown feelers which make it hard to remove during colonoscopy. This is what I was told by the doctor. Can you specifically address this?
Expert:  Dr. Arun Phophalia replied 6 years ago.

Hello,

I will opt out, so some fellow expert can help you out on this.

Dr. Arun

Expert:  Daniel Nelson, MD replied 6 years ago.

DearCustomer

Polyps with "feelers" are usually wider at the base and a little more difficult to snare, cauterise, and remove. There is more tissue to cut through and cauterise in the process of removal. This additional tissue and wideness at the base where the polyp attaches to the wall of the colon goes into the colon wall deeper or more broadly than smaller slim-stalked polyps, like fingers reaching in to grab and hang on, and becomes increasingly more difficult to snare, cauterise, and remove completely. This results in an increased chance that some polyp tissue is left behind, although with most polyps, the "feelers" can get burned and die from the electro-cautery. When all of the polyps are removed successfully, we ask the pathologists to look at them under the microscope, because sometimes these "feelers" represent simple connective tissue and are perfectly benign and often removed in totality (but with more difficulty than a simple benign slim-stalked pedunculated polyp). Sometimes the pathologist may see precancerous or cancerous "feelers" at the margin where the snare and cautery cut through at the base.

I use the analogy of recreational rock climbing walls. In some places, you can only grab onto the wall with one finger, maybe two ... this is like a polyp with few to no "feelers" holding it onto or into the wall of the colon. The snare gets up really close to the base of these types and cuts and cauterises them off in totality. That is like me grabbing hold of your single rock climbing finger and its tiny attachment point, and taking both of them off the wall ... the finger right along with its attachment point. Gone. Done. Fine. Pathologist confirms to me that the polyp had no concerning cells ... all's well and benign. See you in a few to five years for a repeat colonoscopy.

Now, on that same rock climbing wall are larger grips where you can grab ahold with all four fingers (i.e. "feelers"), and even use your thumb to reinforce your tight grip. It's now more difficult for me to place a snare around your whole hand, all the fingers, and the larger grip point on the wall. The same is true for wider-based polyps with more tissue-feelers hanging onto and into your colon wall. The more tissue I try to gather up in my snare, the more likelihood I have of cutting into normal tissue as well and causing a perforation ... so I settle for a happy medium of getting as much of the polyp and its base as possible, but not so much that I risk perforating your colon wall with the snare or especially the cautery. Fortunately, the cautery also kills many "feelers" of this type as well. Again, the pathologist looks at the polyps microscopically and tells me if all of the tissue obtained looks benign, precancerous, or cancerous. If everything is benign, repeat colonoscopy in a few to five years.

If the "feelers" appear to extend beyond the margin of the cut and cautery, and they appear concerning for precancer (severe dysplasia) or cancer ... then we often go to the next step, laparoscopic or open surgical removal and staging.

People with polyps have a 60% or more rate of forming new polyps, so regular periodic screening for you young lady. The good news is polyps form slowly, over years, so periodic colonoscopy is the best and most complete screening tool we have. I will hope and pray your pathology report is all good news.

Thank you for visiting JustAnswer.com's Health Information. I hope that all of your concerns have been addressed and that your experience here was positive and helpful. If you have a new or different question, please don't hesitate to come back or submit a new question. It has been a pleasure helping you. Your FEEDBACK is very important to me.

Kindest Regards,
Daniel

--
XXXXX XXXXX, MD
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Daniel Nelson, MD, Doctor (MD)
Category: Health
Satisfied Customers: 258
Experience: Licensed MD. Mayo Clinic Rochester trained physician in Internal Medicine - Critical Care Medicine.
Daniel Nelson, MD and 6 other Health Specialists are ready to help you
Customer: replied 6 years ago.
Thank you for your detailed answer. It's much appreciated.

Teresa Duran
Expert:  Daniel Nelson, MD replied 6 years ago.

It was my honour and pleasure.

Kindest Regards,
XXXXX XXXXX, MD

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