What are the causes of colonic polyps? How to prevent it correctly?

Intestinal polyps are vegetations protruding into the intestine due to excessive proliferation of intestinal mucosa. According to pathology, they can be divided into adenomatous polyp, hamartomatous polyp, inflammatory polyp and proliferative polyp. The detection rate of intestinal polyps by colonoscopy is 10% ~ 20%, and the incidence of adenomatous polyp is about 70%. Adenomatous polyp is a precancerous lesion, which is closely related to the occurrence of intestinal cancer. So why do intestinal polyps happen and what preventive measures are there?

intestinal polyp

Let's talk about the cause of intestinal polyps 1. Genetic factors: The occurrence of some polyposis is related to heredity. It is generally believed that the formation of intestinal polyps is closely related to gene mutation and genetic factors. The most common is familial adenomatous polyposis. Classic patients have long polyps since adolescence, and there are hundreds of polyps in the intestine. If left untreated, these polyps will become cancerous. When a family member suffers from adenomatous polyp, the possibility of other members suffering from colorectal polyp is obviously increased, especially familial polyposis has obvious familial inheritance. This kind of intestinal polyp can't be prevented, only early detection and early treatment can be achieved.

2. Bad living and eating habits: Smoking is closely related to adenomatous polyp. Most people who smoke for less than 20 years have small adenomas, while those who smoke for more than 20 years have large adenomas. A diet with high fat, high protein (especially red meat) and low fiber is prone to colon polyps. More than 40% fat in the diet is an important factor in the formation of intestinal polyps. If the fat intake does not exceed 15% of the diet, the incidence of intestinal polyps is low.

A high-fat and high-protein diet

3. Intestinal infection: Intestinal infection may be caused by bacterial, viral and parasitic infections. General inflammatory polyp is related to chronic intestinal inflammation, and the occurrence of adenomatous polyp may be related to viral infection. Chronic inflammation of colonic mucosa is the main cause of inflammatory polyp, which is more common in chronic ulcerative colitis, Crohn's disease, amebic dysentery, intestinal schistosomiasis and intestinal tuberculosis, and also in the anastomotic site after colon surgery.

4, vitamin and mineral deficiency: the lack of calcium, vitamin D, folic acid is also a risk factor to promote polyps.

5. Metabolic abnormalities: Metabolic abnormalities include: overweight, obesity (especially abdominal obesity), hyperlipidemia, type 2 diabetes, nonalcoholic fatty liver, and metabolic syndrome. These metabolic abnormalities can cause hyperinsulinemia, insulin resistance and the increase of insulin growth factor level, and then affect the production of intestinal polyps by increasing cell proliferation and reducing cell apoptosis.

fat

6. Intestinal flora imbalance: Under normal circumstances, intestinal microecology is in a state of balance. If probiotics decrease and pathogenic bacteria increase, it may lead to chronic inflammation of colon mucosa, and then colon polyps occur.

7. Fecal and mechanical injuries: Fecal coarse dregs and foreign bodies stimulate intestinal mucosal epithelium for a long time, and other reasons cause rectal mucosal injury, causing abnormal cell proliferation and forming polyps. Constipation can prolong the residence time of carcinogens in the intestine. If constipation people use laxatives indiscriminately, most drugs contain anthraquinones, which can enhance cell proliferation activity, inhibit cell apoptosis, mutate DNA and eventually cause intestinal polyps.

What measures are there to prevent intestinal polyps? I. Drug prevention

1. Non-steroidal anti-inflammatory drugs: At present, non-steroidal anti-inflammatory drugs are the most studied and used in clinic. Taking aspirin regularly can reduce the occurrence and recurrence of polyps and reduce the canceration rate of polyps. A study in the United States found that the incidence of adenomatous intestinal polyps and hyperplastic polyps decreased by 27% and 8% respectively after oral administration of 100 mg every day for two consecutive years. In another study, the same method was used orally, and the recurrence rate of intestinal polyps decreased by 60% one year after resection. Sulindac is the earliest non-steroidal anti-inflammatory drug used to treat familial adenomatous polyposis in China, which can delay the growth of polyps and reduce the chance of canceration, thus reducing the colon resection rate. Celecoxib is a new non-steroidal anti-inflammatory drug, which is commonly used in clinic because of its relatively mild gastrointestinal side effects. Animal experiments have proved that it can prevent the formation of intestinal polyps in mice. Long-term use costs are high, and there are some drug reactions.

Aspirin

2. Metformin: It is the basic drug for treating diabetes. At present, it is found that it has certain effect on the prevention of intestinal polyps. A study on 5 199 1 case found that the drug could not reduce the incidence of intestinal polyps in diabetic patients, but it could reduce the cancer risk of intestinal polyps by 49%. A study of 498 cases of recurrent cases of intestinal polyps after resection in Japan found that the recurrence rate of colonoscopy was 38% when the low dose of 250 mg was taken orally for one year, and 56% when it was not taken. This drug is easy to obtain, cheap, and has few side effects. It is easy to carry out clinical research on more cases and is expected to become a drug to prevent recurrence after resection of intestinal polyps.

Melbin

3. Allopurinol is a commonly used drug to treat gout. A recent study on the pathogenesis of intestinal polyps found that after oral administration of 100~300 mg per day, the oxidative inflammatory factor NF-kb in intestinal polyps decreased significantly, suggesting that the drug has potential clinical value in the prevention and treatment of polyps. The medicine has the characteristics of easy availability, low price and little side effect after long-term administration.

4. Calcium and vitamin D: Animal studies have found that calcium deficiency leads to overgrowth of colon cells; Clinical studies have found that daily calcium supplementation of 1200 mg can reduce the risk of intestinal hyperplastic polyp by 14%~35% and reduce the recurrence of polyps, but it can increase the risk of serrated polyps. It is generally believed that calcium intake from diet is beneficial and safe to prevent intestinal polyps.

5. Plant extract: Curcumin is extracted from Curcuma longa, a traditional Chinese medicine, which has the functions of reducing blood fat, anti-inflammatory, anti-oxidation, anti-tumor and cholagogic. A study on familial polyposis found that after taking 480 mg curcumin and 20 mg quercetin every day for 6 months, the number of polyps decreased by 60% and the number of polyps decreased by half. Many other plant extracts, such as myricetin, dipyridamole and sulforaphane. It has a certain curative effect on preventing intestinal polyps and is expected to become a pioneering field of clinical drugs for preventing intestinal polyps in the future.

Second, diet prevention.

1. Eat less high-fat and high-protein foods: red meat (pigs, cattle, mutton, etc. ) contains heme, nitrite that makes meat redder, heterocyclic amine mixture produced by high-temperature cooking, etc. Can stimulate the occurrence of intestinal polyps and colorectal cancer. Meat contains too much saturated fatty acids. Excessive intake will stimulate the body to produce too much bile, which will be converted into carcinogen valeric acid when it stays in the large intestine. Saturated fat contains more arachidonic acid, which can promote the abnormal growth of intestinal epithelium into polyps and even cancer.

2, eat more dietary fiber: dietary fiber is not absorbed by the human body, after entering the large intestine, it promotes intestinal peristalsis and reduces the residence time of food and potential carcinogens in the intestine. Foods rich in dietary fiber include coarse grains, such as millet, corn, barley, swallows and buckwheat. There are also some fruits and vegetables, such as celery, leeks, spinach, cabbage, apples, bananas, oranges and peaches.

Eat more fruits and vegetables.

3. Eat more foods rich in vitamins and minerals: Vegetables and fruits are rich in vitamins and minerals, such as spinach, green peppers, broccoli, tomatoes, peppers, red bell peppers, carrots, pumpkins, yellow peppers, purple cabbage, avocados, mangoes, oranges and so on.

Third, change living habits.

1. Quit smoking and limit alcohol: Smoking and excessive drinking will increase the risk of colon polyps and colon cancer. Women should not drink more than150ml of wine, 360ml of beer or 40ml of white wine every day, and men should not drink more than twice as much as women. If you have a family history of colon cancer, you should especially reduce smoking and drinking to reduce the risk of colon cancer.

2. Strengthen physical exercise: It is recommended to exercise for at least 30 minutes five times a week. If you can do moderate-intensity exercise for 45 minutes every day, it will be more effective to reduce the risk of intestinal polyps.

Practice regularly

Fourth, the treatment of intestinal diseases

Intestinal infection and intestinal flora imbalance are closely related to the occurrence of intestinal polyps. Therefore, we should actively treat chronic intestinal inflammation, avoid long-term use of broad-spectrum antibiotics, and reduce the occurrence of flora imbalance. Probiotics such as Bifidobacterium and lactic acid bacteria can be properly applied to provide intestinal nutrition, produce acetic acid and lactic acid, acidify the intestine, inhibit the growth of harmful microorganisms, provide a healthy environment for the growth of intestinal cells, reduce the possibility of intestinal cells transforming into polyps and canceration, and prevent the occurrence of intestinal polyps.