"How Can Proliferative Polyps Be Effectively Treated?"

Polyps are a unique type of disease that can occur in many parts of the human body and are classified as a type of benign tumor. They can be divided into various types, such as hyperplastic, inflammatory, hamartomatous, adenomatous, and other tumors. Small polyps may be asymptomatic, while larger ones can manifest various symptoms. Timely treatment is essential after the diagnosis of polyps. Let's explore how hyperplastic polyps are treated.

I. Treatment of Hyperplastic Polyps

Hyperplastic polyps are extremely common but have a very low risk of malignancy. They are often found as clusters of tiny polyps in the rectum or sigmoid colon, with nearly half of adults over 50 years old having them, increasing in number with age and more prevalent among smokers. Due to their minimal risk, clinical intervention, such as removal or excision, is not recommended. If detected during a check-up, there's no need for panic or frequent follow-ups. However, a type similar to hyperplastic polyps but with a potential for malignancy, called "serrated adenoma," must be removed. Experienced endoscopists can easily and accurately diagnose or differentiate adenomatous polyps, serrated adenomas, and hyperplastic polyps using narrow-band imaging or chromoendoscopy.

II. Common Types of Polyps

1. Nasal Polyps

Nasal polyps are benign growths that protrude from the nasal mucosa or sinus lining. They are a common nasal disease, primarily affecting adults and rarely children. They can be single or multiple and are commonly found in the maxillary sinus, ethmoid sinus, middle meatus, and middle turbinate. Bilateral occurrence is more common than unilateral. Common symptoms include nasal congestion or increased nasal secretions, accompanied by facial pain or swelling, and decreased or lost sense of smell. Nasal endoscopy reveals one or more smooth, grayish-white, yellowish, or pinkish translucent masses resembling lychee flesh. They are soft, painless, and non-bleeding, rarely becoming malignant. Small polyps can be controlled with medication, while most require surgical intervention.

2. Vocal Fold Polyps

Vocal fold polyps are benign proliferative lesions occurring in the superficial layer of the vocal fold, a specific type of chronic laryngitis. Any cause of chronic laryngitis can lead to vocal fold polyps. Clinical diagnosis is made through laryngoscopy. The primary symptom is hoarseness. Treatment includes appropriate vocal rest, correction of vocal habits, medication, and surgical therapy, with surgery being the primary approach.

3. Gastrointestinal Polyps

Polyps can occur in the esophagus, stomach, intestines, and anus.

4. Gallbladder Polyps

Gallbladder polyps refer to a group of lesions that protrude into the lumen of the gallbladder wall, classified as benign or malignant, with benign polyps being more common. Benign gallbladder polyps include cholesterol polyps, inflammatory polyps, adenomatous polyps, myoepithelial hyperplasia, and heterotopic polyps. Adenomatous polyps are potential precancerous lesions associated with gallbladder cancer. However, non-neoplastic polyps like cholesterol polyps, inflammatory polyps, and gallbladder adenomyomatosis do not develop into cancer. Obesity, smoking, hyperlipidemia, hyperinsulinemia, liver cirrhosis, and anatomical abnormalities of the upper digestive tract and biliary tract are predisposing factors for gallbladder polyps. Most patients are asymptomatic and are often discovered incidentally during health check-ups or population surveys. Treatment of gallbladder polyps involves determining their benign or malignant nature. Small, asymptomatic polyps without malignancy risk factors can be monitored with periodic ultrasound scans, with no immediate need for surgery. Those with evident malignancy risk factors should undergo early cholecystectomy.

It is generally believed that the size of gallbladder polyps correlates with their benign or malignant nature. Small polyps (with a diameter less than 10mm), asymptomatic, and without malignancy risk factors can be observed. However, those with evident malignancy risk factors should undergo early cholecystectomy.