Colon Polyps and Irritable Bowel Syndrome

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Colon Polyps and Irritable Bowel Syndrome

Question:

Five years ago, I had a rather large polyp removed from my colon. Later, I noticed that I no longer suffered from the occasional IBS symptoms I used to have, such as painful cramps and diarrhea. Can polyps alone cause these symptoms?

Answer

I am very happy that you are free of your occasional symptoms of irritable bowel syndrome, but find it hard to credit this to the removal of your colon polyp. Even when polyps are large, they do not cause pain, constipation or diarrhea. Polyps rarely cause any symptoms. When they do, it is almost always bleeding. Some people see bright red blood, though blood is more commonly discovered by stool testing.

It's possible that a huge polyp blocked your bowel and caused your symptoms, but this would be extraordinarily rare. Also, your symptoms would have been constant, not occasional.

Rare types of polyps, called villous adenomas, can produce diarrhea when they arise in the rectum, though they don't cause pain.

I doubt that these rarities pertain to you, but you should check with your doctor.

We do not fully understand the causes of irritable bowel syndrome. We do know that many people find their symptoms activated by life's stresses. A minority of cases appear to be triggered by infectious diarrhea. Severe IBS may be related to depression, anxiety, or a hypersensitivity to minor triggers of discomfort that other people don't feel. For example, in studies in which a small balloon is placed in the rectum and gently inflated, people with IBS report pain at much lower pressures than other people do. Other investigations have described differences in the strength and frequency of bowel contractions in people with IBS.

But there are no connections that I know of that associate IBS with intestinal polyps.

Stephen Goldfinger, M.D., is a professor of medicine at Harvard Medical School. He is a graduate of Columbia College of Physicians and Surgeons, and his clinical base is at the Massachusetts General Hospital.

Last updated:	July 20, 2009