Diminutive polyps and rectal bleeding: An overview

Authors I. Bouzakis.


Rectal bleeding is very common in the general population.
It is usually minimal, with outlet-type characteristics, but
it can also be an expression of lower gastrointestinal bleeding.
Colon investigation is usually indicated during rectal
bleeding evaluation. Diminutive polyps cause no symptoms
and they are an incidental finding in up to 50% of colonoscopies
for various indications. Distal hyperplastic polyps
are considered harmless. The natural history of adenomas,
especially the diminutive ones, is largely unknown. Diminutive
adenomas are rarely histologically advanced. Distal
advanced diminutive adenomas or =3 distal diminutive
tubular adenomas, can be markers of advanced proximal
neoplasia. The importance of 1-2 diminutive tubular adenomas
is highly controversial. Endoscopic removal of all
polyps, although not specifically studied for diminutive
ones, results in significant decrease of colorectal cancer
Key words: rectal bleeding, minimal rectal bleeding, adenomas,
hyperplastic polyps, diminutive polyps, colorectal cancer,
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