Polyps are abnormal tissue growths that form on the inside of the colon or rectum. They are common, especially as people get older, and are usually noncancerous (benign). However, some polyps can eventually turn into colon cancer if not removed. That’s why it’s recommended that people get colonoscopies starting at age 45 to look for and remove polyps.
A common question about polyps is whether they can come out in your stool (poop). The short answer is yes, small polyps can sometimes come out with a bowel movement. But there are some important things to understand about this.
Can Large Polyps Come Out in Stool?
Larger polyps are unlikely to come out in the stool whole or intact. Most polyps are attached to the wall of the colon by a stalk. For a large polyp to come out through the stool, it would have to break off at this stalk.
Larger polyps also tend to be more firmly attached and embedded in the tissue lining the colon. Passing an intact large polyp would require it to fully detach from the tissue it’s attached to, which is uncommon.
However, parts or pieces of a large polyp can break off and be passed in the stool. You may see small flecks or shreds of tissue. Sometimes this is referred to as “polyp shedding.”
So while it’s possible to pass elements of larger polyps, fully passing an intact large polyp is very rare. Polyps over 2 cm (about 1 inch) in size are unlikely to fully come out in stool.
Can Small Polyps Come Out Whole?
Small polyps, meaning those less than 5 mm (about 1/5 inch), can sometimes fully come out in the stool. This occurs if the small stalk attaching the polyp detaches from the colon wall.
Factors that make passing a small polyp more likely include:
– Having a polyp with a long stalk
– Having inflammation in the colon, which can loosen tissue
– Having excess straining or forceful bowel movements
One study found that up to 13% of small polyps, especially those on long thin stalks, may spontaenously detach and be passed out through bowel movements.
So while rare overall, it is possible for small, stalked polyps to become dislodged and come out whole in stool.
Appearance of Passed Polyps
If you do pass an intact polyp, it will likely be small, shaped like a mushroom or bulb, and be yellowish in color. The polyp will be surrounded by stool but may stand out due to its distinct shape and color.
The tissue may also appear grape-like in shape if it is adenomatous, meaning pre-cancerous tissue. Or it may appear smooth and round if it is hyperplastic, which is usually benign tissue.
You may see blood in the stool from the spot where the polyp detached from the colon wall. Bleeding is common when polyps are passed.
It’s important not to confuse passed polyps with undigested food, seeds, or other stool contents that may look unusual but are harmless. Anything of concern should be shown to a doctor.
Should You Worry if You Pass a Polyp?
Passing a polyp does not necessarily mean something is wrong. As discussed, it’s normal on occasion for small polyps to detach and come out in stool.
However, some considerations regarding passed polyps include:
- Size – Larger passed polyps are more concerning than tiny polyps less than 5 mm.
- Frequency – Frequently passing polyps may indicate an underlying condition.
- Appearance – Adenoma or pre-cancerous looking polyps warrant more follow up.
- Age – People under 50 passing polyps may need earlier screening.
- Family history – Those with a family history of colon polyps or cancer should have any passed polyp evaluated.
In most cases, an occasional passed polyp is not a major cause for concern, especially if you already get regular colonoscopies.
But it’s still a good idea to consult a doctor if you pass something that looks like it could be a polyp. They can determine if additional testing or more frequent colonoscopy surveillance is recommended.
Can Passing Polyps Lead to Colon Cancer?
The main concern when polyps are passed is whether they increase the risk of eventually developing colorectal cancer.
It was previously thought that when polyps detach, they could leave behind polyp cells that could grow into new polyps or cancerous tumors.
However, recent research has found this is likely not the case. A study published in Gastroenterology followed patients with passed polyps and found they did not have an increased risk of cancer compared to matched controls.
Another study found no cancer or polyps remained in the spot where a polyp had detached from in over 90% of cases.
Overall, evidence now suggests that passing an intact polyp alone does not increase colon cancer risk or leave behind cells to form new polyps. The colon tissue typically heals normally once the polyp stalk detaches.
Regular screening is still important for early detection, however, as new polyps can still grow over time.
Should You Try to Retrieve Passed Polyps?
If you spot what appears to be a polyp in your stool, you may wonder if you should try to retrieve it and bring it to your doctor. This is not recommended, for a few reasons:
– Handling stool carries a risk of bacterial contamination
– Polyps start to break down quickly after detaching
– The tissue alone often cannot definitively diagnose a polyp’s risk
It’s safest and most hygienic to simply note the passing of something unusual and inform your doctor at your next visit. They can determine if more testing is needed.
Taking a photo can be helpful. But attempting to handle and retrieve passed polyps is not needed in most cases.
How to Reduce Your Risk of Passing Polyps
While passing the occasional polyp is usually harmless, you may want to take steps to avoid frequently passing polyps. Things you can do include:
- Get colonoscopies starting at age 45, and follow recommended intervals based on findings.
- Eat more fruits, vegetables and fiber to promote colon health.
- Exercise regularly to reduce inflammation.
- Quit smoking, as smoking makes polyps grow faster.
- Limit alcohol, as heavy use is linked to more polyps.
- Maintain a healthy weight to lower colon cancer risk.
Following colonoscopy and lifestyle recommendations can help minimize excessive polyp growth and shedding.
Conclusion
Small polyps, usually less than 5 mm, can occasionally detach and pass out whole in stool. Larger polyps are unlikely to fully pass intact due to their size and firm attachment in the colon.
Seeing tissue pass that looks like it could be a polyp is usually not a major cause for concern. But it’s recommended to consult a doctor for evaluation, especially if polyps are passed frequently or if they appear potentially cancerous.
While polyps can spontaneously detach, this alone does not appear to raise colon cancer risk once the polyp is passed.
To help prevent excessive polyp growth and passing, follow screening guidelines, eat a healthy diet, exercise, maintain a healthy weight, and avoid smoking and heavy alcohol use. Being proactive helps optimize colon health.