A Functional Medicine Approach to Colon Polyps

Colon cancer is an increasingly prevalent type of cancer in the United States and becoming more so even in younger people. Colorectal polyps are small growths that develop from the lining of your colon or rectum. These clusters of abnormal cells can sometimes develop into colorectal cancer over time. 

Colon polyps are common especially in older age, affecting around 20% of adults overall and about 40% of adults over the age of 50. They are also found in 6% of children where they are often due to inherited genetic syndromes. Polyps can form in any part of the colon but are most common on the left side of the colon and/or in the rectum where feces is stored before being excreted.

Functional medicine for colon polyps offers a comprehensive way to understand and manage this condition, focusing on underlying causes and holistic treatment. This approach uncovers risk factors that contribute to the development of colon polyps and tailors prevention and management for each individual's personalized needs and background. 

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What Are Colon Polyps?

Colon polyps are growths of abnormal cells that grow out of the mucus lining that covers the inside lining of your colon or large intestine. They can be classified based on their shape and pathological appearance under a microscope. Polyps that have a head and stalk are pedunculated while those that are shaped more like a raised lump with a broad base are called sessile.

These small tumors can be benign and not cause further issues in many cases. But sometimes, colon polyps can grow and develop into colorectal cancer, usually over many years. These are known as neoplastic polyps. Although the majority of polyps do not turn into cancer, almost all colon cancers start as polyps. Overall, the chance that a random, average-size colon polyp will become cancerous is around 8% over 10 years and 24% over 20 years. Therefore, finding them early and removing them with colonoscopy screening is an important preventive step. 

Different types of polyps have different growth characteristics that make them more or less likely to develop into cancer or be neoplastic. Adenomatous polyps (adenomas) such as tubular adenomas, villous adenomas, tubulovillous adenomas, and traditional serrated adenomas are neoplastic as are sessile serrated polyps, meaning they have the potential to develop into cancer. While about two-thirds of colon polyps are precancerous adenomas only around 5 percent of adenomas progress to cancer. Non-neoplastic benign types of polyps include hyperplastic polyps and hamartomas (juvenile polyps).

Often colon polyps do not cause many noticeable symptoms so screening with colonoscopy is important for detecting and removing them before they have the chance to turn into colon cancer. When polyps do cause symptoms they may include changes in your bowel movements like chronic diarrhea or constipation and/or mucus and blood in your stool which can cause iron deficiency anemia over time that is accompanied by weakness and fatigue.

What Are The Risk Factors for Colon Polyps?

While the cause for many colon polyps is not clear, several risk factors for colon polyps can contribute to their development. Some factors like older age, family history, and being male are not changeable but others like inflammation and gut health can be modified. Many different factors that contribute to inflammation and imbalances in the large intestine may increase the risk of abnormal cell growth that creates polyps.

Genetic factors are the main risk factor for the development of colon polyps. Errors or mutations in DNA that make up the genetic code that cells use to reproduce can cause changes that lead to the proliferation of the cells lining your colon. The cells that form the mucus lining of your large intestine turn over and replace themselves often so there is an increased chance for errors to occur that can lead to abnormalities. Mutations can occur sporadically or be passed on through hereditary syndromes including familial adenomatous polyposis (FAP), Peutz-Jeghers syndrome, MUTYH-associated polyposis, Gardner syndrome, PTEN hamartoma tumor syndrome, Turcot syndrome, serrated polyposis syndrome, and juvenile polyposis syndrome.

In addition to genetic factors and predisposition, exposures from your physical environment, social environment, and lifestyle habits can influence your chance of developing colon polyps. These lifestyle factors include smoking, heavy alcohol use, a diet high in saturated and trans fats lacking enough fiber, and a lack of exercise. In addition, colon polyps are more common in people with obesity, diabetes, and inflammatory bowel disease. 

Obesity is associated with increased inflammation and metabolic dysfunction as well as dysbiosis in the microbiome. Studies suggest that obesity contributes to a range of gastrointestinal diseases including colon polyps and cancer. Much of this increased risk may be related to the impacts of metabolic dysfunction that accompanies obesity such as metabolic syndrome and insulin resistance. These conditions involve elevated glucose and fatty acids in the blood that contribute to elevated insulin-like growth factor, inflammation, alterations in cell signaling, oxidative stress, and metabolic dysregulation known to play a role in the development of polyps and colon cancer.  

The composition of the gut microbiome has been correlated with the development of adenomatous polyps. The environmental and lifestyle factors discussed throughout this article all influence the balance of microbes in the gut microbiome, and, in turn, the microbiome has significant impacts on the integrity of the gut barrier, immune system function, and inflammation. Imbalances in the gut microbiota and its metabolites can occur due to an inflammatory diet lacking fiber, exposure to environmental toxins, and other factors. This dysbiosis creates a dysfunction of the gut’s epithelial barrier, an increase in the gut’s permeability, and the production of pro-inflammatory cytokines. 

Functional Medicine Assessment of Colon Health

A functional medicine approach to assessing colon health includes looking at the range of factors that can impact the health of the gastrointestinal tract and your risk of developing colon polyps. This functional medicine assessment for colon health includes comprehensive evaluations of diet, lifestyle, gut microbiome, and family history. 

To assess the whole person and picture of colon health, it is imperative to listen to the patient tell her story. A functional medicine assessment involves taking a complete family and personal history and evaluating dietary and lifestyle factors. 

In addition, functional diagnostic tools such as stool tests and microbiome analysis can help give a comprehensive picture of colon health. A comprehensive stool analysis like the GI-MAP + Zonulin test by Diagnostic Solutions provides an evaluation of factors that can contribute to the development of colon cancer. This stool test measures various microbes that make up the intestinal microbiome while also screening for infections and leaky gut by measuring markers of digestion and absorption, intestinal inflammation, short-chain fatty acids, and the range of microorganisms inhabiting the large intestine. 

Other laboratory tests that can contribute to the diagnosis of colon polyps include a complete blood count (CBC) to look for evidence of anemia from chronic bleeding and a basic metabolic panel to evaluate any electrolyte imbalances that may occur with chronic diarrhea or metabolic issues like elevated blood sugar that can contribute to inflammation and imbalances in the gut microbiome.

Genetic testing can be helpful in some cases depending on family history. This is especially relevant if a hereditary syndrome runs in the family.

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Dietary and Nutritional Interventions

Colon polyps are more likely to form when there is inflammation in the large intestine for a variety of reasons. You can support a healthy environment in the colon by consuming an anti-inflammatory diet for colon polyp prevention and optimizing your gut health to create a terrain in the body where polyps are less likely to develop.

To protect the health of the colon and keep your microbiome balanced, focus on whole foods like fruits and vegetables that provide plenty of antioxidants and fiber. A variety of whole foods such as cruciferous veggies like broccoli and cauliflower, leafy greens like kale and chard, sea vegetables, berries, citrus fruits, mushrooms, beets, carrots, and bell peppers provide a colorful range of phytonutrients. To round out your nutrition, studies on integrative approaches to colon cancer and health suggest emphasizing plant and fish proteins and healthy fats tailored to the individual’s unique needs.

‍Microbiome-supporting foods such as artichokes, onions, and garlic act as prebiotics. Consuming these foods feeds healthy bacteria in your colon that produce short-chain fatty acids that help to strengthen the gut barrier integrity and function, modulate lipid and glucose metabolism, and balance the inflammatory response and immune system. 

In addition, naturally, probiotic-rich foods like kimchi and sauerkraut support a healthy balance of gut bacteria that helps to inhibit the colonization of pathogenic bacteria in the intestine, support a healthy intestinal mucosa layer, and enhance your immune system to reduce the risk of colon polyps forming.

Vitamin D plays a key role in modulating immune health and impacts the balance of the microbiome. While research suggests that increasing vitamin D3 reduces the chance of polyps coming back after removal and lowers colon cancer incidence, studies of supplementation have yielded conflicting results. Encouraging your body to naturally produce vitamin D by getting adequate safe sun exposure for 15-20 minutes a day and incorporating vitamin-D-rich foods like oily fish (salmon, sardines, swordfish, and tuna) may be better ways to keep levels sufficient.

As part of an anti-inflammatory colon healthy diet, avoid consuming added sugars, refined grains, foods with chemical additives and preservatives, ultra-processed foods, trans fats, and alcohol. Avoiding conventionally raised red meats and processed meats such as bacon, sausage, hot dogs, and lunch meats can also help to reduce your risk of colon polyps and cancer. 

Lifestyle and Environmental Considerations

Lifestyle factors in colon polyp risk are significant. Several lifestyle factors have been shown to influence the risk of developing colon polyps. These include diet, physical activity, stress management, and toxin exposure.

In addition to the nutrient-rich anti-inflammatory diet discussed above, physical activity has many benefits for colon health. Studies show that exercising regularly can reduce your risk of colon cancer by 40-50 percent. Being physically active is protective against colon polyps and colorectal cancer by helping you maintain a healthy body weight while also keeping blood sugar and inflammation more balanced. Balanced exercise has also been shown to benefit the microbiome, improve circulation, support the immune system, improve digestive function, and reduce stress. 

In addition to exercise, finding a meaningful stress management practice that works for you is a key lifestyle practice for keeping your colon healthy. The gut-brain axis connects the gut and nervous system in a network that allows microbes in your gut to communicate with the brain and vice versa. Chronic unmanaged stress contributes to imbalances in gut microflora, increases inflammation, slows motility in the gut, and weakens the intestinal mucosal barrier, increasing the risk of colon polyps. 

Meditation, tai chi, breathing exercises, and other mind-body practices stimulate your parasympathetic nervous system and allow the body to focus more on digestion and repair.

In addition, aim for at least 7-8 hours of restorative sleep to support your microbiome and overall health. 

Environmental carcinogens and colon health are intricately intertwined. For example, when you smoke, carcinogens from cigarettes are absorbed into your bloodstream and can contribute to abnormal growth in cells throughout the body. Studies show that heavy cigarette smokers have a 2- to 3-fold increased risk of developing an adenoma in the colon. The duration of smoking seems to impact risk, so stopping smoking and vaping or avoiding exposure to tobacco smoke can help reduce your risk of polyps.

Integrative and Complementary Therapies

Complementary approaches to colon health incorporate practices like acupuncture and herbal medicine to keep your large intestine functioning optimally. Integrative therapies can be used alongside conventional treatments to address the whole person, help minimize side effects, and increase the quality of life. 

Integrative therapies for colon polyps like acupuncture can help to reduce the risk of this condition. Acupuncture is a therapy used in ancient Chinese Traditional Medicine (TCM) that involves inserting small needles to stimulate meridian points in the body. Acupuncture and electro-acupuncture using electricity to stimulate these meridian points have been shown to improve the health of the microbiome and treat chronic constipation. 

In addition, herbal medicine that is often integrated into TCM and other traditions of healing has shown promise for preventing colon polyps and colon cancer. For example, resveratrol has been shown to help induce the death of colorectal cancer cells and inhibit cell proliferation via epigenetic modifications.

Berberine is another herbal medicine that has been shown to support weight loss and metabolic health in some studies that seem to favorably impact genetic expression in colon cancer. 

Monitoring and Follow-Up Strategies

The following are recommended follow-up strategies:

Screening

Monitoring for colon polyps is key for early detection and preventing the development of colon cancer. On average, it can take up to 10 years for colon cancer to form from a polyp. Pay attention to your body and discuss any new symptoms like abdominal pain, bloody stools, and unexplained changes in your bowel habits with your practitioner. 

Since colon polyps can often not cause any symptoms, regular screening tests are important. The type and age to begin screening varies based on your personal and family history and risk factors. 

Colonoscopy is commonly used to detect and remove polyps before they develop into cancer. During a colonoscopy, a small tube with a light and camera is inserted into your rectum to look at your colon and sample or remove (polypectomy) any polyps that are found. The National Polyp Study found that colonoscopic surveillance resulted in a 76-90 percent reduction in cancer development. 

An alternative screening tool that is sometimes used depending on your level of risk and other factors is a virtual colonoscopy or CT scan view of the colon. This can help to visualize the colon but if a polyp is found a follow-up colonoscopy is needed to examine and remove it.

Newer stool-based tests are also used to help detect signs of colon polyps or cancer. These tests check the stool for blood and DNA for evidence of a colon polyp or cancer. They are followed by a colonoscopy if they suggest signs of disease. 

Diagnostic

If polyps are found during a colonoscopy, biopsies can be taken. This involves removing the polyp or a sample of the tissue to send to the laboratory for analysis under the microscope. 

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A Functional Medicine Approach to Colon Polyps: Key Takeaways

Colon polyps are common growths in the lining of the large intestine that can develop into colon cancer in some cases. A holistic approach to colon polyp prevention recognizes that lifestyle, dietary, and environmental factors contribute to the risk of developing these growths.

Functional medicine provides a comprehensive, individualized strategy that addresses diet, lifestyle, and environmental factors for optimal colon health. For example, a personalized approach can be guided by functional medicine testing like a comprehensive stool analysis to support the long-term health of the colon. A plan for preventing colon polyps may include eating an anti-inflammatory diet, avoiding smoking and excess alcohol, exercising regularly, getting enough vitamin D from natural sun exposure, and maintaining a healthy weight. This creates a terrain in the large intestine where polyps and cancer are less likely to develop.