Well, I was thoroughly prepared for a routine annual "look/see" of my pouch and environs this morning. I asked my surgeon to describe what he was looking at as I watched the "TV screen" showing what he was seeing. All of a sudden, I asked, "What's that?" He said, "A polyp." I asked him where it was and he told me he couldn't tell because he couldn't see the anastamosis. Then I told him it looked huge to me. He said it was about the size of a pea. I never have had a polyp and next week is my 6 year anniversary of my colectomy and 5 year takedown anniversary. Everything has been functioning very well. Guess I want to know if others out there have had their surgeons tell them they couldn't see the anastamosis and why couldn't he describe where the *#*#* polyp was? He reminded me that I still have a mucousal lining in my rectal cuff. Soooo????? I asked him if everything else looked okay and he said, "Yes." He took a biopsy of the polyp and said he'd have the results in a week. I told him I want the polyp taken out. He said he couldn't do it in his office because he didn't have a snare there. Grrrrrrr! So, I'd like to know if it is a good idea to have it removed if it isn't malignant? Also, what if its location is right at the line of anastamosis....which he can't see??? Any problems removing the polyp if it is right on the line? I know I'm putting the cart before the horse and just need to wait to get the biopsy results before I begin worrying about "what ifs"......but, since when have I done things the way I should? Thanks!

I just had my routine scope last week. I had two polyps removed that were on or near the anastomosis. My GI said that he had a hard time telling the difference between the ileal mucosa and the retained rectal cuff mucosa also. (I don't go to the surgeon anymore because he does not do flex sigs, with all the "trappings"- the GI is always prepared because it is done in endoscopy clinic.) I didn't think much of it because I know that the ileal mucosa changes over time to more closely resemble colonic mucosa. Further up the pouch, he could more easily tell. I couldn't see the suture line either, but after 12 years, I am not surprised that the sutures have been grown over by mucosa. I had my first polyp removed about 4 years ago, and it was just an inflammatory polyp (typical of UC). This time one was obviously an inflammatory polyp, but the other one looked different and more of a solid "knob" type thing, but it was not elevated on a stalk, like the usual precancerous polyps you read about. He did not use the snare to remove it, but used large biting forceps. They bled more than the usual biopsies. So, like you, I am awaiting biopsy results.

But to get to your question, it does not matter that the polyp is at the anastomosis. Removal is the same. Your anastomosis at this point is merely a landmark, not anything of surgical importance. If it is just an inflammatory polyp without displasia or carcinoma, there's no need to remove the rest of it.

Jan

Thank you so much, Jan! I've seen pictures of polyps here and on other sites but was so shocked to actually see one as a part of my body! At first I thought it was an internal hemmoroid. Guess not, or the doc would have mentioned it as a possibility. I continue to see my surgeons (2 of them on alternate years) for my annual scopes. I saw my wonderful GI once for the same exam and even though he has his own endoscopy center, he performed the exam in his office. No polyps then but the poor guy had to search (in the basement storage room)for a sigmoidoscope saying he never does those anymore....just colonoscopies in his endoscopy center. Anyway, all he could say at the time was, "Beautiful! Beautiful!" I felt I gave him a gift in allowing him to see a well functioning J-pouch from the inside out since he probably doesn't see many. Once again, thanks so much for sharing your knowledge with me.