Is a Lipoma Causing My Symptoms?

Medically reviewed by: Gary H. Hoffman, MD

The great majority of lipomas in the colon cause no symptoms, and are discovered only because of a routine preventative colonoscopy. While these benign growths are fairly common, it is rare for them to grow large enough to cause symptoms.

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If you are experiencing bloody stools, pain in the abdomen, constipation and other possible lipoma symptoms, it is important to schedule an appointment with your doctor as soon as possible. Symptomatic lipomas sometimes require removal through endoscopic or laparoscopic procedures, or through traditional surgery.  A colorectal surgeon, also known as a proctologist, is trained to diagnose and treat intestinal lipomas.

What is a Lipoma?

Lipomas are round, fatty tumors that are benign in nature. Most are anchored to the bowel walls, although they have been found throughout the digestive system. Even though they are non-cancerous, large tumors may rarely cause serious symptoms, so removal is sometimes necessary.

Lipomas are most commonly seen in women between the ages of 50 and 70, but also occur in men. Only occasionally are they diagnosed in patients outside of middle age.

What are The Most Common Symptoms of a Lipoma?

Most lipomas have no symptoms, and when patients experience symptoms a lipoma is rarely their first thought. These common tumors are found with less frequency than polyps, they are much less familiar to most people than a variety of other colon health concerns.

When lipomas do cause symptoms, though, these symptoms can be concerning. Symptoms include:

  •   Anemia
  •   Abdominal distention
  •   Bowel blockage
  •   Intussusception
  •   Nausea
  •   Vomiting
  •   Weight loss

Bowel blockage and intussusception can be especially dangerous, and require emergency medical treatment.

What Testing is Used to Diagnose a Lipoma?

The symptoms of a lipoma — even when it grows large enough to cause serious symptoms — are not unique to only this condition, and are often intermittent. This means they are difficult to diagnose without somewhat invasive testing.

Because of the fleeting nature of minor lipoma symptoms, most are diagnosed during routine preventative testing such as a colonoscopy. When you have more serious symptoms, however, this may not be the first test performed.

If you report symptoms to your doctor, a stool occult blood test is typically the first step in diagnosing a lipoma. A colonoscopy or radiological exam is sure to follow, especially if the test results are positive. Your doctor may take a biopsy during the colonoscopy, or may use other tests to confirm the lipoma diagnosis.

Could It be Something More Serious?

Lipomas, in both symptoms and appearance, resemble a number of other gastrointestinal issues. One of the most important reasons to ensure you see a doctor and get a lipoma diagnosis is because of the similarities to malignant neoplasia, a type of colon cancer.

In order to rule out a malignancy, the Proctologist or other specialist performing your colonoscopy will not only locate the growth, but also conduct tests to ensure it is a benign lipoma. The first tests typically looks for characteristics called “the pillow sign.” By pressing on the growth with a tool placed through the endoscopic tube, they can determine if it indents under pressure. Most fatty growths will indent then gradually return to normal.

A sample may also be removed from the growth. Lab testing of the lipoma should find only yellow fatty tissue. Other findings may indicate the need for further testing or more cautious removal.

Since lipomas are both benign and encapsulated, they can usually be removed endoscopically using a tool that scoops out the abnormal tissue. If the tests do not confirm a lipoma, however, careful removal is necessary. If the growth turns out to be malignant, improper removal could spread cancerous cells and fail to remove all of the tumor. In most cases, a laparoscopic procedure or surgical resection is used to remove a potentially cancerous growth. Even if it turns out to be a benign lipoma, it pays to be careful just in case.

When Treatment is Required For a Lipoma?

Most lipomas are smaller than 2 cm and cause no symptoms. These growths usually require no treatment, although regular endoscopic monitoring is recommended. If your doctor determines that a lipoma is causing your symptoms, however, removal will most likely be recommended. This is especially true if the growth is larger than 2 cm.

There are three ways that a colon and rectal surgeon can remove the capsule and yellow fat that compose the growth. These include:

  •   Endoscopically, often during a colonoscopy
  •   Laparoscopically
  •   Traditional open surgery

Just a few years ago, removing a lipoma from the colon endoscopically was too dangerous and often ineffective. Today, however, this is one of the most common ways to safely excise small symptomatic lipomas or larger lipomas with a narrow base connecting them to the bowel wall. Known as a “colonoscopic snare” procedure, this is the least invasive method to treat lipomas.

Excising larger lipomas is much more hazardous, and include the risk of bowel perforation and hemorrhage. Growths that are blocking the bowels or causing other serious symptoms almost always require invasive procedures for removal. Most surgeons prefer laparoscopic surgery, which utilizes cameras and requires only small incisions. Traditional open surgery, however, is sometimes necessary to ensure all of the lipoma is removed and the damage is repaired.

What Should I Do if I Believe a Lipoma is Causing My Symptoms?

The only way you will know if a lipoma is causing your symptoms is to visit your doctor or a colon and rectal specialist for testing. A colonoscopy is the most reliable way to rule out a more serious cause, and determine what treatment is needed to resolve your symptoms.

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