Familial Adenomatous Polyposis

Familial Adenomatous Polyposis – General Information

Familial Adenomatous Polyposis – Symptoms

Familial Adenomatous Polyposis – Treatment

It is very important to diagnose Familial Adenomatous Polyposis at an early stage, not only for the patient medical status, because if the disease is discovered before the colon cancer appears, they can not be affected. In most cases doctors chose a procedure that not only shows the exact quantification of polyps through the patient’s colon, but also a histological diagnosis, known as colonoscopy. Doctors can also use barium enema and virtual colonoscopy to diagnose this medical condition. After the patient has been diagnosed with Familial Adenomatous Polyposis, the doctor has to apply a close colonoscopic surveillance which uses polypectomy as main procedure. There are cases in which the patient presents more than fifty polyps in the colon, or there are severely dysplastic polyps, or the patient presents multiple polyps which can have more than one cm in diameter. In these clinical cases the main treatment option is the prophylactic colectomy. The doctor can also perform a partial colectomy, which has to be accompanied by a colonoscopic surveillance of the remaining colon because the patient can be exposed to an increased risk to develop colon cancer.

There are cases in which the doctor can apply the ultrasound procedure on the patient’s abdomen, or blood tests to observe the liver function and to exclude any metastasis of the liver. In cases in which the family has been diagnosed with Familial Adenomatous Polyposis, the doctor can apply genetic counseling. The genetic tests can also determine the exact diagnose in families that know they have the disease. The treatment for Familial Adenomatous Polyposis depends on the genotype of the patient. In most cases, patients who present the disease’s mutation develop the colon cancer after the age of 40 years. That is why the doctor recommends the prophylatic surgery within the age of 25. The patient can choose from many types of surgical options, which usually consist in removing the colon or both colon and rectum. The type of surgical option that the patient requires depends on the number of polyps that are present in the rectum, but also on his family history. If the patient presents few polyps in the rectum, the doctor can remove the colon and the ileum, the small bowel, which are connected to the rectum, using a procedure kwon as ileorectal anastomosis. There are cases in which the rectum is affected and when this happens, it is also removed along with the colon, and the patient may require a permanent stoma where the stool goes into a bag on the abdomen, process called ilepstomy. In these cases, the doctor can also perform an ileoanal pouch reconstruction procedure. The most effective medications used to treat Familial Adenomatous Polyposis are the non steroidal anti inflammatory drugs, that have the effect of slowing the malignant degeneration of the polyps. The medicines also help to reduce the number of polyps, but when this number is high, the main treatment option is the endoscopical operation.