Familial Adenomatous Polyposis

Familial Adenomatous Polyposis treatment
  • Familial adenomatous polyposis (called “FAP” here) is a disease that causes abnormal growths within the bowel (also called the colon), rectum, and other areas. Gastroenterologists call these growths “polyps.” they’re not cancer, but can become cancer.
    Most people with FAP have hundreds or thousands of polyps. This suggests they have a way higher risk of colon cancer than others. Without treatment, the majority of people who have FAP get colon cancer by age 45. Some people have a milder variety of FAP that causes fewer polyps. People with FAP also can develop cancer of the stomach, small intestine, thyroid, pancreas, or brain. FAP is caused by an abnormal gene that runs in families. Those who have FAP usually start showing signs of it in their teens or 20s. But some people get it in childhood.

  • FAP may not cause any symptoms. If it does, symptoms can include:
    • Bright red blood in bowel movements
    • Diarrhoea – Runny, watery bowel movements
    • Constipation – Trouble having bowel movements
    • Belly cramps
    • Weight loss
    • Bloating – Feeling just like the belly is full all the time
    • Tiredness
    If someone in your family has FAP, you might have regular tests to check for it. Your Gastroenterologist might find it before you have symptoms.

Yes. Your Gastroenterologist will do an exam and find out about any symptoms you have. you may also have the following tests:

  • A test called a “colonoscopy” – during this test, the Gastroenterologist puts a tube and a small camera through your anus and into your colon. During the test, he or she will check for polyps and take samples of tissue for testing. Another doctor looks at the tissue under a microscope. It can show if you have FAP or a special condition.
    • A test called a “sigmoidoscopy” – This test is very similar to a colonoscopy, but it only looks at the last part of the colon, near the rectum.
    • A test called an “upper endoscopy” – This test uses a tube and tiny camera to test the upper digestive system. The Gastroenterologist can also take samples of tissue during this test.
    • Genetic testing – this is often a blood test to look for the abnormal gene that causes FAP. Before the test, you may talk with a genetic counsellor. A genetic counsellor may be a person who can help you understand what having the gene could mean for you and your family.
    You might have these tests in a different order or more than once. As an example, if someone in your family has FAP, you may have genetic testing to determine if you’ve got the abnormal gene. otherwise you might need a colonoscopy to look for polyps. If a genetic test shows you have FAP, you may have a colonoscopy or flexible sigmoidoscopy and upper endoscopy. The tests can show your Gastroenterologist how many polyps you’ve got and where they are.

If you have FAP, your doctor might do exams or tests to look for other kinds of cancer, like thyroid cancer.

Treatment depends on your situation. Treatments include:
• Surgery to remove the colon – this can be called a “colectomy.” It’s the main treatment for FAP. Taking away the tissue with polyps lowers the chance of cancer.
• Polyp removal – Some people have a milder kind of FAP that causes fewer polyps. Sometimes, Gastroenterologists can remove polyps during a colonoscopy or endoscopy instead of doing a colectomy. Your Gastroenterologist will talk with you about the treatment most likely to prevent cancer in your situation.

Dr. Harsh J Shah