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Familial Adenomatous Polyposis
(FAP)
Definition
Familial adenomatous polyposis (FAP) is a rare disease that causes hundreds of
polyps
to form in the colon and rectum.
| Colon Polyp |
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Risk Factors
Your chances for FAP are highest if you have other people in your family with the same disease. But, FAP can also happen without anyone in your family having it. This is caused by new changes in the gene.
Symptoms
You may not notice any symptoms at first. When they appear, FAP may cause:
- Rectal bleeding
- Blood in the stool
- Diarrhea
- Cramping pain in the belly
- Bloating
- Weight loss
- Feeling tired
Diagnosis
The doctor will ask about your symptoms and health history. You may have:
- A physical exam
- An eye exam to look for changes in the back part of your eye
- Tests to check your genes
- Endoscopy—A lighted scope is used to look inside the colon and rectum. Tissue samples are taken at this time and tested for cancer.
Treatment
FAP is treated with surgery. Since FAP causes so many polyps, they can’t be removed one by one. The goal of surgery is to remove the part of the colon that contains them. The type depends on how much of the colon has polyps.
Surgery
The 3 main surgical treatments are:
- Colectomy with ileorectal anastomosis (IRA) —The colon is taken out. The last part of the small intestine is connected to the rectum. Bowel use will stay.
- Restorative proctocolectomy—The colon and rectum are taken out. A pouch is made with the last part of the small intestine. The pouch mimics how the rectum works. It’s then attached to the anal canal. Bowel use will stay.
- Total proctocolectomy with a colostomy —The colon is taken out. This results in the need for a colostomy. A path for solid waste to pass from the body is made through the belly wall. A special bag is needed to collect the waste.
Endoscopy is used to find polyps in the small intestine. This is done through small cuts in the belly. Tubes are placed in the cuts. Tools and lights are inserted into the tubes. Polyps are taken out through the tubes.
Medicines
Nonsteroidal anti-inflammatory drugs (NSAIDs) shrink the polyps. They can also keep new ones from forming.
RESOURCES
American Cancer Society
https://www.cancer.org
https://www.cancer.org
United Ostomy Associations of America
https://www.ostomy.org
https://www.ostomy.org
CANADIAN RESOURCES
Canadian Cancer Society
https://www.cancer.ca
https://www.cancer.ca
Ostomy Canada Society
https://www.ostomycanada.ca
https://www.ostomycanada.ca
References
Familial adenomatous polyposis. EBSCO DynaMed website. Available at:
http://www.dynamed.com/topics/dmp~AN~T113901/Familial-adenomatous-polyposis. Accessed January 29, 2021.
Familial adenomatous polyposis. Genetics Home Reference website. Available at: https://ghr.nlm.nih.gov/condition/familial-adenomatous-polyposis. Accessed January 29, 2021.
Jasperson KW, Burt RW.
APC-associated polyposis conditions. GeneReviews. Available at: http://www.ncbi.nlm.nih.gov/books/NBK1345. Accessed January 29, 2021.
Revision Information
- Reviewer: EBSCO Medical Review Board Mohei Abouzied, MD, FACP
- Review Date: 09/2020
- Update Date: 01/29/2021
