Questions related to intestinal polyps?
Hello, doctor.
My husband and I underwent a colonoscopy after 8 years of marriage.
Our child is 7 years old.
I am 28 years old, and my husband is 32.
He has three polyps, two of which are hyperplastic, and one has been removed and tested, all measuring less than 0.5 cm.
I have two polyps, also hyperplastic, measuring 0.4 cm, which do not require removal.
(1) I would like to ask if our child will be at risk for familial adenomatous polyposis (FAP), meaning they could develop hundreds of intestinal polyps starting in adolescence.
What methods are available for screening?
(2) We had our colonoscopies done at Huixiong Clinic, where the polyps were examined under 100x magnification and found to be hyperplastic with no cancer cells.
Do you think removal is necessary? The doctors there said it is not needed.
(3) Are we at a higher risk of developing colorectal cancer compared to the general population?
(4) Do we need to undergo colonoscopies annually?
(5) Is it possible that our young age and presence of intestinal polyps indicate a familial condition? However, no one in our family has had colorectal cancer.
Will our polyps continue to grow? If it is familial adenomatous polyposis, will the polyps fill the entire colon? I have read online that if it is familial, polyps will continue to grow during adolescence.
Given my husband’s and my age, do we fall under the category of polyps due to poor dietary habits or familial predisposition?
Ding Dong, 20~29 year old female. Ask Date: 2011/06/14
Dr. Ke Fangxu reply Surgery
Hello, in response to your questions:
(1) Hyperplastic polyps are a type of benign polyp found among various colorectal polyps.
They are generally believed to be caused by the proliferation of mucosal cells, hence the name "hyperplastic polyp." Hyperplastic polyps are pathologically distinct from familial adenomatous polyps, which are adenomatous in nature and have a hereditary component.
Unless either you or your husband has been diagnosed with familial adenomatous polyps, your children will not have an increased risk of familial polyposis syndrome.
(2) Since hyperplastic polyps are benign, they theoretically do not need to be removed.
However, it is generally recommended to excise them to prevent any potential malignant transformation in the future.
(3) Hyperplastic polyps do not increase the risk of developing colorectal cancer.
(4) If polyps are present, it is generally advised to undergo a follow-up colonoscopy one year after polypectomy.
If polyps are found again, they should be removed.
If no polyps are detected the following year, a colonoscopy can be performed again in three years.
(5) Although hyperplastic polyps are more common in older adults, it is not unusual for younger individuals to have them as well.
Polyps can recur, so regular colonoscopy screenings are necessary.
This is not indicative of familial polyposis syndrome, so there is no need to worry.
The causes of polyp formation are not well understood, and aside from hereditary polyps, they are not necessarily related to diet.
Reply Date: 2011/06/14
More Info
Understanding colorectal polyps and their implications for family risk is crucial, especially when there is a history of polyps or colorectal cancer in the family. Based on the information provided, let's address your questions systematically.
1. Risk of Family Members Developing Familial Adenomatous Polyposis (FAP): Familial Adenomatous Polyposis is a hereditary condition characterized by the development of numerous polyps in the colon and rectum, typically starting in adolescence. However, based on your description, both you and your husband have a limited number of polyps (2-3 each) that are classified as hyperplastic and benign. Since there is no family history of colorectal cancer, it is unlikely that your children will inherit a condition like FAP. Genetic testing can be performed if there is a concern about hereditary syndromes, but given your current situation, it may not be necessary.
2. Need for Polyp Removal: The decision to remove polyps often depends on their size, type, and the presence of dysplasia (abnormal cells). Hyperplastic polyps, especially those under 1 cm, are generally considered benign and do not typically require removal unless they exhibit concerning features. Since your doctor has assessed that the polyps are hyperplastic and without cancerous cells, it may not be necessary to remove them. However, regular monitoring through colonoscopy is essential to track any changes.
3. Increased Risk of Colorectal Cancer: Having polyps does increase the risk of developing colorectal cancer, but the degree of risk depends on the type and number of polyps. Hyperplastic polyps are usually not associated with a significant increase in cancer risk. However, since you both have had polyps, it is prudent to maintain vigilance through regular screenings.
4. Frequency of Colonoscopies: Given your current age and the presence of polyps, it is advisable to have follow-up colonoscopies every 3-5 years, rather than annually, unless advised otherwise by your healthcare provider. The frequency may vary based on the findings during your colonoscopy and any changes in your health status.
5. Family History and Polyp Development: The development of polyps at a young age can be concerning, but it does not automatically indicate a hereditary condition. Lifestyle factors, such as diet and physical activity, can significantly influence polyp formation. If there is no family history of colorectal cancer, it is more likely that your polyps are related to lifestyle rather than a genetic predisposition.
In summary, while you and your husband have polyps, the type and number suggest a lower risk for familial syndromes like FAP. Regular monitoring and maintaining a healthy lifestyle are key to managing your colorectal health. If you have further concerns, discussing them with a gastroenterologist or a genetic counselor may provide additional clarity and guidance tailored to your family's medical history.
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