- Causes: Familial Polyposis Coli is a genetic disorder characterized by an inherited mutation in the APC gene, leading to the development of numerous precancerous colon polyps known as adenomas.
- Symptoms: The main sign of FAP is the presence of multiple colon polyps, and if left untreated, there is a high likelihood of developing colorectal cancer. Most individuals with FAP will have multiple colon polyps by the age of 35.
- Treatment: The primary treatment for FAP involves colectomy, the surgical removal of the colon, to prevent the progression to colorectal cancer. In some cases, prophylactic surgery may also include removal of the rectum. Surveillance and management strategies aim to detect and address adenomas early, reducing the risk of cancer.
- Genetic Counseling: Individuals with a family history of FAP should consider genetic counseling and testing to assess their risk and make informed decisions about screening and preventive measures.
- Lifelong Monitoring: Lifelong surveillance and management involve regular colonoscopies and other diagnostic procedures to monitor and address the development of new polyps, aiming to minimize the risk of colorectal cancer.
Familial Polyposis Coli is known as familial adenomatous polyposis. This is a genetically inherited disease. Many adenomas grow in the epithelium of the colon. They begin as benign polyps but have a tendency to become malignant and lead to colon cancer if not treated properly. There are three types: familial adenomatous polyposis, attenuated FAP also called hereditary flat adenoma syndrome and autosomal recessive FAP also called MYH associated polyposis. Familial Polyposis Coli is the result of a genetic mutation and is the most common adenomatous polyposis syndrome. Attenuated FAP is the result of impaired functionality of the APC gene, has fewer polyps and is somewhat still functional.
Autosomal recessive familial adenomatous polyposis or MYH associated polyposis is mild and manifests only when both the parents are carriers.
Causes of Familial Adenomatous Polyposis
FAP is quiet a rare condition and affects 1 in 10,000 people.
Genetic condition and mutation of the adenomatous polyposis coli or APC gene present in chromosome 5. The APC gene is a tumor suppressor located on band 5q21 and regulates a protein called B-catenin which is responsible for cell growth and destruction. When APC is faulty, then the cells are not controlled and manifest as polyps and can be cancerous.
Inherited from parents
Unexplained mutations which have erupted not due to inheritance
Symptoms of Familial Adenomatous Polyposis
- Iron deficiency anemia
- Abdominal pain
- Rectal bleeding
- Diarrhea
- Weight loss
Diagnosis of Familial Adenomatous Polyposis
Flexible sigmoidoscopy or colonoscopy
This procedure helps in examining the lower part of the bowel via the rectum. Air is blown into the tube which is inserted into the intestine to look for polyps.
Endoscopic colonoscopy
This is done for patients with colonic symptoms to examine the digestive tract.
Genetic testing
A family history for the disease is studied and a genetic testing is done to confirm and clarify the diagnosis.
Treatment for Familial Adenomatous Polyposis
Patients with familial polyposis coli will require total proctococtomy as this condition has a pre-malignant potential.