Familial Adenomatous Polyposis

Where else can adenomas develop?

Some, not all, people with FAP or attenuated FAP may develop adenomas in the first part of the small intestine, or duodenum.

The specially designed fibreoptic tube is called a side-viewing endoscope which is passed down the mouth and into the stomach and duodenum to carefully inspect the lining of the duodenum and the opening, or ampulla, an area where adenomas may cluster. The other more commonly used forward-viewing endoscope is unable to get a clear view of the ampulla which is difficult to see and is often referred to as a blind spot.

In the stomach, two types of polyps may be found. The first type is very common and is generally located in the body, or fundus, of the stomach. When biopsied, the result is often a diagnosis of benign fundic gland polyps rather than premalignant polyps. No treatment is necessary and examination is repeated every 5 years. The second type is an adenoma, generally isolated and very uncommon in the stomach. Treatment depends on the degree of change and size of the adenoma.

In the duodenum, most patients will never develop symptoms from adenomas. Depending on the biopsy and appearance of the duodenum, side-viewing endoscopy is repeated at different intervals, ranging from 6 months to 3 years. Treatment may include laser, surgery, or ongoing observation and biopsy. Since duodenal adenomas are generally slow-growing and may, in fact, be rather small in size and number, an operation is generally not required. New research into medications which can control the growth of duodenal adenomas is underway. As well, genetic information may provide a clue to some families where the risk of developing more extensive duodenal adenomas or duodenal cancer is higher while others have the same low risk as in the general population.

Familial Adenomatous Polyposis

Where else can adenomas develop?

Some, not all, people with FAP or attenuated FAP may develop adenomas in the first part of the small intestine, or duodenum.

The specially designed fibreoptic tube is called a side-viewing endoscope which is passed down the mouth and into the stomach and duodenum to carefully inspect the lining of the duodenum and the opening, or ampulla, an area where adenomas may cluster. The other more commonly used forward-viewing endoscope is unable to get a clear view of the ampulla which is difficult to see and is often referred to as a blind spot.

In the stomach, two types of polyps may be found. The first type is very common and is generally located in the body, or fundus, of the stomach. When biopsied, the result is often a diagnosis of benign fundic gland polyps rather than premalignant polyps. No treatment is necessary and examination is repeated every 5 years. The second type is an adenoma, generally isolated and very uncommon in the stomach. Treatment depends on the degree of change and size of the adenoma.

In the duodenum, most patients will never develop symptoms from adenomas. Depending on the biopsy and appearance of the duodenum, side-viewing endoscopy is repeated at different intervals, ranging from 6 months to 3 years. Treatment may include laser, surgery, or ongoing observation and biopsy. Since duodenal adenomas are generally slow-growing and may, in fact, be rather small in size and number, an operation is generally not required. New research into medications which can control the growth of duodenal adenomas is underway. As well, genetic information may provide a clue to some families where the risk of developing more extensive duodenal adenomas or duodenal cancer is higher while others have the same low risk as in the general population.