Polyposis: What You Need to Know

Polyposis means having many polyps—small growths—most often in the colon or stomach. Polyps can be harmless, but some types grow into cancer over time. If you have a family history of polyposis or notice symptoms like bleeding, changes in bowel habits, or unexplained anemia, don't ignore them. Early detection changes everything.

Causes and types

There are two main categories: sporadic polyps and hereditary polyposis syndromes. Sporadic polyps are common and usually appear as single or a few adenomas. Hereditary syndromes include Familial Adenomatous Polyposis (FAP) and Peutz-Jeghers syndrome; these cause dozens to thousands of polyps and raise cancer risk. Genetic mutations, especially in the APC gene for FAP, explain many inherited cases. Doctors use family history and genetic testing to tell the difference.

Symptoms, tests, and when to act

Polyps often don't cause symptoms until they're large. Watch for rectal bleeding, mucus in stool, persistent abdominal pain, diarrhea, constipation, or weight loss. Routine screening—colonoscopy—is the best way to find polyps early. Your doctor may recommend colonoscopy every 1–3 years if you have polyposis, or sooner if symptoms appear. Genetic testing is advised when many polyps show up at a young age or when a close relative has polyposis.

Treatment depends on polyp type and number. Single polyps are removed during colonoscopy with simple snare or biopsy tools. Multiple polyps may need repeated endoscopic removals. In classic FAP with hundreds of polyps, removing the colon may be recommended to prevent cancer. Newer options include surveillance with frequent endoscopies, medications that can shrink polyps in some cases, and targeted therapies if cancer develops.

Follow-up is crucial. After removal, polyps can recur. Your doctor will set a surveillance schedule based on polyp size, number, and pathology. Keep records of your colonoscopy reports and pathology results. If you carry a known gene mutation, family members should be offered genetic counseling and testing.

Lifestyle changes help but don't replace screening. Eat a fiber-rich diet, cut back on red and processed meat, avoid tobacco, limit alcohol, and stay active. These steps lower general colorectal cancer risk and support gut health. They won't prevent hereditary syndromes, but they can reduce overall risk.

If you find a lump, bleeding, or sudden bowel changes, contact your doctor. If you have a family history of polyposis, ask about genetic testing and an early screening plan. Managing polyposis is about timing—catching growths before they become cancer makes treatment simpler and outcomes better.

Quick checklist: schedule a colonoscopy if you're over 45 or earlier with family history; bring copies of relatives' medical records to appointments; ask about genetic tests (APC, MUTYH) when polyps appear young or in large numbers; follow surveillance intervals your gastroenterologist sets; and consider referral to a hereditary cancer clinic if tests are positive. If surgery is recommended, ask about types of operations, complications, and how life changes afterward. Get support—talk to a nurse or patient group for tips on recovery and long-term follow-up. Share results with family so they can act now.