Attenuated FAP

Individuals with AFAP develop dozens of colorectal adenomas at later ages and in smaller numbers than with classic FAP. Full sequencing of the APC gene will detect a pathogenic mutation in < 80% of individuals with an attenuated phenotype. For family members shown to have AFAP by clinical criteria or genetic analysis, annual colonoscopy should begin at age 12 years. Once polyps are numerous, large, or colonic surveillance is not otherwise feasible, prophylactic colectomy is usually required. If the rectum is retained, annual endoscopy is advised. Upper endoscopy is recommended every 1 to 4 years. If a family FAP mutation is identified, any biological relatives who have this mutation should undergo surveillance and/or surgery as described above. Those relatives without the family mutation are unaffected and can follow general population screening guidelines. However, it is recommended that they each undergo colonoscopy once at age 25 years as a safeguard. If genetic testing is inconclusive (no mutation is detected in an affected person or no affected person has undergone genetic testing), the individual should be screened as though affected.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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