Juvenile Polyposis

Diagnostic clinical criteria for juvenile polyposis (JPS) include more than five colorectal juvenile polyps or multiple juvenile polyps throughout the GI tract or any number of juvenile polyps plus a family history of JP. Approximately 25% of cases are de novo mutations without a family history. Therefore, genetic testing should begin with an affected individual. Mutations of the BMPR1A gene are found in 25%, and of the SMAD4 gene in 20%, of cases. Testing of the two genes via full sequencing maybe sequential or concurrent. For family members with JPS by clinical criteria or genetic analysis, surveillance should begin at age 15 years (or at symptom onset, whichever is earlier) and should include complete blood count, colonoscopy and upper endoscopy every 3 years. Colectomy is recommended if the number of polyps becomes unmanageable via colonoscopic removal. If a family JPS mutation is identified, any biological relatives who have this mutation should undergo surveillance as described above. Those relatives without the family mutation are unaffected and can follow general pop ulation screening guidelines. 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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