Polyposis Syndromes

The GI polyposis syndromes are a group of heterogeneous disorders typified by numerous GI polyps that can be encountered throughout the GI tract. Many of these syndromes have known associated genetic mutations that allow for specific genetic testing to confirm a suspected diagnosis. There is a separate chapter on colonic neoplasia and genetic counseling (see Chapter 94, "Colonic Neoplasia: Genetic Counseling"). The best known and characterized of these syndromes is FAP, however, the clinician must be aware of several other syndromes. Diseases, such as Cowden syndrome, can have a subtle presentation and only recognized by astute observation. The polyposis syndromes are important to correctly identify and diagnose for several reasons. First, patients are at increased risk not only for CRC, but also for several other GI cancers and even extra-GI cancers. Second, because of the high associated cancer risks, certain cancer surveillance recommendations and prophylactic therapies apply to this population of patients. Finally, the hereditary nature of most of these disorders allows for presymptomatic diagnosis in other family members.

Management of patients with polyposis often involves a multidisciplinary approach secondary to the complexity of management decisions. We frequently consult and involve several other specialties in addition to gastroen-terology and genetic counseling, including surgery, gyne-cology, and dermatology.

Although several other polyposis conditions exist, including Cronkite-Canada syndrome, lymphomatous polyposis, nodular lymphoid hyperplasia, and lipomatous polyposis, these are beyond the scope of this chapter and will not be discussed.

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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