The inside of the digestive tract is in a state of constant repair where old cells die and are replaced by new cells. Sometimes this rejuvenation process creates a tissue growth referred to as polyps that can be located in the stomach, small intestine or large intestine. They start as small in size but can grow over time to grape size or larger.

TYPES

We distinguish two types of polyps:

• Hamartomatous polyps are called juvenile polyps
• Adenomatous that can be either flat or like mushrooms

Children usually develop hamartomatous juvenile polyps and have a very low risk of long-term concerns.

Adenomatous polyps can also occur in children and indicate the need for further evaluation.

FREQUENCY

A colon polyp occurs in about 1-2% of children. The most common type is the hamartomatous that accounts for more than 95% of polyps. Juvenile polyps are more common in boys and girls aged 2 to 6 years, but can also be found in younger and older children up to about 10 years old. Most are harmless and are located in the lower half of the colon.

DIAGNOSIS

Children with polyps usually experience painless bleeding. The bleeding may recur for weeks to months, with small amounts of blood from the rectum. Over time, some children may develop iron deficiency anemia (weakness, fatigue, pallor, or headache).

In some cases, children may experience other symptoms, such as abdominal pain or mucus diarrhea. Polyps can be seen by parents after a bowel movement where they protrude out of the anus and then return to the rectum. But this only happens when the polyp is located close to the anus.

TREATMENT

Your doctor will recommend a colonoscopy which examines the inside of the colon with an instrument called a colonoscope. When a polyp is found, the pediatric gastroenterologist will use a small capture device that is inserted into the colonoscope to remove the entire polyp. The pediatric gastroenterologist will examine the entire colon with a colonoscope to make sure all polyps have been found and removed. The polyp is then sent for a pathological examination to determine its type.

What are the possible complications of polyps?

The importance of juvenile polyps in most children is not the same as that of adenomatous polyps in adults who are at increased risk for colon cancer.

If a child is found to have juvenile polyps he or she should begin screening for colorectal cancer in adulthood at age 50 such as the general population.

When do I need further studies for my child if he/she has polyps ?

Additional risk indicators that need further study include:

• Positive family history
• A child with more than 5 juvenile polyps on the first examination of the colon.
• The development of additional juvenile polyps after the initial removal of polyps.
• Polyps in the stomach or small intestine.
• One or more adenomas in a child or adolescent.