JP & You

We need to tell the difference between a condition with several juvenile polyps and a solitary juvenile polyp. Doctors do tests to find out if a patient has just one or two juvenile polyps or several juvenile polyps. Having one or two juvenile polyps usually doesn't cause any difficulties as you get older. In contrast, a patient with several juvenile polyps should be monitored by a specialist and will need further testing. This condition is called juvenile polyposis. This topic can be confusing for anyone. To understand your specific type of polyp condition, you should check with your doctor.

What is a Solitary Juvenile Polyp?
A solitary juvenile polyp is usually found in the colon and looks like a mushroom on a stalk.

You can see an example below of a solitary juvenile polyp in a five-year-old boy. This boy noticed rectal bleeding which was painless. Most children with a juvenile polyp may have painless rectal bleeding or the polyp coming through the rectum. Studies have not shown an increased risk in colon cancer in people with a solitary juvenile polyp.

What is Juvenile Polyposis?
Juvenile polyposis is a rare condition with multiple juvenile polyps in the gastrointestinal tract. The number of polyps needed to make the diagnosis of juvenile polyposis remains controversial. Most specialists agree that about 7 or more polyps are a reasonable cut-off. Doctors need to find out if a person has juvenile polyposis because patients have to be checked regularly.

Some patients with juvenile polyposis may be born with other problems, for example, heart problems.

What are the Symptoms of Juvenile Polyposis?
Children with juvenile polyposis usually develop rectal bleeding, anemia (a low red blood cell count), rectal prolapse, or protrusion of a polyp through the rectum. Rarely, juvenile polyposis can present during infancy with failure to gain weight, rectal bleeding, and diarrhea.

Do Polyps need to be removed?
If the polyps are causing problems such as bleeding they can usually be removed during colonoscopy. Most juvenile polyps can be removed by placing a snare (a wire) around the stalk of the polyp and pinching it tight.

To the right is an example of a juvenile polyp in the lower bowel of an eight-year-old girl with rectal bleeding. During colonoscopy, the wire was placed around the stalk and the polyp was safely removed. It does not hurt to have a polyp removed.

Is Juvenile Polyposis Inherited?
There is more than one form of juvenile polyposis. Sometimes more than one family member is affected. In other cases, there is just one family member with juvenile polyposis syndrome. In most cases there is a 50 per cent chance each child of an affected parent to have the disease gene.

Is there a Risk of Cancer?
Yes. Having juvenile polyposis does increase the chances of developing bowel cancer. Patients with juvenile polyposis may have a lifetime risk of colon cancer as high as 50 per cent.

How Should I be Monitored?
The screening recommendations include a colonoscopy beginning with symptoms or in early teens if no symptoms occur. The frequency of the colonoscopies is determined by the number of polyps but at least every three years once begun. Talk to your doctor to find out how often you should have colonoscopy.

Juvenile Polyposis and Kids
Some kids have of lots of polyps in their bowel. The polyps do not usually hurt but can cause some bleeding from the rectum. Tell your parents if you see bleeding on the toilet paper or in the toilet bowl. The best way to help keep you healthy is to check the polyps every two or three years. This is done with a colonoscope. Colonoscopy allows the doctor to see inside your bowel to make sure everything is fine.