A polyp is an outgrowth of tissue from the lining of the large or small intestine and sometimes the stomach. A polyp may look like a mushroom with a narrow stalk attached to the gastrointestinal wall or it may grow flat against the gastrointestinal wall.

Most children with a polyp(s) develop a form of polyp known as a juvenile polyp, which is different than the type typically found in adults. A juvenile polyp usually poses no risk of malignancy (cancer). Some children may be found to have inherited syndromes in which polyps are common. These include: familial adenomatous polyposis, juvenile polyposis syndrome, Peutz-Jeghers syndrome, Bannayan-Riley-Rubvalcaba syndrome and Cowden disease.

Symptoms

Blood passed through stool over several weeks or months is the most common symptom. Less common symptoms include abdominal pain, diarrhea or protrusion of a polyp outside the rectum.

Exams and Tests

If your child has experienced blood in his/her stool for a prolonged period or if a polyp is visible outside the rectum, your child will be referred to a pediatric gastroenterologist who will perform a colonoscopy. If a polyp is present, the gastroenterology specialist will use a special tool to remove it. The polyp will be sent to a pathology laboratory for testing.

Colonoscopy

While your child is asleep under the care of an anesthesiologist, a long lighted tube containing a camera allows the pediatric gastroenterologist to see the end of the small intestine and the entire large intestine. If a polyp(s) is found, it will be removed at that time. Your child will feel no pain or discomfort during the procedure.

The doctor will talk with you and your child before the procedure and answer your questions. Some children may get a medication to help them relax before being taken to the operating room area. After the procedure, your child will be taken to the recovery room, allowed to fully awaken, and then be brought out to you. The doctor will discuss the preliminary findings of the procedure and show pictures taken during the procedure. Your child will be allowed to go home in a couple of hours after the procedure but must be fully awake and able to drink liquids before being discharged home. The total time spent at the hospital will depend on the procedure time and the time for your child to wake up. It is best to expect to spend 4-5 hours at the hospital.

Treatment

A child with a single polyp will likely need no other treatment once the polyp is removed. If the child has multiple polyps or pathology testing determines the child to have one of several possible genetic syndromes, routine monitoring of the intestine via colonoscopy may be recommended.

Points to Remember

• If your child has experienced blood in his/her stool for a prolonged period, a polyp is one possible cause.
• A polyp can be diagnosed during a colonoscopy, which is done on an outpatient basis.
• Most juvenile polyps do not pose any risk of further complications, but do need to be removed.
• In rare cases, a child will be found to have an inherited syndrome in which polyps tend to recur over time. The child will need to be monitored on a regular basis.

For More Information

North American Society for Pediatric Gastroenterology, Hepatology and Nutrition - NASPHGAN.org