Familial adenomatous polyposis (FAP) is an autosomal dominant disorder characterized by hundreds of colorectal
adenomatous polyps that progress to
colorectal cancer. Management of patients with FAP is with a total
colectomy. Chemopreventive strategies have been studied in FAP patients in an effort to delay the development of
adenomas in the upper and the lower gastrointestinal tract and to prevent recurrence of
adenomas in the retained rectum of patients after prophylactic surgery.
Sulindac, a nonsteroidal anti-inflammatory
drug, causes regression of colorectal
adenomas in the retained rectal segment of FAP patients. However, evidence regarding long-term use of this
therapy and its effect on the intact colon has been insufficient. We report a case in which the long-term use of
sulindac was effective in reducing the size and the number of
colonic polyps in patients with FAP without a prophylactic
colectomy and polypectomy; we also present a review of the literature.