When is genetic counselling recommended for familial adenomatous polyposis?

Familial adenomatous polyposis, or FAP, is an inherited condition in which many growths can develop in the bowel. A counsellor reviews the family history, explains how an inherited gene change may be passed through a family, and discusses what a genetic test can and cannot show.

Counselling may be useful before testing so you can consider privacy, emotional effects and what results could mean for relatives. A result can help guide bowel surveillance and discussions with adult relatives or children who may also need assessment.

Ask the clinician managing the bowel condition for referral to a genetics service, especially after a diagnosis, when polyps appear at an unusually young age, or when several relatives have bowel polyps or bowel cancer. Bring any known pathology reports and a simple family history covering relatives on both sides of the family.

A genetics team can explain whether testing an affected relative first is useful, which relatives might benefit from testing, and how surveillance is coordinated if a familial gene change is found.

Genetic counselling is not an emergency service, but arrange it promptly after a possible or confirmed FAP diagnosis so bowel specialists and relatives can plan appropriate follow-up. Seek urgent care for heavy rectal bleeding, black stools, severe abdominal pain, repeated vomiting or fainting.

Ask which findings raise concern for FAP, whether genetic testing is appropriate now, which relatives should be offered counselling, and how bowel monitoring will be arranged while results are pending.