Polyposis Medication: What Works and What to Know

If you or a family member has polyposis, especially familial adenomatous polyposis (FAP), you’ve probably heard that pills can shrink or slow down polyp growth. The idea is simple: use drugs to keep the colon clear while you plan surgery or other interventions. Below we break down the meds most doctors prescribe, what to expect, and how to stay on top of safety.

Common Medications for Polyposis

The first line of drug therapy usually involves non‑steroidal anti‑inflammatory drugs (NSAIDs). Sulindac is the classic choice. It’s taken twice a day, often 150 mg each dose, and can reduce the number of polyps by 30‑50 % in many patients. Some people tolerate it well, but stomach upset is common, so taking it with food or a proton‑pump inhibitor helps.

Celecoxib, a COX‑2 selective NSAID, is another option. Because it spares the stomach lining more than regular NSAIDs, it’s a favorite for long‑term use. Typical dosing is 200 mg twice daily. Studies show celecoxib can shrink polyps and keep new ones from forming, especially when combined with a low‑dose aspirin regimen.

Aspirin itself, at low doses (81 mg daily), is sometimes added for its anti‑platelet and chemopreventive effects. The dose is small enough to avoid most bleeding risks for healthy adults, but you should still discuss it with your doctor if you have a history of ulcers or are on blood thinners.

In some cases, a combination of sulindac and a COX‑2 inhibitor is used to boost the effect. Your doctor will decide based on how many polyps you have, your age, and any other health issues.

How to Use and Track Your Medication

Start any polyposis drug only after a full medical review. You’ll need a prescription, and most pharmacies will ask for a recent colonoscopy report. Keep a simple log: note the date you start, the dose, and any side‑effects you notice. Common issues include mild nausea, headache, or occasional heartburn.

Regular lab checks are key. For NSAIDs, doctors often order liver function tests and kidney panels every three months. If you’re on celecoxib, a blood pressure reading each visit is wise because the drug can raise systolic pressure in some people.

Never stop a medication abruptly without talking to your clinician. If you miss a dose, take it as soon as you remember unless it’s almost time for the next one – then just skip the missed pill. This avoids double‑dosing, which can increase stomach irritation.

Finally, remember that medication is only part of the plan. Endoscopic surveillance every 1–2 years, a healthy diet high in fiber, and timely discussion of surgical options (like colectomy) are all part of staying ahead of polyps.

Bottom line: the right meds can buy you time and reduce polyp burden, but they work best when paired with regular check‑ups and a clear monitoring routine. Talk to your gastroenterologist about which drug fits your situation, and keep that symptom diary handy. Staying informed and proactive is your best defense against polyposis complications.