RARE DISEASE
Cap polyposis
Cap polyposis
Cap polyposis
Synonyms: Cap inflammatory polyposis, Eroded polypoid hyperplasia, Inflammatory myoglandular polyps, Polypoid prolapsing folds
Synonyms: Cap inflammatory polyposis, Eroded polypoid hyperplasia, Inflammatory myoglandular polyps, Polypoid prolapsing folds
Synonyms: Cap inflammatory polyposis, Eroded polypoid hyperplasia, Inflammatory myoglandular polyps, Polypoid prolapsing folds
Drug discovery
48
papers
On emerging therapies
Overview
Cap Polyposis Overview
Cap polyposis (CP) is a rare inflammatory condition characterized by fibrin-capped polyps predominantly in the rectum and sigmoid colon. Symptoms include rectal bleeding, mucus-laden stools, tenesmus, and alternating constipation/diarrhea. Etiology remains unclear but may involve mucosal prolapse, H. pylori infection, or dysbiosis. Diagnosis relies on colonoscopy and histopathology showing ulcerated crypts with fibromuscular hyperplasia. Treatment is challenging, with high recurrence rates after resection [2][7][12][13][17].
Therapies
Medical: H. pylori eradication, antibiotics (e.g., metronidazole), corticosteroids, or anti-TNF agents (e.g., infliximab) [3][8][17].
Endoscopic: Polypectomy, EMR, or ESD for focal disease; recurrence rates up to 59% [2][3][13].
Surgical: Reserved for refractory cases; recurrence common (e.g., partial colectomy) [2][5][12].
Categories: rare gastroenterological diseases, rare transplant-related disorders
Research Papers
48 drug discovery papers about Cap polyposis. Recent publications:
48 drug discovery papers about Cap polyposis. Recent publications:
categories:
Small molecules
small molecules
2026-06-25 | Endoscopic characteristics and clinical management of cap polyposis: Insights from seven cases.
Cap polyposis (CP) is an uncommon benign condition affecting the colorectal region. This study aimed to examine endoscopic features, therapeutic responses, and clinical outcomes of CP, with particular emphasis on the variable response to Helicobacter pylori eradication. This retrospective case series evaluated seven patients diagnosed with CP at Tianjin Union Medical Center between February 2018 and April 2023. The diagnosis was established based on distinctive endoscopic and histological findings, with clinical exclusion of other conditions such as ulcerative colitis (UC) and solitary rectal ulcer syndrome. Clinical data, endoscopic characteristics, treatments, and outcomes were systematically reviewed. This case series included seven patients (six males, one female) with a median age of 36 years. Four patients were H. pylori -positive. All patients exhibited characteristic sessile or semi-pedunculated polyps covered by a whitish fibrinopurulent cap, predominantly located in the rectosigmoid region with normal intervening mucosa. Treatment outcomes varied. Two H. pylori -positive patients with short disease duration achieved complete remission following eradication therapy combined with polypectomy. Two other H. pylori -positive patients showed only initial improvement after eradication, with subsequent recurrences; one ultimately required total colectomy due to disease progression. In contrast, one H. pylori -negative patient achieved remission through polypectomy and medical therapy alone. CP poses significant diagnostic challenges and demonstrates heterogeneous responses to treatment. Eradication of H. pylori may prove effective in certain patients with early-stage disease. Therefore, timely diagnosis and personalized treatment strategies, including endoscopic resection, are essential for achieving favorable outcomes.
2026-06-16 | [Analysis of clinical and endoscopic characteristics of cap polyposis in children].
Objective: To summarize the clinical features, endoscopic characteristics, treatment and prognosis of cap polyposis (CP) in children. Methods: In this case series study, clinical data including clinical manifestations, laboratory tests, endoscopic examinations, pathological results, treatment plans and follow-up conditions of 6 CP children diagnosed at Xi'an Children's Hospital from January 2018 to August 2025 were summarized. Results: Among the 6 children, there were 5 males and 1 female, with the age range at diagnosis of 9.2 to 14.3 years. The symptoms included bloody stool in all 6 cases, diarrhea in 4 cases, prolapse of perianal masses in 2 cases, and malnutrition in 2 cases. Among the auxiliary examinations, 3 cases were positive for 13C-urea breath test, and 5 cases were positive for Helicobacter pylori (Hp) in gastric mucosa histopathology. Colonoscopy revealed irregular polyps covered with white mucus, with 3 cases involving the rectum and 3 cases involving both the rectum and sigmoid colon. Histopathology showed inflammatory polyps covered with fibrous purulent exudate. The treatment plan included Hp eradication, mesalazine, hormone enema, thalidomide, and endoscopic polypectomy. The symptoms of all 6 children improved. Five of the children underwent re-examination with colonoscopy. Among them, 3 cases showed small polyp-like protrusions, and 2 cases showed local intestinal mucosa with slight congestion. Conclusions: CP is rare in children, with hematochezia and diarrhea as the main clinical manifestations. Colonoscopy typically reveals polyps with mucus adhering to the surface. Diagnosis requires histopathological examination, and individualized treatment should be formulated based on the specific condition of the child.
2023-10-02 | An Unusual Case of Isolated Gastric Cap Polyposis
Kang, Hansol MD; Schwartz, Cooper MD; Furth, Emma E. MD; Hubbi, Maimon E. MD, PhD Author Information
2020-02-10 | Effect of Gender and Age on the Correlation between Helicobacter pylori and Colorectal Adenomatous Polyps in a Chinese Urban Population: A Single Center Study
To investigate whether Helicobacter pylori (H. pylori) infection increases the risk of colorectal adenomatous polyp (CAP) in the context of age and gender.A total of 563 study subjects (male/female, 368/195) from Beijing, China, with higher nursing level who underwent colonoscopy were retrospectively collected. H. pylori and CAP were detected by carbon-13 urea breath test and colorectal colonoscopy. The correlations between the number, size, distribution, and pathological grade of CAP and H. pylori infection were analyzed. The population was further stratified by age and gender in order to examine the risk of H. pylori and CAP in the context of these variables. The influence of H. pylori on the risk of CAP was assessed by logistic regression model.315 participants were diagnosed with CAP, and 207 participants were classified as healthy controls. The prevalence of H. pylori in the CAP group was significantly higher than that in the healthy control group (119/315, 37.8% versus 44/207, 21.3%) (p < 0.001). The proportion of H. pylori positive plus CAP in participants <50 years old was significantly higher than that in participants >50 years old (87/250; 34.8% versus 32/65; 49.2%) (p < 0.001). The proportion of H. pylori positive plus CAP in participants <50 years old was significantly higher than that in participants >50 years old (87/250; 34.8% versus 32/65; 49.2%) (p < 0.001). The proportion of H. pylori positive plus CAP in participants <50 years old was significantly higher than that in participants >50 years old (87/250; 34.8% versus 32/65; 49.2%) (p < 0.001). The proportion of H. pylori positive plus CAP in participants <50 years old was significantly higher than that in participants >50 years old (87/250; 34.8% versus 32/65; 49.2%) (.H. pylori is a major risk factor for CAP. Further studies are needed to assess the effects of H. pylori treatment or persistent infection on the occurrence or recurrence of CAP.
2019-04-29 | Cap polyposis in children: case report and literature review.
Cap polyposis is a benign disease of the colon, characterized by inflammatory polyps with a "cap" of inflammatory granulation tissue. Its prevalence is very low, especially in children. A 16-year-old girl presented with frequent bowel movements with mucous discharge and bloody stool, leading to the initial suspicion of chronic inflammatory bowel disease. Results of further investigation by endoscopy and histological examination were consistent with a diagnosis of cap polyposis. Treatment with systemic steroids resulted in symptom improvement. A review of the literature shows that cap polyposis can occur at any age, including childhood, with a slight predilection for the male gender. Rectal bleeding and rectal polyps are consistent features in all reported cases. Other typical symptoms include constipation, diarrhea, and abdominal pain. Symptoms may be very similar to those of chronic inflammatory bowel disease, the most important differential diagnosis. The cause of cap polyposis is still unclear, and specific therapy has not as yet been established. Conservative therapeutic measures should be preferred, especially in children.
antibodies
2024-06-14 | Cap polyposis refractory to drug treatment, including infliximab.
Cap polyposis is a rare disease characterized by the presence of inflammatory polyps with an adherent fibrin sheath ("cap"), in variable number and size, in the rectum and sigmoid. It presents with tenesmus, mucous stools and rectorrhagia. There is currently no standardized treatment, having been treated empirically with aminosalicylates, oral or rectal steroids, metronidazole, H. pylori eradication therapy and infliximab with variable results. In refractory cases, endoscopic resection of polyps may be used and surgery may even be necessary. We present the case of a 36-year-old patient diagnosed in our center with cap polyposis, refractory to both pharmacological and endoscopic treatment, and therefore treatment with infliximab was decided out of indication. The case we present is the fourth case of cap polyposis treated with infliximab available in the current literature and highlights the difficulty of achieving a clinical response with pharmacological treatment, including biologic drugs such as infliximab.
2021-07-26 | SATB1 Expression of Colorectal Adenomatous Polyps is Higher than that of Colorectal Carcinomas.
"Special AT-rich sequence-binding protein-1" (SATB1) is a global genome organizer and is found to have effects on carcinogenesis and progression of various malignancies including colorectal carcinoma (CRC). We aimed to investigate the expression of SATB1 in CRC and colorectal adenomatous polyps (CAP), the correlation between clinicopathologic parameters, and overall survival. We examined 227 CRCs and 129 CAPs. SATB1 protein expression was evaluated by immunohistochemistry. We found higher SATB1 expression in adenomatous epithelium than in CRC tissues (55.0% vs. 42.7%, respectively) (P<0.05). None of the adjacent normal colorectal mucosa stained positive in CRC cases, and only one of the adjacent normal mucosa of the CAP cases was positive. SATB1 expression of left-sided CRC was higher than that of right-sided CRC (46.3% vs. 28.6%, respectively) (P<0.05), and SATB1 expression of conventional adenocarcinomas was higher than that of mucinous carcinomas (45.5% vs. 6.3%, respectively) (P<0.05). SATB1 expression was higher in CAPs consisting of high-grade dysplasia than in polyps with low-grade dysplasia (77.8% vs. 51.4%) (P<0.05). SATB1 expression did not correlate with patients' overall survival. In conclusion, due to the higher expression of SATB1 in CAP than in CRC, we think SATB1 may have a role in the early stages of carcinogenesis of CRCs. This is the first study investigating SATB1 expression in CAPs. Besides this is the first report that shows different SATB1 expressions in conventional colorectal adenocarcinoma and mucinous carcinoma, and also in right-sided and left-sided CRC. Our results, with supporting new studies, can provide SATB1 as a possible candidate for targeted therapy for CRC patients.
2009-12-30 | Remission of Cap Polyposis Maintained for More Than Three Years after Infliximab Treatment
Cap polyposis is a rare disorder with characteristic endoscopic and histological features; its etiology is still unknown, and no specific treatment has been established. We report a case of cap polyposis that improved remarkably after infliximab infusion and had no recurrence for 3 years.
2004-06-01 | Successful treatment of cap polyposis with infliximab
Cap polyposis is a disorder characterized by bloody diarrhea with rectosigmoid polyps covered by a cap of fibropurulent exudate. The pathogenesis is unknown, but histological features suggest that mucosal prolapse may play a role. Drug therapies are usually unsuccessful, and treatment requires sigmoid resection or, if the disease recurs after initial surgical resection, panproctocolectomy. We report the case of a 36-year-old woman with characteristic clinical, endoscopic, and histological features of cap polyposis. Investigations included normal anorectal manometry and defecography, without evidence of prolapse. The patient's disease was unresponsive to treatment with mesalamine, antibiotics, lidocaine enemas, and corticosteroids. One infusion of infliximab 5 mg/kg provided dramatic symptomatic improvement but minimal endoscopic or histological change. After 4 infliximab infusions at 8-week intervals, endoscopy of the rectum and sigmoid colon was normal, and biopsies showed complete histological resolution of the inflammatory process. Well-being with normal endoscopy and histology has been maintained at 38 months, without further treatment. It was concluded that infliximab is effective therapy for cap polyposis and avoids the requirement for surgery. No clinical evidence was obtained to support mucosal prolapse as a causative factor, but the response to infliximab suggests a role for tumor necrosis factor-α in the pathogenesis of this disorder.
small molecules
2026-06-25 | Endoscopic characteristics and clinical management of cap polyposis: Insights from seven cases.
Cap polyposis (CP) is an uncommon benign condition affecting the colorectal region. This study aimed to examine endoscopic features, therapeutic responses, and clinical outcomes of CP, with particular emphasis on the variable response to Helicobacter pylori eradication. This retrospective case series evaluated seven patients diagnosed with CP at Tianjin Union Medical Center between February 2018 and April 2023. The diagnosis was established based on distinctive endoscopic and histological findings, with clinical exclusion of other conditions such as ulcerative colitis (UC) and solitary rectal ulcer syndrome. Clinical data, endoscopic characteristics, treatments, and outcomes were systematically reviewed. This case series included seven patients (six males, one female) with a median age of 36 years. Four patients were H. pylori -positive. All patients exhibited characteristic sessile or semi-pedunculated polyps covered by a whitish fibrinopurulent cap, predominantly located in the rectosigmoid region with normal intervening mucosa. Treatment outcomes varied. Two H. pylori -positive patients with short disease duration achieved complete remission following eradication therapy combined with polypectomy. Two other H. pylori -positive patients showed only initial improvement after eradication, with subsequent recurrences; one ultimately required total colectomy due to disease progression. In contrast, one H. pylori -negative patient achieved remission through polypectomy and medical therapy alone. CP poses significant diagnostic challenges and demonstrates heterogeneous responses to treatment. Eradication of H. pylori may prove effective in certain patients with early-stage disease. Therefore, timely diagnosis and personalized treatment strategies, including endoscopic resection, are essential for achieving favorable outcomes.
2026-06-16 | [Analysis of clinical and endoscopic characteristics of cap polyposis in children].
Objective: To summarize the clinical features, endoscopic characteristics, treatment and prognosis of cap polyposis (CP) in children. Methods: In this case series study, clinical data including clinical manifestations, laboratory tests, endoscopic examinations, pathological results, treatment plans and follow-up conditions of 6 CP children diagnosed at Xi'an Children's Hospital from January 2018 to August 2025 were summarized. Results: Among the 6 children, there were 5 males and 1 female, with the age range at diagnosis of 9.2 to 14.3 years. The symptoms included bloody stool in all 6 cases, diarrhea in 4 cases, prolapse of perianal masses in 2 cases, and malnutrition in 2 cases. Among the auxiliary examinations, 3 cases were positive for 13C-urea breath test, and 5 cases were positive for Helicobacter pylori (Hp) in gastric mucosa histopathology. Colonoscopy revealed irregular polyps covered with white mucus, with 3 cases involving the rectum and 3 cases involving both the rectum and sigmoid colon. Histopathology showed inflammatory polyps covered with fibrous purulent exudate. The treatment plan included Hp eradication, mesalazine, hormone enema, thalidomide, and endoscopic polypectomy. The symptoms of all 6 children improved. Five of the children underwent re-examination with colonoscopy. Among them, 3 cases showed small polyp-like protrusions, and 2 cases showed local intestinal mucosa with slight congestion. Conclusions: CP is rare in children, with hematochezia and diarrhea as the main clinical manifestations. Colonoscopy typically reveals polyps with mucus adhering to the surface. Diagnosis requires histopathological examination, and individualized treatment should be formulated based on the specific condition of the child.
2023-10-02 | An Unusual Case of Isolated Gastric Cap Polyposis
Kang, Hansol MD; Schwartz, Cooper MD; Furth, Emma E. MD; Hubbi, Maimon E. MD, PhD Author Information
2020-02-10 | Effect of Gender and Age on the Correlation between Helicobacter pylori and Colorectal Adenomatous Polyps in a Chinese Urban Population: A Single Center Study
To investigate whether Helicobacter pylori (H. pylori) infection increases the risk of colorectal adenomatous polyp (CAP) in the context of age and gender.A total of 563 study subjects (male/female, 368/195) from Beijing, China, with higher nursing level who underwent colonoscopy were retrospectively collected. H. pylori and CAP were detected by carbon-13 urea breath test and colorectal colonoscopy. The correlations between the number, size, distribution, and pathological grade of CAP and H. pylori infection were analyzed. The population was further stratified by age and gender in order to examine the risk of H. pylori and CAP in the context of these variables. The influence of H. pylori on the risk of CAP was assessed by logistic regression model.315 participants were diagnosed with CAP, and 207 participants were classified as healthy controls. The prevalence of H. pylori in the CAP group was significantly higher than that in the healthy control group (119/315, 37.8% versus 44/207, 21.3%) (p < 0.001). The proportion of H. pylori positive plus CAP in participants <50 years old was significantly higher than that in participants >50 years old (87/250; 34.8% versus 32/65; 49.2%) (p < 0.001). The proportion of H. pylori positive plus CAP in participants <50 years old was significantly higher than that in participants >50 years old (87/250; 34.8% versus 32/65; 49.2%) (p < 0.001). The proportion of H. pylori positive plus CAP in participants <50 years old was significantly higher than that in participants >50 years old (87/250; 34.8% versus 32/65; 49.2%) (p < 0.001). The proportion of H. pylori positive plus CAP in participants <50 years old was significantly higher than that in participants >50 years old (87/250; 34.8% versus 32/65; 49.2%) (.H. pylori is a major risk factor for CAP. Further studies are needed to assess the effects of H. pylori treatment or persistent infection on the occurrence or recurrence of CAP.
2019-04-29 | Cap polyposis in children: case report and literature review.
Cap polyposis is a benign disease of the colon, characterized by inflammatory polyps with a "cap" of inflammatory granulation tissue. Its prevalence is very low, especially in children. A 16-year-old girl presented with frequent bowel movements with mucous discharge and bloody stool, leading to the initial suspicion of chronic inflammatory bowel disease. Results of further investigation by endoscopy and histological examination were consistent with a diagnosis of cap polyposis. Treatment with systemic steroids resulted in symptom improvement. A review of the literature shows that cap polyposis can occur at any age, including childhood, with a slight predilection for the male gender. Rectal bleeding and rectal polyps are consistent features in all reported cases. Other typical symptoms include constipation, diarrhea, and abdominal pain. Symptoms may be very similar to those of chronic inflammatory bowel disease, the most important differential diagnosis. The cause of cap polyposis is still unclear, and specific therapy has not as yet been established. Conservative therapeutic measures should be preferred, especially in children.
antibodies
2024-06-14 | Cap polyposis refractory to drug treatment, including infliximab.
Cap polyposis is a rare disease characterized by the presence of inflammatory polyps with an adherent fibrin sheath ("cap"), in variable number and size, in the rectum and sigmoid. It presents with tenesmus, mucous stools and rectorrhagia. There is currently no standardized treatment, having been treated empirically with aminosalicylates, oral or rectal steroids, metronidazole, H. pylori eradication therapy and infliximab with variable results. In refractory cases, endoscopic resection of polyps may be used and surgery may even be necessary. We present the case of a 36-year-old patient diagnosed in our center with cap polyposis, refractory to both pharmacological and endoscopic treatment, and therefore treatment with infliximab was decided out of indication. The case we present is the fourth case of cap polyposis treated with infliximab available in the current literature and highlights the difficulty of achieving a clinical response with pharmacological treatment, including biologic drugs such as infliximab.
2021-07-26 | SATB1 Expression of Colorectal Adenomatous Polyps is Higher than that of Colorectal Carcinomas.
"Special AT-rich sequence-binding protein-1" (SATB1) is a global genome organizer and is found to have effects on carcinogenesis and progression of various malignancies including colorectal carcinoma (CRC). We aimed to investigate the expression of SATB1 in CRC and colorectal adenomatous polyps (CAP), the correlation between clinicopathologic parameters, and overall survival. We examined 227 CRCs and 129 CAPs. SATB1 protein expression was evaluated by immunohistochemistry. We found higher SATB1 expression in adenomatous epithelium than in CRC tissues (55.0% vs. 42.7%, respectively) (P<0.05). None of the adjacent normal colorectal mucosa stained positive in CRC cases, and only one of the adjacent normal mucosa of the CAP cases was positive. SATB1 expression of left-sided CRC was higher than that of right-sided CRC (46.3% vs. 28.6%, respectively) (P<0.05), and SATB1 expression of conventional adenocarcinomas was higher than that of mucinous carcinomas (45.5% vs. 6.3%, respectively) (P<0.05). SATB1 expression was higher in CAPs consisting of high-grade dysplasia than in polyps with low-grade dysplasia (77.8% vs. 51.4%) (P<0.05). SATB1 expression did not correlate with patients' overall survival. In conclusion, due to the higher expression of SATB1 in CAP than in CRC, we think SATB1 may have a role in the early stages of carcinogenesis of CRCs. This is the first study investigating SATB1 expression in CAPs. Besides this is the first report that shows different SATB1 expressions in conventional colorectal adenocarcinoma and mucinous carcinoma, and also in right-sided and left-sided CRC. Our results, with supporting new studies, can provide SATB1 as a possible candidate for targeted therapy for CRC patients.
2009-12-30 | Remission of Cap Polyposis Maintained for More Than Three Years after Infliximab Treatment
Cap polyposis is a rare disorder with characteristic endoscopic and histological features; its etiology is still unknown, and no specific treatment has been established. We report a case of cap polyposis that improved remarkably after infliximab infusion and had no recurrence for 3 years.
2004-06-01 | Successful treatment of cap polyposis with infliximab
Cap polyposis is a disorder characterized by bloody diarrhea with rectosigmoid polyps covered by a cap of fibropurulent exudate. The pathogenesis is unknown, but histological features suggest that mucosal prolapse may play a role. Drug therapies are usually unsuccessful, and treatment requires sigmoid resection or, if the disease recurs after initial surgical resection, panproctocolectomy. We report the case of a 36-year-old woman with characteristic clinical, endoscopic, and histological features of cap polyposis. Investigations included normal anorectal manometry and defecography, without evidence of prolapse. The patient's disease was unresponsive to treatment with mesalamine, antibiotics, lidocaine enemas, and corticosteroids. One infusion of infliximab 5 mg/kg provided dramatic symptomatic improvement but minimal endoscopic or histological change. After 4 infliximab infusions at 8-week intervals, endoscopy of the rectum and sigmoid colon was normal, and biopsies showed complete histological resolution of the inflammatory process. Well-being with normal endoscopy and histology has been maintained at 38 months, without further treatment. It was concluded that infliximab is effective therapy for cap polyposis and avoids the requirement for surgery. No clinical evidence was obtained to support mucosal prolapse as a causative factor, but the response to infliximab suggests a role for tumor necrosis factor-α in the pathogenesis of this disorder.
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