Schistosomal disease of the colon: a reversible form of polyposis

Colonic polyposis is a common complication of schistosomiasis in Egypt and is associated with significant morbidity and mortality. Recent studies have shown that niridazole is an effective therapeutic agent in this condition and may be associated with polyp regression. The purpose of the study was to evaluate, by direct visual inspection and biopsy, the effect of medical therapy in patients with schistosomal colonic polyposis. Pre treatment evaluation included physical examination, laboratory studies, stool parasitology, colonoscopy, and colon biopsy. All patients were treated with niridazole (25 mg per kg per day for 10 days), and post treatment studies were completed at 3, 6, and 12 months. By 12 months, all patients were symptom free, and there was marked improvement in physical condition, laboratory studies, barium enema results and colonoscopy. These data support the efficacy of medical treatment in this condition and indicate that polyposis may be a reversible lesion.