28th February 2025

A 25-year-old plumber presents to the clinic with a 3-month history of intermittent rectal bleeding

A 25-year-old plumber presents to the clinic with a 3-month history of intermittent rectal bleeding and abdominal bloating. He has lost 5 kg in the last 6 months but attributes this to the new vegetarian diet he has adopted. He smokes 10 cigarettes per day and drinks alcohol only socially. Family history could not be obtained as he was adopted as an infant.

Physical examination is unremarkable asides for a polypoidal mass felt on rectal examination.

On colonoscopy, multiple polyps of 1 cm and above are seen from the distal colon to the rectum, up to the anal canal. Genetic testing confirms the presence of APC tumour suppressor gene.

Which of the following is the most appropriate management option?

Select the SINGLE most appropriate option from the list below. Select ONE option only.