Cap polyposis is characterized by the presence of inflammatory polyps with a "cap" of granulation tissue. It may represent one end of a spectrum of conditions caused by chronic straining. Polyps have an erythematous and inflamed appearance and are capped with a purulent fibrin exudate. The pathogenesis is not well known although many affected individuals have long standing colonic dysmotility manifested by chronic constipation. It is hypothesized that recurrent mucosal trauma due to chronic straining can result in the clinical spectrum of mucosal prolapse syndrome which includes solitary rectal ulcer syndrome and the more dramatic finding of cap polyposis.
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