The most appropriate management is reassurance. Solitary juvenile polyps are one of the most commonly found polyps, particularly in children under the age of 10 years; they confer no future health risk once the polyp is removed, and follow-up surveillance colonoscopy is not required. It is important to distinguish between a sporadic, nonsyndromic juvenile polyp and juvenile polyposis syndrome (JPS) because management of JPS is substantially different. The clinical criteria for diagnosis of JPS include (1) more than three juvenile polyps of the colon, (2) juvenile polyps throughout the gastrointestinal tract, or (3) one or more juvenile polyps combined with a family history of JPS. Patients with JPS have an increased risk for colon cancer (39%), gastric cancer (25%), and more rarely small-bowel and pancreatic cancer.

Patients with JPS should undergo genetic counseling and testing for the mutations known to cause the disease (SMAD4 and BMPR1A genes). Surveillance guidelines for patients with JPS recommend colonoscopy and upper endoscopy every 2 to 3 years beginning at age 15 years or sooner if symptoms are present. Because this patient does not meet criteria for JPS, these interventions are not appropriate at this time.