For more information on the following, other diseases and conditions, please refer to the American Society of Colon and Rectal Surgeons.

• COLONOSCOPY

• POLYPS

• COLORECTAL CANCER

• DIVERTICULAR DISEASE

• IRRITABLE BOWEL SYNDROME

• ULCERATIVE COLITIS & PROCTITIS

• ANAL FISSURE

• ANAL ABSCESS AND FISTULA

• HEMORRHOIDS

• CONSTIPATION

• INCONTINENCE

COLONOSCOPY:

What is colonoscopy? Colonoscopy is the visual examination of the lining of the colon and rectum. A colonoscopy is performed to diagnose colon and rectal problems, perform biopsies and remove colon polyps. Most colonoscopies are done on an outpatient basis. Who should have colonoscopy? If you have a change in bowel pattern or bleeding, your physician may recommend colonoscopy. Colonoscopies are also performed to check unexplained abdominal symptoms; to check inflammatory bowel disease (colitis); to verify identification of polyps or tumors located with a barium enema exam; to examine patients who test positive for blood in the stool; and to monitor patients with a past history of colon polyps or cancer. How is colonoscopy performed? After a patient's bowel is thoroughly cleaned (as prescribed by the physician), the colonoscope is inserted into the anus and gently advanced around the bends of the colon to where the small intestine enters. Polyps can be removed as necessary and biopsies may be taken. The procedure usually takes less than an hour and there is little pain. Intravenous sedation is usually given. Occasionally patients may experience slight discomfort following the procedure, which is often improved by expelling gas.

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POLYPS:

What are polyps? Polyps are abnormal growths that form on the inside lining of the colon. Polyps are one of the most common conditions affecting the colon and rectum. Although most polyps are benign (non-cancerous), the relationship of certain polyps to cancer is well established. Since there is no way of predicting whether or not a polyp is or will become malignant, total removal of all polyps is advised. How are polyps diagnosed? Polyps are diagnosed either by looking at the colon lining directly (via endoscopy) or by x-ray study (barium enema). There are 3 types of colorectal endoscopy: 1. rigid sigmoidoscopy (examines the lower six to eight inches of the rectum), 2. flexible sigmoidoscopy (examines the lower one-fourth to one-third of the colon), and 3. colonoscopy (examines the entire length of the colon). Both the rigid and flexible sigmoidoscopies can be performed in the doctor's office. The discovery of one polyp necessitates a complete colon inspection. Once a polyp is completely removed, its recurrence is very unusual; however, new polyps will develop in at least 40% of people who have previously had polyps. These patients should therefore have regular exams. How are polyps removed? Most polyps can be removed by snaring them with a wire loop passed through the instrument. Small polyps can be destroyed by touching them with a coagulating electrical current, whereas large polyps may require more than one treatment for complete removal. If polyps cannot be removed by instruments because of their size or position, surgery may be required.

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COLORECTAL CANCER:

What is colorectal cancer? Colorectal cancer is the second most common cancer in the United States (for both sexes combined), striking 140,000 people annually, and causing 60,000 deaths. However, if diagnosed in the early stages, this disease is highly curable. Who is at risk for colorectal cancer? While more than 90% of patients with colorectal cancer are over the age of 40, the disease can occur at any age. Family history of colorectal cancer and polyps and a personal history of ulcerative colitis or Crohns' Disease, colon polyps or cancer of other organs, especially of the breast or uterus, are other contributing risk factors. How does colorectal cancer start? Nearly all colon and rectal cancers begin in benign polyps. This fact offers an opportunity to prevent colon cancer by removing polyps in the pre-cancerous stage. What are the symptoms of colorectal cancer? Rectal bleeding and changes in bowel habits are the most common symptoms. Abdominal pain and weight loss are usually late symptoms, possibly indicating extensive disease. After the age of 40, your routine physical should include colorectal detection procedures and methods, since many polyps and early cancers do not produce symptoms. How is colorectal cancer treated? In nearly all cases, surgery is required for a complete cure. Sometimes radiation and chemotherapy are used in addition to surgery. If the cancer is detected and treated in the earliest stages, 80-90% of patients can be cured. If diagnosed in the later stages, 50% or less are cured, and less than 5% require a colostomy (the surgical construction of an artificial excretory opening from the colon). Can colorectal cancer be prevented? Steps you can take to lower the risk of colorectal cancer include: having benign polyps removed by colonoscopy; being aware of changes in your bowel habits; and having regular bowel examinations as part of routine physicals at an earlier age. Additionally, a diet which is high in fiber and low in fat may be important in prevention of colorectal cancer.

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DIVERTICULAR DISEASE:

What is diverticular disease? Diverticula are pockets that develop in the colon wall. "Diverticulosis" is the term used to describe the presence of these pockets. "Diverticulitis" implicates inflammation of these pockets. Diverticulosis and diverticulitis afflict about 50% of Americans by the age of 60, and nearly all by the age of 80. What are the symptoms of diverticular disease? The major symptoms are abdominal pain, diarrhea, cramps, change in bowel habit, and sometimes severe rectal bleeding. When the diverticula become infected (diverticulitis), symptoms may include pain, chills, fever, change in bowel habit, and more serious complications such as perforation, abscess or fistula formation. What causes diverticular disease? A low-fiber diet over the years creates increased colon pressure and results in pockets or diverticula. How is diverticular disease treated? Usually diverticular disease is treated by diet and occasionally medication to help control pain and change in bowel habits. Pressures in the colon may be reduced by increasing the amount of fiber and sometimes restricting certain foods in one's diet. Mild cases of diverticulitis may be managed with oral antibiotics, dietary restrictions and possibly stool softeners. Hospitalization with intravenous antibiotics and strict dietary restraints may be required for more severe cases. Surgery is reserved for recurrent episodes, complications or severe attacks when there is little or no response to medication.

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