Because the symptoms of different colon and rectal disease can closely resemble those of other such diseases, there is the potential for misdiagnosis and mistreatment. This is a crucial reason why these diseases should be treated by colon and rectal surgeons, experts in the surgical and nonsurgical treatment of colon and rectal problems.
Colorectal cancer annually strikes about 140,000 people and causes 60,000 deaths, but is potentially curable if detected in its early stages. More than 90 percent of patients are over 40, at which point the risk of contracting the disease doubles every ten years.
Detection methods include a digital rectal exam (an exam of the rectum by a physician with his or her finger) and a chemical test of the stool for blood. Colorectal cancer can be prevented if polyps are detected and removed through an outpatient colonoscopy (examination of the entire colon), or an endoscopy flexible sigmoidoscopy (examination of the lower large intestine).
If symptoms such as rectal bleeding and changes in bowel habits appear, a colon and rectal surgeon should be immediately consulted to determine if the patient has colon cancer or another bowel disease, and the patient should be promptly treated as appropriate.
Surgery is required in nearly all cases of colorectal cancer for a complete cure, which is sometimes accompanied by radiation and chemotherapy. Between 80-90 percent of colorectal cancer patients are restored to normal health if the cancer is detected and treated in the early stages, but the cure rate drops to 50 percent if treatment does not begin until later disease stages.
Ulcerative colitis is an inflammatory disease of the large intestine (the colon) that affects about 500,000 people, predominantly under 30, and can eventually increase the risk of developing large bowel cancer.
Certain symptoms may signal that a person has ulcerative colitis. They can include bleeding with bowel movements, abdominal pain or bloating, constipation, diarrhea, or a combination. Although no medical cure exists for ulcerative colitis, a physician can prescribe medicine to relieve symptoms. Surgery may be recommended for chronic cases or when medical therapy fails. These surgeries can include a proctocolectomy, which removes the entire colon, rectum and anus, creating either a Brooke ileostomy (bringing the end of the bowel through the abdomen wall, where an appliance is constantly used to collect waste), or a continent ileostomy (creation of an internal abdominal reservoir which is periodically drained with an instrument).
The newest surgery for ulcerative colitis, the ileoanal procedure, removes the colon and rectum, which is replaced by a bowel pouch to collect waste, and preserves the anal canal. This procedure almost eliminates the risk of recurrent ulcerative colitis and allows a normal route of evacuation.
Crohn’s disease is a chronic inflammatory condition primarily involving the intestinal tract that predominantly affects young adults between 16 and 40 living in northern, industrialized areas, such as the United States and northern Europe. About 20 percent of the estimated 500,000 people with Crohn’s have a family member with the disease.
Crohn’s is diagnosed through a physical examination, review of symptoms and family history. In addition, testing may include barium x-rays of the upper and lower intestinal tract, a sigmoidoscopy or colonoscopy, which allow a direct examination of the colon with a lighted tube inserted through the anus, and intestinal biopsies. The cause and how to prevent Crohn’s is unknown.
Medical treatment with anti-inflammatory or immunosuppressive medication to control symptoms is the preferred initial form of therapy. However, surgery to remove the diseased segment of the bowel and join the healthy bowel ends together, called resection and anastamosis, is recommended in more advanced or complicated cases.
Surgery is eventually required in up to three-fourths of all Crohn’s patients and is best conducted by a colon and rectal surgeon, who is skilled and experienced in Crohn’s disease management. Surgery often provides long-term relief from symptoms and limits or eliminates the need for medication