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A first-time episode of diverticulitis is usually treated with conservative medical management, including bowel rest i. Depending on the severity of your attack, this treatment plan may or may not require hospital admission. Once your pain begins to resolve, most patients will be placed on a low residue diet.

This low-fiber diet gives the colon adequate time to heal without needing to be overworked. Later, patients are typically placed on a high fiber diet as there is some evidence this lowers the risk for second and third attacks, known as recurrence. Patient suffering one-time attacks typically do not require surgery so long as the attack resolved with medical therapy. Recurring attacks or more severe first-time cases may require surgery, either immediately or on an elective basis see below.

The decision to perform surgery for diverticulitis is always handled on a patient by patient basis so you should discuss your specific case with your doctor. In some cases, surgery may be required to remove the area of the colon most affected by the disease. For example, if the involved segment is the sigmoid colon, the procedure is known as a sigmoid colectomy.

You should understand that segmental colectomy only involves removing the infected or thickened area. Surgeons routinely leave other areas of diverticulosis behind to avoid removing large amounts of your colon. However, repeat surgery is not usually warranted. In more emergent cases, when there has been perforation to the intestine from diverticulitis, two operations are usually involved. More typically, elective surgery for diverticulitis occurs. As discussed above, this is called segmental colectomy and can be performed either open or laparoscopically. In open surgery, a large abdominal incision is made.

Through this incision the surgeon is able to remove the diseased intestine. Once the diseased bowel is removed the remaining colon is reconnected. With this, the patient is able to have normal bowel movements, the same as before the surgery. In laparoscopic surgery, small incisions are made in the abdominal wall through which instruments and a viewing tube laparoscope are inserted.

A camera attached to the viewing tube sends images of the inside of the abdomen to a television screen. The surgeon looks at the screen to see what he or she is doing while using the instruments to perform the surgery. Recent studies show that when laparoscopic colectomy is performed by an appropriately trained surgeon, the short- and long-term outcomes are better than with open surgery.

This stems from shorter recovery time, reduced length of hospital stay and earlier return to daily activities. You should ask your surgeon about this approach and about his personal skill level and experience with laparoscopic colectomy. In the case of recurrent complicated diverticulitis, the risks of ongoing inflammation and infection are greater than the risks described below and surgery is thus indicated. Colorectal cancer is cancer of the large intestine colon , the lower part of your digestive system.

Rectal cancer is cancer of the last part of your colon.

Colon Disease - Treatment Options | Medtronic

Together, colorectal cancer is the 2 cause of cancer-related deaths in the United States second to lung cancer. In most cases of colon cancer, the process begins in the form of a polyp.


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These are benign non-cancerous clumps of cells that are often small, and produce few symptoms other than silent and slow bleeding which may manifest as dark stool. It is not possible to distinguish adenomatous from hyperplastic polyps in the body so the current standard of care is to completely remove any colon polyps to permit complete analysis. On occasion, it may be found that colon cancer has already developed in a removed polyp. In such cases, if the cancer has been completely removed, no further tissue removal is necessary.

In cases where residual cancer is left, or if there is uncertainty if cancer cells remain, removal of the affected portion of the colon is indicated see below. Screening tests, as well as simply lifestyle and diet changes, can greatly reduce your overall risk of developing colon cancer because most polyps can be found and removed before they turn into cancer. Polyps rarely cause symptoms by themselves. On occasion, polyps may bleed and this will typically manifest as dark or tarry stool. Such a finding should prompt a phone call to your physician.

There are often no symptoms of colorectal cancer during its early stages. When symptoms do occur, they will vary according to the location and size of the cancer.


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  • Most colon cancers develop from adenomatous polyps, so early and routine screening is very important for detecting colon cancers. Common screen procedures include:. The treatment or combination of treatments depends on the stage or extent of cancer present: Segmental Colectomy is a surgical procedure that removes the part of your colon that contains the cancer, plus a margin of healthy colon on either side to make sure no cancer is left behind.

    The two ends of colon are typically then reconnected.

    Traditionally, surgery for colon cancer has been done through one large incision in the abdomen. More recently, several large-scale studies have been done to prove that laparoscopic surgery can be used to safely remove colon cancer and reattach the ends. In each of the studies, researchers have shown that colon cancer patients treated by laparoscopic colectomy have the same propensity for survival as those treated with open colectomy but receive all the benefit of the quicker recovery of a laparoscopic operation.

    In laparoscopic colectomy, surgeons utilize special instruments and cameras that are inserted inside the body through multiple small incisions, rather than one large incision. Patients usually recover faster after this technique and leave the hospital earlier on average than patients who choose open surgery. The cosmetic benefits also apply. Not everyone is a candidate for laparoscopic colectomy. People who have large tumors or those who have had many abdominal surgeries in the past, may not be candidates for this technique.

    This should be discussed with your surgeon as the decision is always dependent on your unique situation and your surgeon's level of comfort.

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    In the case of polyps or cancer, the risks of developing or leaving known cancer in the body are greater than the risks described below and surgery is thus indicated. Major risks of laparoscopic colectomy for colon polyps or cancer can include, but are not limited to:. Radiation is typically reserved for patients with rectal cancer only because it is dangerous to radiate the small bowel that comes in contact with the areas of the colon other than the rectum. Radiation therapy involves treatment with powerful energy rays that kill cancer cells. This allows high energy rays to focus directly onto the tumor.

    This technique is more frequently used with rectal cancer, prostate cancer, and in older or ill patients who would not be able to withstand surgery.

    Colon Disorders and Surveillance - CRASH! Medical Review Series

    Radiation therapy causes several side effects: They may be given intravenously or taken by mouth. The drugs penetrate through the bloodstream, making them effective for cancers that have spread throughout the body. Chemotherapy after surgery can increase the survival rate for some patients with invasive colorectal cancer. However, there are negative aspects to chemotherapy as well. While killing cancer cells, chemotherapy drugs can also damage normal, healthy cells too. This leads to side effects such as:. These drugs target the special defects that allow cancer cells to grow and proliferate.

    Currently, there are 3 drugs available to patients with advanced cancers and are still experimental. When caught early colorectal cancer is one of the most preventable and curable cancers. Because so many polyps are left untreated, colorectal cancer is now the third most common cancer in men and women. Each year there are more than , new colorectal cancer cases and more than 52, deaths related to colorectal cancer. A comparison of laparoscopically assisted and open colectomy for colon cancer.

    N Engl J Med. Laparoscopic surgery versus open surgery for colon cancer: Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information. Your browser is out of date With an updated browser, you will have a better Medtronic website experience.

    Colon Disease Treatment Options. Diseases of the colon Several diseases can interfere with the normal functioning of the colon. There are two forms of inflammatory bowel disease: Crohn's disease and ulcerative colitis are similar — so similar that they're often mistaken for one another. Both diseases cause inflammation of the lining of your digestive tract, and both may result in severe bouts of diarrhea and abdominal pain. Crohn's disease can occur anywhere in your digestive tract, often spreading deep into the layers of affected tissues.

    Ulcerative colitis, on the other hand, usually affects only the innermost lining of your large intestine colon and rectum. The common signs and symptoms of inflammatory bowel disease Patients with inflammatory bowel disease could present with any of the following: Abdominal pain Nausea, vomiting Diarrhea, bloody stool Weight loss or weight gain Various associated complaints or diseases, often autoimmune disorders arthritis, skin lesions, and liver and bile duct disorders.

    What needs to be done if you have inflammatory bowel disease Medical Therapy: Usually, treatment of inflammatory bowel disease begins with medical therapy. Depending on the level of severity, inflammatory bowel disease may require immunosuppression to control the symptoms. Such medications often used include azathioprine, methotrexate, or 6-mercaptopurine. If initial treatment is unsuccessful, a combination of the aforementioned immunosuppression drugs may or may not be administered, depending on the patient.

    During times of acute exacerbation of inflammatory bowel disease, steroids are often used to control disease flares. This includes infection abscess , perforation, blockage or obstruction and possible fistula connection between bowel and other structures. Ulcerative Colitis Of the two conditions, patients with ulcerative colitis are more likely to undergo surgery because removal of the colon and rectum will cure the disease.

    Surgery for ulcerative colitis usually entails removing the entire colon. There are different ways to remove the colon as well as different ways to put the colon back together. The surgery that was traditionally performed for ulcerative colitis was a proctocolectomy which removed the entire colon, rectum and anus. However, this operation required the creation of an ileostomy.

    This is an opening in the small intestine that is brought up to the skin where waste is expelled. This opening requires a bag to be worn over the opening in the skin to collect waste. Another surgical option would be to create an ileostomy with an internal pouch that acts as a collecting system. This eliminates the need for a bag; however, the opening in the skin still exists. Defecation is maintained by the patient on a schedule. A different surgical approach would be to only remove the large intestine colon leaving the rectum and anus.

    The small intestine ileum would then be connected to the rectum. This relieves the patient of having to live with a colostomy but leaves large intestine behind that may be susceptible to recurrent ulcerative colitis. However, there is a lot of variation in the amount of stool a normal person passes. This can vary from 3 times daily to 3 times per week.

    Functional disorders are disorders in which the bowel looks normal but doesn't work properly. These are the most common problems affecting the colon and rectum. The direct cause is frequently unknown. Constipation is defined as small, hard, difficult, or infrequent stools. Constipation may be caused by:. A person who is constipated may strain during a bowel movement or just pass very hard stool.

    Passage of hard stool may contribute to the development of anal problems such as fissures painful cracks in the anal tissue lining or hemorrhoids. Irritable or sensitive bowel is a condition in which the colon muscle contracts in an abnormal fashion, which may lead to several problems. Some patients have predominantly diarrhea ; others have constipation; and others alternate between constipation and diarrhea.

    The abnormal contraction can lead to high pressure that builds up in the colon causing abdominal cramps , gas , bloating, and sometimes extreme urgency. Treatment includes avoiding foods that make the problems worse, tailoring diet to the particular symptoms, managing stress , and medications. Structural disorders are those in which there is something visually abnormal that may need to be removed, altered, or repaired by an operation.

    These may include removing a portion of the colon for diverticulitis or for a cancer. Internal hemorrhoids are normal blood vessels that line the inside of the anal opening. We are born with them. They are thought to be the fine-tuning mechanism that allows us to contain gas and avoid passing it until we feel it is socially acceptable.

    When they become enlarged as a result of straining or pregnancy , they may become irritated and start to bleed. Occasionally internal hemorrhoids can become enlarged enough to protrude outside the anal opening. New treatments are being developed all the time. Traditional care has included improving bowel habits, using elastic bands to pull the internal hemorrhoids back into the rectum, or removing them surgically.

    There are new devices that use sound waves to discover exactly where the excessive blood flow is occurring into these vessels and allow the doctor to specifically tie off the area. Also there is the 'stapled' hemorrhoidectomy where a special device is used to pull the hemorrhoid tissue back into the body and staple it in place.

    Doctors can examine patients and pick the treatment that would best treat their problems. External hemorrhoids are veins that lie just under the skin on the outside of the anus. Usually they do not cause any symptoms. Occasionally a blood clot can form and can be very painful. Many times this will get better on its own.

    Sometimes, removal of the clot is done under local anesthesia in the doctor's office. These are not dangerous blood clots that can travel to other organs. The biggest concern they raise is pain.

    Colonic Diseases

    An anal fissure is a split or tear in the lining of the anus that occurs after trauma, which can be from a hard stool or even diarrhea. As a result, the person experiences bleeding and intense burning pain after bowel movements. The pain is caused by spasm of the sphincter muscle, which is exposed to air by this tear. The pain with bowel movements has been described as the feeling of passing razor blades.

    Fissures are the anal problem misdiagnosed most commonly. They frequently are mistaken for hemorrhoids. Fissures often get better by themselves. If they don't improve, your doctor can recommend an ointment or medication that will relieve the pain. In certain cases, surgery may be recommended if the tear does not heal due to excessive sphincter spasm. Our anal region has tiny glands that open on the inside of the anus and probably aid in passage of stool.

    When one of these glands becomes blocked, an infection may develop. When pus forms, there is an abscess a pocket of pus. Treatment includes draining the abscess, usually under local anesthesia in the doctor's office. This is termed a fistula-in-ano. Fistulas drain mucous fluid onto the skin and blood. They rarely heal by themselves and usually need surgery. Between the anal area and the tailbone, hair in this region can burrow under the surface and causing infection.

    This is called pilonidal disease. It may present as abscess in this area just below the tailbone or small draining openings. Usually surgery is needed to treat this problem. Sexually transmitted diseases that can affect the anus include herpes , AIDS , chlamydia , and gonorrhea. Anal warts that are small growths on the anal skin that look like tiny pink cauliflowers and are caused by a virus HPV. Colonic diverticula are little out-pouchings or sacs in the bowel lining that occur when the lining gets pushed through weak spots in the muscle of the bowel wall. They usually occur in the sigmoid colon, where the large bowel exerts the highest pressure.

    Diverticular disease is very common in Western societies and may be due to low-fiber Western diets. Diverticula rarely cause symptoms unless one of the sacs gets blocked and infected. Occasionally, bleeding will occur in this area. Cancer of the colon and rectum is a major health problem in America today.