Diseases of the Colon and Rectum
Disorders of the colon and rectum are quite common in Western cultures. These are likely
due to a variety of factors including heredity, diet, activities and medications. We can categorize these conditions as follows:
 |
Functional Disorders
Functional disorders result from an abnormality of the muscular contractions of the
colon or rectum. Chronic constipation can result from weakened colonic contractions, as well as
from medications and dietary causes. Overactive colonic contractions can
cause Irritable Bowel Syndrome which results in abdominal cramps, bloating and diarrhea. Overactive
contractions of the pelvic muscles cause the Levator Spasm Sydrome which results in recurrent crampy discomfort around the rectum. Most functional disorders can be treated using dietary changes,
medication and other supportive measures. Surgical treatment is reserved
only for complicated cases. |
Inflammatory/Infectious Disorders
Bacterial infections of the colon can occur from dietary intake. We must be careful with raw or partially cooked foods, especially when
traveling to foreign countries. We can also develop bacterial colitis as a result of taking antibiotics for an unrelated cause, such as a sore throat or ear infection. The antibiotics will kill certain bacteria, allowing others to multiply and cause symptoms such as cramps and diarrhea. Colon-specific antibiotics can
reverse this.
Infections of the lower rectum or anal canal are quite common. These will cause swelling, discomfort and at times, fever. Many of these will drain spontaneously, but some will require surgical drainage.
Inflammatory disorders of the colon such as ulcerative colitis and Crohn's Disease result
from the over-stimulation of our immune system by agents which have yet to be discovered. The resulting inflammation can be controlled in most cases using a combination of anti-inflammatory medications. Surgery is reserved for complications such
as obstruction, abscess or chronicity.
Diverticulosis/Diverticulitis
Diverticuli are outpouchings of the lining of the colon which develop in many adults,
especially after the age of sixty. This very common process is thought to be promoted by increased pressure within the colon, seen frequently in association with chronic
constipation. Increased fiber in our diet may be preventative. The presence of diverticuli
(diverticulosis) does not, in itself, cause any symptoms or problems. When a diverticulum becomes mechanically obstructed, then infection and surrounding inflammation can set in
(diverticulitis). Patients who are known to have diverticulosis can help prevent attacks of diverticulitis by
excluding nuts, seeds, and popcorn from their diet as well as by adding some extra dietary fiber. Most cases of diverticulitis are successfully treated with antibiotics. Surgery is reserved for the complications of abscess, perforation, obstruction or
chronicity. Early treatment can help prevent complication.
Hemorrhoids
Hemorrhoids are dilated veins in the anal canal. These veins may protrude, bleed or become uncomfortable. These symptoms, while at times quite bothersome, rarely progress to anything more significant. Hemorroidal symptoms can be relieved in most patients with conservative, at home treatments. Band ligation, a more definitive treatment done in our
office, can relieve symptoms resulting from internal hemorrhoids. Same-day-surgery
hemorroidectomy, a surgical procedure, is reserved for more refractory cases.
Tumors
"Tumor" is a general word which refers to an abnormal growth of tissue. Fortunately, most tumors are benign (not cancer). In the colon and rectum tumors present in the form of polyps. It is
now generally accepted that polyps can, if left untreated for a prolonged period of time, progress to become cancer. Our goal is to detect and remove polyps before they progress any further. This is usually done with a procedure called a colonoscopy. This procedure
utilizes a fiberoptic scope passed through the anus for complete visualization of the colon. The patient is sedated and kept quite comfortable. This is not open surgery. Patients who have no symptoms related to the colon and rectum usually do not need colonoscopy before the age of 50. Symptoms may
indicate the need at an earlier age. You should discuss this with your primary care physician.
Cancers of the colon or rectum are treated surgically. The portion of the colon containing the cancer is removed, allowing complete staging of the process. Subsequent treatment recommendations are made on the basis of staging.
The surgeons at Montclair Surgical Associates have extensive experience in the diagnosis and treatment of diseases of the colon and rectum, both benign and malignant. Consultations can be scheduled any weekday by calling 973-429-7600.
