Colorectal surgery deals with the disorders of the rectum, anus and colon. Another name of colon is  large intestine . These three body parts form the last stages of the digestive process. When the human waste passes through the colon, its salt and water are extracted before it exits the body as human excreta.

Colorectal disorders

Swelling and inflammation of the veins in the anus (also called as Haemorrhoids)
Anal fissures- unnatural cracks and fissures in the anal area
Fistulas or the unnatural connections between the anus and other anorectal areas
Conditions of constipation
Incontinence in passing of faeces
When the walls of the rectum protrude through the anus- also called as Rectal prolapse
Birth defects such as imperforate anus
Anal cancer- this condition is rare
Colorectal cancer- cancer of colon and rectum
Any injuries to the anus
Removal of any objects inserted into the anus
Bowel habits after colorectal surgery
Many patients report cases of diarrhoea, leakage of stool or gas, urgency to use the toilet and a feeling of insufficient evacuation of faeces. Relax; these conditions are not going to last forever. Your rectum and anus are adjusting to new conditions after this surgery. These organs may take six to twelve months to adjust to new bowel habits.

Is there a need to take a laxative or stool softener?
There is no need to take laxatives after a colorectal surgery. Drink lots of water to make your stool softer and easy to pass. If there is a water deficiency in your body, then it may lead to your faeces becoming hard. In that case, take milk of magnesium, colace etc.

Activities post surgery
You can continue with your normal schedule after this surgical procedure. Carry on running, jogging, exercising, climbing up the stairs etc. even after your surgery. Gastroenterologists recommend that patients should desist from lifting loads weighing more than 10 pounds so that there are no post surgery complications.

Diet after colorectal surgery
Avoid spicy and heavy to digest meals after your surgery. Once the intestines begin working normally, you can continue having your spicy food. Chew your food well to aid its digestion.

Returning to work after colorectal surgery
Most people are back to their work after taking a break of 2-5 days. If the surgery is pretty detailed, you may have to take a break of up to a month. Patients undergoing laparoscopic surgery may have to take a rest of 2- 4 weeks before they report back to work. Take it easy before slipping into your regular schedule. If working hurts after your surgery, don t do it.

Colorectal Surgery - Disorders It Can Treat!

Problems of the large intestine are very common and patients should usually consult gastroenterologists for the proper diagnosis and treatment

1. Bleeding per rectum: Bleeding through the anal canal or rectum is usually the most common problem of the patients. It can be due to following reasons: 

A. Piles also known as Hemorrhoids: Hemorrhoids are dilated venous channels of the anal canal. They occur due to long term constipation or chronic cough or due to less fibre intake in the diet. Sigmoidoscopy or proctoscopy is required for diagnosis. Treatment options include medicines and high fibre intake, Injection therapy(Sclerotherapy) for stopping bleeding from piles and Stapler hemorrhoidectomy if the piles are large.

B.  Polyps: Polyps are soft tissue growths seen in the large intestine. They are usually silent but can present with bleeding or anaemia. Polyps usually grow slowly in size and large polyps can turn into cancer of large intestine also known as colorectal carcinoma. Colonoscopy is required for the diagnosis. The gastroenterologists can diagnose the presence of polyps by colonoscopy. Smaller polyps can be removed by polypectomy by gastroenterologists without the need for open surgery. However large polyps or those polyps with suspicion of cancer require surgery.

C. Large intestine Ulcer: They can occur due to early cancer, SRUS, Infections or drugs. They require colonoscopy for the diagnosis. The gastroenterologists usually take Biopsy from the ulcer to know the cause of the ulcer. The mere taking of biopsy does not mean cancer and biopsy samples are seen in the microscope for better diagnosis.

D. Ulcerative Colitis and Crohn s disease: Ulcerative colitis is one form of Inflammatory bowel disease (IBD). The other IBD is known as Crohn s disease. Whereas ulcerative colitis involves only large intestine, Crohn s disease can involve any part of the gastrointestinal tract including small intestine. Ulcerative colitis and Crohn s disease present with Loose stools(diarrhea), bleeding , abdominal pain, weight loss, Anemia and Perianal fissures and  fistula. The diagnosis of IBD is challenging and involves blood tests, CT Scan abdomen, Colonoscopy with biopsy and clinical history. Management includes Medicines which control the inflammation such as Pentasa, Rowasa, Mesacol etc. Severe disease requires additional drugs such as Azathioprine and Anti TNF sich as Infliximab and Adalimumab. Occasional cases require surgery such as those with tight stricture of the intestine, severe dilatation of Large intestine (also known as Toxic megacolon), excessive bleeding, the disease not responding to medical management, or presence of cancer with IBD.

E. Anal fissures: Cut in the anal skin (fissure) causes severe pain in the anal area during passing motions. It is usually due to constipation or straining. It is usually treated by Gastroenterologists initially by medicines and ointments. If the pain continues Surgery is required named as Lateral internal sphincterotomy (LIS).

2. Loose motions or Diarrhea: Excessive passing of liquid motions is known as diarrhea or commonly lose motions. It is usually due to Infections caused by contaminated food and water. It is usually self-limiting. Severe cases with dehydration require admission for IV fluids and antibiotics for the infection. Loose motions for more than 6 to 8 weeks is known as chronic diarrhea. It is evaluated by blood tests and colonoscopy. Usual causes include tuberculosis, celiac disease, ulcerative colitis, microscopic colitis, Malabsorption such as chronic pancreatitis and small bowel bacterial overgrowth.

3. Irritable bowel syndrome (IBS): IBS is very common and at least 20 to 30 percent of Indian patients suffer from it. Symptoms include altered bowel habits such as diarrhoea or constipation, abdominal pain which is usually relieved or increased by defecation. Weight loss or bleeding is not the feature of IBS. Few simple blood tests are required and good medicines are now available for IBS. Few cases may require colonoscopy to rule out alternative causes of the symptoms.

Understanding colonoscopy: Colonoscope is a flexible tube with a camera at its tip to see the inside of the large and small intestine. Bowel preparation is required at least 8 hours before the procedure so that the inside of the large intestine can be seen clearly without the interference of stools.colonoscopy is an OPD based procedure where the patients are discharged the same day. A colonoscopy helps in evaluation symptoms of the large intestine such as loose stools, bleeding and abdominal pain.

In Detail About Colorectal Disorders!

The word colic directly refers to the colon. Colic pain is a sharp abdominal pain followed by bouts of crying usually occurring in infants below the age of one year. The pain only last for a short period of time ranging from a few weeks to a couple of months. Very few number of babies will cry endlessly indicating towards an underlying condition.

It is mainly characterized by sharp crying for supposedly no apparent reason, irregular sleep patterns, and restlessness or owing to deviation from normal postures. The apparent causes of colic pain include indigestion and negative reaction of the sensitive gut to the breast or formula milk, although no concrete cause of the state has been discovered.

Doctors often suggest home remedies such as swaddling, pacifiers, holding and comforting the baby and more frequent feedings to reduce the condition. Since it is so common among infants and relatively less harmful, no proper medication is usually given. Physicians suggest mothers to reduce the content of caffeine, alcohol or spice in their diet. Sometimes a warm bath, burping the baby or going on more frequent walks is useful. Background music draws the attention of the baby and hence drives their focus, away from the abdominal pains.

Colic pains are mainly treated by care rather than medicine. The baby is made to feel comfortable and the distress is reduced just by being around the infant. The primary care giver plays an important role in consoling the child and helping them get through the sudden pain which further plays a significant role in personality development. Colic pains are extremely short lived and probably one of the first few challenges of parenthood. They are primarily dealt with care and feeding except in extreme cases where medicinal cures such as lactase drops and simethicone drops are used to treat the abdominal pain.

Colic Pain - How To Treat It

A Gastroenterologist is a physician with dedicated training and unique experience in the management of diseases of the gastrointestinal tract and liver. If you are planning to visit one, you most likely have a problem in one or many organs like esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. 

Visit your doctor to understand the severity of your condition and the course of treatment, as it is obvious that during this time you must be suffering from anxiety and you may not ask the questions arising in your mind. That is why you need to prepare in advance for your first visit with a gastroenterologist. Being an active partner in the doctor patient relationship is bound to have its benefits. Here are some handy tips:

1. Come mentally prepared: Don't let the anxiety get to you. If you need some extra help calming down, try yoga or meditation. You can simply go out on a walk alone to help you focus your thoughts. This is just like any other doctor visit. The good part is that you are taking the first step in easing your discomfort and starting treatment, so go with a positive mind.

2. Maintain a diary of symptoms: It is likely that you are experiencing discomfort from past few days or weeks before you finally realize the need to seek out a specialist. Try to remember as much as possible about the symptoms you experienced in a chronological order. Write down any over the counter medicines you've tried or anything unusual that you may have consumed in the past week. 

3. Take stock of your medical history: It is likely that your doctor may want to know about any historic conditions you've suffered that may or may not relate to your present condition. Many ask you to fill out forms during your first time patient registration which includes many minor details about your medical past. List down any allergies, especially food allergies you have. 

4. Take stock of your recent medical tests: Bring your latest blood tests and imaging tests (X-rays, ultrasounds, MRIs, and CT scans) with you for the doctor's visit. If you have a pre-existing condition like diabetes, thyroid or you suffer from other chronic conditions like increased uric acid, carry your most recent medical reports with you. 

5. Make a list of questions for the doctor: In most cases, the first visit is a crucial factor in determining whether you want to continue the course of treatment with a particular doctor. This comes out of your ability to trust the doctor, his knowledge and diagnosis and an overall comfort level that comes with how well he handles your questions. Start by making a list of questions you want to ask about your specific condition and course of treatment and see if you get satisfactory answers. 

6. Brace yourself: If you want to suggest a treatment option, make sure you read up all about it before you tell the doctor.

6 Tips For Your First Visit With A Gastroenterologist

Rectal problems in women are quite common. It is experienced by many women in some form or the other such as rectal itching, pain or bleeding. Rectal problems are more common in women than in men. These conditions need to be attended to immediately as severe rectal problems may cause several health problems. There are many ways to deal with rectal problems in women.

Treating rectal itching: Rectal itching is a common rectal problem. These can be treated by

    Improve hygiene: You should clean the rectum area gently using cotton balls moistened with water. You should apply mild ointments to prevent irritation and soothe the skin.
    Unscented toilet paper or unscented lotions and creams: You should use white toilet paper that does not have any scent. Scented soaps, creams or lotions should be avoided as it may cause further irritation. You can also apply ointments containing 1% hydrocortisone.
    Control excessive sweating: Rectal problems may occur due to excess sweating. You should avoid sweating too much by wearing light clothes and using talcum powder for the absorption of moisture.

In case of excessive itching, you should follow the following tips:

    Do not scratch the area as scratching may lead to further itching. You can take an oral antihistamine during the night to get better sleep.
    You can take a warm sitz bath after every bowel movement, for at least three days, every day. The anus should be dried properly after the bath.
    Abstain from foods that stimulate rectal itching like tea, coffee, aerated drinks, alcohol, chocolate, spicy food, tomatoes and excess vitamin C, for a period of two weeks.
    You must maintain short fingernails to avoid injuries during scratching. To prevent unconscious scratching during sleep, wear cotton gloves.
    Stress should be managed as increased stress may lead to enhanced rectal itching. When you are anxious, do not scratch the rectal area.

Treating rectal bleeding: Rectal bleeding is another problem, which may be accompanied by other rectal problems. In case of rectal bleeding, avoid taking aspirin or any other non-steroidal, anti-inflammatory drug. These drugs may cause bleeding in the digestive tract. This will increase the blood amount in your stool. Bleeding hemorrhoids can worsen by the intake of these medicines. For soothing pain, opt for an acetaminophen. Constipation and diarrhoea may also lead to rectal bleeding. However, it is advised to consult a doctor before consuming any medicine.

Prevention
For prevention of rectal problems, you must have a good sense of hygiene. Keep the rectum region clean and avoid sitting in the toilet for a long time. You should have a fiber-rich diet including fresh fruits and vegetables. Avoid food items, which may cause rectal problems. General rectal problems are not very serious and can be treated using simple measures. Maintaining proper rectal hygiene is very important to avoid rectal problems. It is highly recommended to visit a doctor if the problem persists.

Rectal Problems in Women - Doctor Recommended Tips

Screening for cancer of the colon or large intestine and rectum is a proven way of saving a person from the impacts of colorectal diseases. This is partly because colon cancer is something that can be prevented if detected at an early stage and the polyps which may advance to cancer are removed properly. Thus if you are turning 50 soon, be prepared to present yourself for a screening colonoscopy that will help you ensure good health and well-being. It may sound uncanny, but do you know that 50,000 people across the world die from colorectal cancer every year, and it is ranked second in terms of cancer-centric deaths.

Understanding the importance of having colonoscopy
You may wonder how a painful, invasive, embarrassing, uncomfortable and time-consuming health test may be called a present. There are reasons enough. A screening colonoscopy is able to expose a cancerous tumour that's presently under way and cast light on the chances and risk factors that may precede it. When you choose to intervene early, you have the power to nip those risks at their budding stage, much before those malicious cells become malignant.

Spreading of the colorectal cancer
Your large intestine is really a big and last organ of the gastrointestinal system where the small intestine discontinues. Its primary function is to remove the water out of the leftover solids of digestion and get rid of them in the form of stool. Cancer may start to develop anywhere within the tube that expands 5 feet long and squares the vacant area of the abdomen. The large intestine expands up towards the right side, i.e. the ascending colon and then turns left through the liver, i.e., the transverse colon, bending down right at the spleen on its left, i.e. descending colon and loops to the middle, i.e., the sigmoid colon before it runs across the rectum and ends at the anus.

People who need a colonoscopy
To simplify matters, it can be said that all adults are at a potential risk of the colorectal cancer, including those people who lead a healthy life. But some people are at a higher risk. Those individuals have a specific gene mutation that predisposes them to develop into numerous polyps. The risk is also high with people who are first-degree relatives of a person diagnosed with cancer before the age of 50. People with Ulcerative colitis, various types of inflammatory bowel diseases and Crohn's disease are also at a higher risk.

Colorectal cancer is a serious ailment and screening colonoscopy is a feasible means of detecting any polyps that may be cancerous in the future. Speak with a reputed gastroenterologist today to stay ahead of the disease.

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