Colon and Rectal Conditions

Colon polyps are small lumps that form on the inside of the colon. These can be pre-cancerous, meaning they have the potential to turn into cancer if not removed.

A colonoscopy is the procedure offered to find and remove colon polyps.

Learn more about the colonoscopy procedure or download our colonoscopy handout.

Constipation is when you can't move your bowels, you have to push too hard or they move less often than usual. Constipation can cause pain and discomfort. It's important to keep your bowel routine regular and your bowel movements easy to pass.

If your bowel movements are small, dry and hard, you are considered constipated. Constipation happens when you get less exercise, or when you eat and drink less than usual. Some medicines cause constipation.

You are at risk for constipation if you have:

• Cancer that causes pressure on your bowel or changes in the way your bowel works
• A decrease in the amount you eat and drink each day
• A decrease in your activity or exercise
• Medication that causes constipation

Crohn’s Disease is a type of inflammatory bowel disease. It is caused by an overactive immune system, where the immune system acts against its own organs. This creates chronic inflammation of the intestines.

Crohn's Disease is often managed with medications, decreasing the abnormal immune system activity. Sometimes proper treatment for this disease requires surgery to remove the affected part of the colon or small intestine.

Irritable bowel syndrome (IBS) is an intestinal disorder. It's considered a functional disorder as there is no sign of disease upon examination. Because doctors have been unable to find an organic cause, IBS is believed to be caused by emotional conflict or stress. While stress may worsen IBS symptoms, research suggests that other factors also are important.

It often causes the following symptoms:

• Bloating
• Changes in bowel habits
• Crampy pain
• Gassiness

IBS often causes a great deal of discomfort and distress, but it is not believed to:

• Cause permanent harm to the intestines
• Lead to a serious disease such as cancer
• Lead to intestinal bleeding of the bowel

IBS has not been shown to cause serious, organic diseases. There is also not conclusive linkage between IBS and other inflammatory bowel diseases.

Volvulus is a twisting of a GI tract segment often leading to bowel obstruction. The most common sites of volvulus are colon, both the sigmoid (left side) and cecum (right side). Volvulus in other areas of the GI tract, like the stomach, gallbladder and small bowel are rare. A volvulus is often caused by a “floppy” colon, or a colon not adhered to the inside of the abdominal wall. This causes it to “flop over” on itself and become twisted, much like a balloon animal.

Symptoms and diagnosis

The majority of patients with sigmoid volvulus complain of:

• Abdominal distension
• Abdominal pain
• Constipation
• Nausea
• Vomiting (less common)

Some patients, particularly younger patients, may have on-and-off recurrent attacks of abdominal pain. The discomfort, and its disappearance, is due to spontaneous twisting and de-twisting of the colon. The diagnosis is often suspected based upon the symptoms and physical examination. The pain associated with sigmoid or cecal volvulus is usually continuous and severe. Intermittently, you will experience crampy pains and your abdomen is usually distended and firm.

Compromise of the blood supply to the twisted colon can lead to gangrene (the tissue starts to die). This results is widespread abdominal pain and sepsis, or severe body-wide infection. Fortunately, the majority of patients come to medical attention before they develop gangrene.

An abdominal x-ray or CT scan will confirm a volvulus diagnosis.

Treatment

Sigmoid volvulus

The goal of treatment is to prevent gangrene and to address the abnormality that led to the volvulus. An effective way to restore the blood supply to the colon is to untwist the volvulus. This is accomplished by advancing a flexible or rigid sigmoidoscope through the twisted segment. This may release the twisting, and stop the immediate danger. There is a high chance of the twist recurring; so surgery is usually still required.

Cecal volvulus

A colonoscopy is not likely to untwist the colon; so surgery is required.

Surgery for treatment

When surgery is required, we perform it as open surgery, under general anesthesia. Your surgeon may attempt to secure the colon to your abdominal wall. This would prevent it from twisting again. Or he/she may need to remove that piece of the colon. If the colon has gangrene and is unhealthy, that segment will definitely need removal.

Ulcerative colitis (UC) is an inflammatory bowel disease (IBD). UC occurs when the inner lining of the large intestine (colon or bowel) and rectum become inflamed. Inflammation usually begins in the rectum and lower intestine and spreads upward. Ulcerative colitis rarely affects the small intestine, but when it does, it affects the lower section.

The inflammation causes diarrhea, or frequent emptying of the colon. As cells on the surface of the lining of the colon die and slough off, ulcers (open sores) form. This may cause a discharge of pus, mucus and bleeding.

Although children and older people develop UC, it most often starts between the ages of 15 and 30. It affects males and females equally and appears to run in some families.

Learn more about ulcerative colitis.