Bloating, cramps, blood in your stool—colorectal issues can range from mild to serious, but they can often be safely managed if you take care of them quickly. Whether you need a colonoscopy or further testing, you deserve a caring doctor who offers personalized medicine and honest, transparent advice.
At Midtown Surgical & Skin Institute, we care about collaborating with you to find the correct approach for your colorectal and gastrointestinal concerns. Our compassionate, personalized medical consultations make it easier for you to feel better and enjoy your health and your life.
Signs and Symptoms of Colorectal Disorders
The most common signs of an intestinal or colorectal problem include:
- Family history of colon cancer
- Blood in stool
- Blood on undergarments or toilet tissue
- Frequent gassiness
- Abdominal cramping or pain
- Unexpected weight loss
- Vomiting or nausea
- Abdominal mass
- Being pale—due to chronic blood loss
Common Colorectal Disorders
- Polyps — Small tissue growths can form in your colon, and while many colonic polyps are benign, others are pre-cancerous and can become cancerous over time. When you have a screening colonoscopy starting at 45, now the recommended age by American Cancer Society, polyps can be detected and removed at the same time.
- Ulcerative colitis — An inflammatory bowel disease, this condition causes inflammation and sores (ulcers) in the lining of the colon and rectum, causing pain, bleeding, weight loss and other issues.
- Diverticulosis and diverticulitis — The large intestine (colon) can form small pouches called diverticula that bulge through weak areas in the colon wall. This condition is called diverticulosis, and may cause mild cramping and bloating. If these pouches become inflamed or infected, it’s known as diverticulitis, which is painful and can lead to bleeding, tears, blockages, and even perforations if left untreated.
- Irritable bowel syndrome (IBS) — Although IBS is not life-threatening, it can be very painful, with abdominal cramps, bloating, constipation and diarrhea as other common symptoms.
- Colorectal cancer — Most likely to occur in people over 50 years old, this form of cancer often does not display symptoms until in its later stages. Screening colonoscopies help to prevent advanced stage colon cancer and are paramount in early detection. Early detection increases survival rates.
Diagnosing Colorectal Disorders
If you or your doctor suspect you are suffering from a colorectal problem, tests may be performed:
- Traditional colonoscopy — A small tube with a camera attached is inserted into your rectum while you are asleep to allow a visual inspection of your colon. Any and all polyps are easily removed and/or biopsied. This is the most thorough and complete evaluation that can be done, and it has a very low percentage of missed tumors or pre-cancerous polyps.
- Flexible sigmoidoscopy — This procedure also uses a small tube and camera, but it examines only the rectum and lower part of the colon, and is used to help diagnose rectal issues. This evaluation does NOT examine the entire colon, and therefore can miss tumors/cancers or pre-cancerous polyps in other parts of the colon.
- Virtual colonoscopy or CT colonography— The colon is examined using computer imaging. The procedure is less invasive than a traditional colonoscopy. However, you are exposed to radiation and any polyps or growths seen cannot be removed and would require a traditional colonoscopy to remove any polyps or growths.
- Barium enema — Like a virtual colonoscopy, this procedure is not as invasive as other tests. A contrast dye is inserted into the rectum via a tube, while completely awake, so that any abnormalities can be seen by X-ray. However, you are exposed to radiation and any polyps or growths seen cannot be removed and would require a traditional colonoscopy for removal.
- Stool sample tests — Performed ONLY on individuals with average risk for colorectal cancer. It is NOT to be performed on individuals of high risk.
- Highly sensitive fecal immunochemical test (FIT) — 1-3 stool samples are tested for microscopic blood. This can be a sign of a bleeding polyp, cancerous polyp, or colorectal cancer. This test should be performed annually. It does not require a prep, is easy to perform, and requires no special diet. However, there can be false-negatives. And if positive, it will require a traditional colonoscopy. Also, people in high risk categories can NOT utilize this test.
- Multi-targeted stool DNA test (MT-sDNA) (i.e., Cologuard®) — 1 stool sample is tested for altered DNA in the stool or blood in the stool. This can be a sign of a bleeding polyp, cancerous polyp, or colorectal cancer. This test can be performed every 3 years. It does not require a prep, is easy to perform, and requires no special diet. However, there can be false-negatives. And if positive, it will require a traditional colonoscopy. Also, people in high risk categories can NOT utilize this test.
- Highly sensitive guaiac-based fecal occult blood test (gFOBT) — Multiple stool samples are taken over a period of 3 days. It detects microscopic blood in the stool. This can be a sign of a bleeding polyp, cancerous polyp, or colorectal cancer. This test should be performed annually. It does not require a prep, and it is easy to perform. However, there can be false-negatives and a special diet is required. If positive, it will require a traditional colonoscopy. Also, people in high risk categories can NOT utilize this test.
High Risk Categories for Colorectal Cancer
- A personal history of colorectal cancer or certain types of precancerous polyps, such as adenomas
- A family history of colorectal cancer
- A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
- A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
- A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer
Medical and Surgical Solutions
- Lifestyle changes — For issues such as IBS, Crohn’s disease, and diverticulosis, diet and exercise can be helpful at reducing symptoms.
- Prescription medication — Can be useful to reduce inflammation, pain, and infection.
- Polyp removal during colonoscopy — These are completely removed and by being removed, it can prevent the development of colorectal cancer.
- Cancer treatments — Will include surgical colon resection and possibly other medical approaches, including chemotherapy, if indicated.
A simple colonoscopy is an outpatient procedure. You will take a colon prep the day before the procedure and recuperate the rest of the day of the procedure at home.
If a surgical procedure is required, the recovery process will be somewhat longer. However, minimally invasive surgical techniques and other modalities are utilized to minimize recovery, pain, and complications.
Some conditions such as IBS and diverticulosis may last throughout your life but can be managed with medication and lifestyle changes.
Recommended Diet and Lifestyle Changes
Adjusting your diet can be helpful for eliminating minor colorectal issues and preventing complications of colorectal diseases.
- Eliminate unhealthy foods — Foods high in saturated or trans fats, processed foods, and refined carbohydrates, such as white bread and white rice
- Eat a healthy high-fiber diet — Fruits, vegetables, fiber, low-fat dairy products, dark leafy greens, tofu, beans, lentils, nuts, fish
- Exercise daily — A sedentary lifestyle adds to colorectal issues. Do something daily to move around — walking, jogging, biking, swimming, etc.
How do I know if I’m at greater risk for colorectal cancer?
Those who are more likely to get this form of cancer are people over age 50, with a personal history of colorectal polyps, ulcerative colitis, Crohn’s disease, smoking, having a family history of colorectal cancer, or eating a diet that is high in fat and low in fiber.
What can I do to lessen my chances of developing colorectal issues?
Obesity and a sedentary lifestyle can contribute to the formation of polyps in the colon, so getting to a healthy weight, exercising and eating a healthy diet can all be useful tools to help prevent colorectal diseases. Having a colonoscopy every 5-10 years starting at age 45 is the best preventive measure, since polyps can be found and removed before they become cancerous.
How does my lifestyle affect colorectal disorders?
What you eat can have a strong effect on your colon! There are ways to help decrease the chances of having colon cancer, IBS, and other issues. These include eating a diet that is low in fat, low in animal protein, low in processed carbohydrates—which are white bread and white rice. And consume a diet high in fiber—beans, whole wheat and other whole grains. In addition, exercise frequently! Being sedentary and obese also increases your risk of colorectal problems and cancer.