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Serious Medicine. Extraordinary Care.

The Colon

The Colon

The colon is the large intestine; it is the lower the digestive tract. The intestine is a long, tubular organ consisting of the small intestine, the colon (large intestine) and the rectum, which is the last part of the colon. After food is swallowed, it begins to be digested in the stomach and then empties into the small intestine, where the nutritional part of the food is absorbed. The remaining waste moves through the colon to the rectum and is expelled from the body. The colon and rectum absorb water and hold the waste until it is expelled.

Diverticulosis

Diverticulosis is an abnormal condition that affects the colon. It consists of small out-pouchings forming in the weak areas in the walls of the colon. These small pouches are called diverticuli. Many people may have diverticulosis but no symptoms or problems. Diverticulitis develops if these small pouches become inflamed or infected by bacteria that normally live in the colon. Mild cases of diverticulitis may resolve with bowel rest and oral antibiotics. However if diverticulitis is severe, the pouches can rupture leading to further complications like abscess formation, peritonitis, fistula (abnormal communication tract) formation with urinary bladder. The abscess may sometimes be drained by inserting tubes under guidance of CAT scan. If the infection in the abdomen is very severe, emergency surgery to drain the abscess with or without removal of part of colon may be required. If a patient has multiple attacks of diverticulitis, the surgeon might recommend removal of part of the colon.

Colon Cancer

Colon cancer is a tumor that arises in the colon. There are certain types of polyps that can eventually develop into colon cancer over time. A biopsy of the polyps may be performed and sometimes removed during colonoscopy. However, once colon cancer develops, surgery is usually required to remove a portion of the colon. Surgery removes the segment of colon containing the tumor along with the associated and lymph nodes. The removal of the portion of colon allows the pathologist and oncologist to stage the progression of the cancer and further direct a patient?s treatment. Further treatment with chemotherapy may be advised by the oncologist after surgery depending on stage of cancer.

Lower GI Testing

Flexible Sigmoidoscopy

Flexible Sigmoidoscopy is a procedure that enables a surgeon to examine the lining of the rectum and lower colon (large bowel). The patient lies on one side while the sigmoidoscope is advanced through the rectum and lower colon. A lubricated soft, bendable tube about the thickness of the index finger is gently inserted into the anus and advanced further into the rectum and the lower part of the colon. The patient is awake during the procedure. Occasionally, the surgeon may administer a light sedation. The procedure is usually well tolerated and rarely causes discomfort. Inside the colon there are few nerve endings; therefore, it is unusual to feel the scope moving within the body. Air is injected to distend or widen the passage. This may cause a feeling of pressure, gassiness, bloating, or cramping during the procedure. The procedure usually lasts for 5 to 15 minutes.

Colonoscopy

Colonoscopy is a procedure that enables a surgeon to examine the lining of the rectum and entire colon (large bowel). A colonoscope is a soft, bendable tube about the thickness of the index finger, which is inserted into the anus and then carefully advanced through the entire large intestine. The patient lays on their side or back while the colonoscopy is performed. This procedure is generally well tolerated and lasts anywhere from 15 to 60 minutes. This procedure requires a wash out of the bowel for which some medication will need to be taken the night before. The surgeon will give the patient sedation to relax and tolerate any of these discomforts. There may be a feeling of pressure, gassiness, bloating or cramping at various times during the procedure. During this procedure, the surgeon may feel necessary to take a biopsy for analysis. Any polyps found are usually removed or a biopsy is performed. Mild cramping or bloating from the air that was placed into the colon during the examination is often experienced.

Lower Gastrointestinal (GI) series

Lower Gastrointestinal series uses x-rays to diagnose problems in the large intestine, which includes the colon and the rectum. Abnormal growths, ulcers, polyps, diverticuli, and colon cancer can be discovered with this procedure. Before x-rays are taken, a thick liquid called barium is injected into the colon, commonly also called a barium enema. The barium coats the lining of the colon and rectum, giving a clearer picture of any signs of disease as well as the size and shape of the organs. Position changes are important while multiple x-rays are taken, the different positions allow for different views of the colon to be seen. The patient may experience a feeling of fullness and pressure in your abdomen, giving them the urge to want to have a bowel movement. The lower GI series takes about 1 to 2 hours to complete.