Rectal Cancer

Rectal Advancement Flaps for Complex Anal Fistulas : A Surgical Approach An anal fistula is a challenging and often painful condition that requires careful consideration and surgical management. One of the surgical techniques employed in treating complex anal fistulas is the Rectal Advancement Flaps for Complex Anal Fistulas procedure. This approach has proven to be effective in many cases. Understanding Anal Fistulas An Anal Fistulas is an abnormal connection or tunnel that forms between the anal canal (the end of the large intestine) and the skin near the anus. It typically results from an infection or abscess near the rectum. Anal fistulas can cause persistent pain, discharge, and recurrent infections, significantly affecting a patient’s quality of life. Several surgical techniques are available to manage these fistulas, and the choice of procedure depends on the type as well as complexity of the fistula. Here are some of the surgical options: Fistulotomy: This is a straightforward surgical procedure in which the surgeon cuts open the entire length of the fistula tract, allowing it to heal from the inside out. It’s typically used for simple, low-risk fistulas. Seton Placement: A seton, which is a special elastic thread, can be placed through the fistula tract. This helps in gradual drainage as well as allows the surrounding tissues to heal. Seton placement is often used when there’s a high risk of incontinence with other procedures. Seton can be used as a cutting seton too. LIFT Procedure (Ligation of the Intersphincteric Fistula Tract): This technique involves identifying and ligating the internal opening of the fistula tract while leaving the rest intact. It’s suitable for certain complex fistulas. Advancement Flap Surgery: As previously discussed, advancement flap surgery involves creating a flap of healthy tissue to cover the internal opening. This is ideal for complex fistulas near the sphincters. Plugs as well as Fillers: Special plugs or biologically derived materials can be used to seal the internal opening. These act as a barrier to encourage healing. This has not proved to be very successful as well as has high recurrence rates. Other Factors Of Anal Fistulas Fibrin Glue: Fibrin glue is injected into the fistula tract to seal it. This technique is suitable for some low to moderately complex fistulas. Again it is not used these days as the recurrence rates are very high. Video-Assisted Anal Fistula Treatment (VAAFT): VAAFT is a minimally invasive procedure in which a small endoscope is inserted into the fistula tract. It’s used to locate as well as close the internal opening with glue or sutures. This procedure can be used in very simple fistula; it too has high recurrence rates. Staged Procedures: In complex or recurrent cases, surgeries may need to be staged, where several procedures are performed over multiple sessions. Colostomy: In severe cases or when all other methods fail, a colostomy may be considered. This involves diverting the fecal stream to allow the area to heal. The choice of surgery depends on individual factors, such as the type and location of the Anal Fistulas, the patient’s overall health, as well as the surgeon’s preference and expertise. A thorough evaluation by a colorectal surgeon is necessary to determine the most suitable surgical approach for each patient. While these surgical techniques have their own advantages as well as considerations, the primary goal is to treat the fistula effectively while preserving anal function and minimizing the risk of complications such as incontinence. Consulting with a specialist is crucial to ensure the best possible outcome for patients dealing with Anal Fistulas. The Role of Rectal Advancement Flaps The Rectal Advancement Flap procedure is a surgical technique designed to treat complex anal fistulas. Complex anal fistulas are those that are associated with a high risk of recurrence or have multiple tracts, making them challenging to manage with simple procedures like fistulotomy. How The Procedure Works? Patient Preparation: The patient is placed under general anaesthesia and positioned on special contraption, called yeloow fin stirrups. Identifying the Fistula: The surgeon carefully identifies the fistula’s tract or tracts, often using specialized tools as well as techniques. Creating a Flap as well as suturing the internal opening: A flap of healthy rectal tissue is created. This flap is designed to close the internal opening of the fistula, which is usually situated within the rectal lining. Flap Advancement: The created flap is advanced as well as sutured over the internal opening, effectively sealing it. Drainage: n some cases, a seton or drain may be placed to ensure proper drainage while the fistula heals. Closure: The external opening of the fistula is left open or may be partially closed depending on the specific case. Advantages of Rectal Advancement Flaps Low Risk of Incontinence: One significant advantage of the Rectal Advancement Flap procedure is its low risk of causing faecal incontinence. This makes it a preferred choice for many complex fistulas, especially those close to the anal sphincters. Effective Closure: By creating a flap of healthy tissue, this procedure effectively closes the internal opening of the fistula, reducing the risk of recurrence. While the Rectal Advancement Flap procedure offers many advantages, there are also potential considerations as well as complications: Healing Time: Healing can take several weeks to months. It’s essential for patients to follow post-operative care instructions carefully. Recurrence: While the risk of recurrence is low, it can still occur, particularly in challenging cases. Infection: As with any surgical procedure, there is a risk of infection, which needs to be managed with appropriate antibiotics. Conclusion The Rectal Advancement Flap procedure is a valuable surgical approach for treating complex Anal Fistulas, providing effective closure while minimizing the risk of incontinence. It’s essential for patients to consult with experienced colorectal surgeons to determine the most suitable treatment for their specific condition. For More Information Stay Updated With : drrajeevkapoor.com Also Read: Latest Surgical Management of Left Colon Cancer The Technology Behind Robotic Surgery Is Bowel Content Leakage A Sign Of Cancer? Fecal Incontinence can be cured: A real life story The Rising

Cancer, Colorectal Cancer, Rectal Cancer, Rectal Cancer Surgery

What is sphincter preservation surgery for Rectal Cancer?

Cancer, Colorectal Cancer, Rectal Cancer, Rectal Cancer Surgery / kapoorcmc

Surgeons frequently remove both the rectum and the anus from patients who have colorectal cancer in the lower portion of the colon. The patient usually requires a permanent colostomy if the anus is removed; permanent colostomy is an opening from which faeces is collected in a bag that is fastened to the abdominal wall. Surgery that “spares” the anal sphincter while safely removing the rectal cancer is known as sphincter-sparing surgery. The rectum can be completely or partially removed during Low Anterior Resection, a surgical option for low rectal cancer. Rectal cancer treatment frequently necessitates the removal of entire rectum. The final component of digestive system is the large intestine, which is composed of colon and rectum. The rectum and anal region make up the final 18 cm of the large intestine. Sphincters are located along the anal canal, which is the 3.8 cm portion lying next to the anal opening. Principles of cancer surgery includes removing a minimum of 2 cm of rectum below the edge of the cancer to ensure complete removal of rectal cancer. Advantages of Sphincter-sparing Surgery This surgery allows a patient with low rectal cancer retain control over the bowel movements; it also helps to Enhances the quality of life Provides cancer cure rates equal to more extreme surgery Eliminates the need to remove the sphincter muscles and anus, which allows you to eventually return to passing bowel movements through your anus What Happens During Sphincter-sparing Surgery? In this surgery, the surgeon mobilizes the rectum beyond the tumour till the edge of the sphincter. He tries to get beyond the tumour by a minimum of 2 cm and creates a space to place the stapler. If possible, it is called sphincter sparing surgery and prevents the patient from having a permanent stoma. What are these surgeries called These surgeries are called Low Anterior Resection or Ultra Low Anterior Resection What are the special requirement for sphincter saving surgery? There are many requirements for this surgery. The most important is availability of stapling devices. As we know that pelvis is a very small narrow area located in the lower part of the abdominal cavity. The rectum is located in the pelvis. Along with rectum, the pelvis also has a urinary bladder as well prostate in males and uterus and both ovaries in females. Once the rectum is removed, precise stapling instruments help the surgeon to join back the cut end of the lower rectum as well as the cut end of the left colon. The include circular stapling devices as well as flexible right angles stapling devices. There are many variants available to choose from. The choice will depend upon the kind of surgery as well as the patients’ habitat. What are the precautions required for sphincter saving surgeries? Oncologic principles of cancer removal have to be followed. Can sphincter saving surgeries be done with minimal access? Yes. These surgeries can be done with a robotic or laparoscopic approach. However, a small incision will have to be given to remove the excised part of colon. Conclusion Thus, if one has a low rectal cancer, there is a probability that sphincter saving procedure can be done. Patient should consult a colorectal surgeon and discuss the possibility.

Colorectal Cancer, Rectal Cancer

How to control Stage 4 Rectal Cancer

Colorectal Cancer, Rectal Cancer / kapoorcmc

Stage 4 rectal cancers are the ones which have spread to distant body organs as well as tissues such as the liver or lungs. Therapy alternatives for stage 4 cancer cells depend somewhat on exactly how extensive the cancer cells is. Management of Stage 4 Rectal cancer with minimal spread If there’s a possibility that all of the cancer cells can be removed (as an example, there are only a less or singular lesion in the liver or lungs), the most common treatment choices include: Surgery to eliminate the rectal cancer and far-off cancer, followed with by chemo (and/or radiation therapy sometimes). Chemo, accompanied or followed with by surgical procedure to remove the rectal cancer as well as distant cancer, generally sandwiched with by chemo as well as radiation treatment (chemoradiation). Chemoradiation, followed with by surgical procedure to eliminate the rectal cancer as well as remote cancer. This could be followed with more radiation treatment. These strategies might sustain a patient with stage 4 rectal cancer much longer. Surgical treatment to remove the rectal cancer would typically be a low former resection (LAR), proctectomy with colo-rectal anastamosis, or abdominoperineal resection (APR), depending upon where it’s located. Management of Stage 4 Rectal Cancer spread only to the liver If the only place of rectal cancer spread is to the liver, one might be treated with chemo that’s given into the artery of the liver directly. This might diminish the cancers in the liver far better than if the chemo is provided right into a arm vein (IV) or by mouth. Management of Patients with Stage 4 rectal cancer with widespread metastasis If the cancer is much more widespread as well as can not be gotten rid of entirely by surgical treatment, therapy choices depend on whether the cancer is creating an obstruction of the intestine, in which situation surgery may be required. If not, the cancer cells will likely be treated with chemo and/or targeted therapy drugs (without surgical procedure). FOLFOX: leucovorin, 5-FU, and also oxaliplatin. FOLFIRI: leucovorin, 5-FU, and irinotecan. CAPEOX or CAPOX: capecitabine (Xeloda) and oxaliplatin. FOLFOXIRI: leucovorin, 5-FU, oxaliplatin, and also irinotecan. One of the above combinations, plus either a medicine that targets VEGF (bevacizumab [Avastin], ziv-aflibercept, or ramucirumab, or a medicine that targets EGFR (cetuximab [Erbitux] or panitumumab. 5-FU and leucovorin, with or without a targeted drug. Capecitabine, with or without a targeted drug. Irinotecan, alone or in combination with a targeted drug. Cetuximab alone. Panitumumab alone. The option of drugs or drug mixes depends upon a number of elements, including any kind of previous therapies, your overall health and wellness, as well as how well you can tolerate treatment. If chemo shrinks the cancer cells, sometimes it may be possible to consider surgical treatment to try to get rid of all of the cancer now. Chemo might then be provided once more after surgical treatment. Treatment of Stage 4 non-responsive Rectal Cancer If the cancer does not diminish, a different drug combination might be attempted. For people with specific gene changes in their cancer cells, another option after preliminary radiation treatment might be therapy with an immunotherapy drug such as pembrolizumab or nivolumab. Palliative treatment for stage 4 rectal cancer For cancers that do not shrink with chemo and also extensive cancers that are causing symptoms, therapy is done to soothe signs and symptoms as well as prevent long-term problems such as bleeding or obstruction of the intestines. Treatments may consist of several of these: Surgical treatments required for palliation include: A colostomy to bypass the rectal cancer (Diversion Stoma). Fulgurating cancer in the lower rectum through the anal opening. Positioning a stent (hollow steel tube) within the rectum to keep it open; this does not require surgery. If the cancer in the liver cannot be removed by surgical treatment since they are as well huge or there are a lot of them, it may be feasible to damage them (partly or entirely) with ablation or embolization. Tips about Treatment of Advanced or Stage 4 Rectal Cancer

Colon Cancer Surgery, Colorectal Cancer, Colorectal Surgery, Colostomy, Ileostomy, Permanent Stoma, Rectal Cancer, Rectal Cancer Surgery

Avoid Permanent Colostomy or Ileostomy

Colon Cancer Surgery, Colorectal Cancer, Colorectal Surgery, Colostomy, Ileostomy, Permanent Stoma, Rectal Cancer, Rectal Cancer Surgery / kapoorcmc

Colon and rectal cancer survivors can lead an energetic way of life after surgical treatment, and also most can avoid the need for a colostomy bag with innovative operations available There is an increase in colon and rectal cancer in people those in their 20s to 40s; millennials have actually seen a 1.3% annual boost in colon cancer as well as a 2.3% annual rise in rectal cancer from the mid-1990s. This is an extremely active population that is in prime of their lives, building families and also occupations. When they get cancer, they are worried about getting an ileostomy or a colostomy — a surgically created opening in the body that directs faeces into an external waste collection receptacle called a colostomy bag. Both colostomy or ileostomy are also referred to as a stoma Contrary to common belief, about 80% to 90% of patients who have surgical procedure to get rid of a rectal or colon cancer will not require a permanent ileostomy or colostomy. The mix of advanced imaging technology as well as sophisticated investigation permits us to identify cancers earlier and also remove them with even more accuracy, typically eliminating the need for a colostomy bag. For colon cancer, it is rare that a person will require a permanent ileostomy or colostomy. Those at greater risk can consist of people in bad general health and wellness prior to surgery as well as those that need emergency surgical treatment. How sophisticated rectal cancer surgery can avoid a permanent stoma Sphincter-sparing surgical treatment is an innovative procedure in which we remove a cancer that is close to the anus without needing to operate on the sphincter. One research study showed that from 1990 onward for 20 years, 67% to 73% of people who had rectal cancer cells got sphincter-sparing surgical treatment. Executing this technique calls for knowledge, skill and dexterity far beyond a general surgeons skills. Colorectal surgeon have that requisite skill. Before performing the sphincter-sparing surgery for rectal cancer, we need to initially find the cancers relationship to the anal sphincters. If there is a chance to go beyond the tumour for 2 cm without damaging the sphincter, permanent colostomy is avoided. Once the part of rectum containing the cancer is eliminated, along with the fat as well as lymph nodes that surround the anus, the colorectal surgeon will reconnect the colon to the cut end of the rectum. This avoids cutting into the sphincter and removes the requirement for an irreversible colostomy in most patients. Special equipment to connect the two ends is used, which is called stapling devices. Multiple kind of these stapling devices are available and are chosen according to the patients requirement. Ileostomy may be required, but it is temporary and reversed after 12 weeks. It will depend on the patient’s anatomy and how much rectum we got rid of, a short-term ileostomy typically is required as the body heals. Timing to connect back will also depend upon on whether the person needs to receive further chemotherapy treatment and when the person feels strong sufficient to undertake a 2nd surgery. Living an active life with an ileostomy or colostomy If you are among the little percent of individuals who do need a permanent ileostomy/colostomy, we’ll review your current activity level before surgical treatment and also give thorough guidelines on exactly how to keep your way of life with a stoma. To help attain these outcomes, a team strategy along with a stoma therapist is utilized to plan each person’s care. Looking after a temporary or permanent ileostomy or colostomy Dealing with a stoma takes some getting used to, but everyone gets used to it. One of the greatest problems is whether a stoma be apparent to others; in the majority of scenarios, it is not visible. Stoma nurses are professionals in ileostomy care. They’ll educate you in correct cleaning and also upkeep methods, along with offer suggestions to adjust your wardrobe and regular activities as you accommodate to your new routine. When you return house, you will have accessibility to Stoma Care nurse who will certainly help you in taking care of the ileostomy or colostomy. A colostomy irrigation protocol followed daily removes the need for wearing a colostomy bag for almost all patients with a permanent colostomy. Highlights

Cancer, Colorectal Cancer, Rectal Cancer, Survivor story

Rectal Cancer Survivor takes life one day at a time

Cancer, Colorectal Cancer, Rectal Cancer, Survivor story / kapoorcmc

“Take one day at a time; always look on the positive side; and never give up.” This is what Ruchi (name changed) has to say as she battled a life changing event in her life when in May, 2012, she was diagnosed with rectal cancer that had spread to her liver. She was 32, recently married and planning to have a child. Signs and symptoms of rectal cancer Ruchi noticed something was wrong when she had multiple bleeding bouts over a span of 14 days. She had been diagnosed with haemorrhoids years ago and thus attributed her symptoms to haemorrhoids flaring up. She hoped the bleeding and urgent need to use the washroom was temporary and what she was experiencing was just a one-time flare up. However, over the next few weeks, the bleeding became more frequent and urgency continued. By the end of November, Ruchi’s symptoms stayed and she was forced (as she says) to seek appointment with me. Ruchi’s energy level had dropped so low, she was having trouble performing her job working. Bleeding with stools can be due to many reasons and should never be ignored. One of the reason for this could be a cancer of the lower colon or rectum. Many a times these bleedings are attributed to piles and thus managed without seeking a doctors consult. If this bleeding is because of a cancer, we lose chance of picking it up early and thus ensuring cure. I examined Ruchi and found that she had external haemorrhoids. However on examination of her back passage I found a tumour in her rectum. Rectum is the last portion of the intestines, where stools are stored. This area can be examined digitally with a gloved finger right in the outpatient clinic. I ordered tests which also included a colonoscopy. Her haemoglobin was low because of her bleeding. In colonoscopy, I found a large tumour in the lower rectum, 2 cm away from her anal opening. I took biopsies which came as cancer. Her CT scan revealed that she also had a solitary tumour in the liver and thus she was diagnosed to be having stage 4 rectal cancer. Counselling about rectal cancer and outcomes I sat down with Ruchi and her husband and broke the news to them. I explained about the disease and various treatment options. I also gave hope as stage 4 rectal cancers can be treated successfully and almost up to 30 percent patients have a good survival chance. The session lasted for almost an hour. I called them again next day to further discuss her treatment plans as well as answer any more questions they had. They were of course devastated at the news. Stage 4 rectal cancer requires chemo as well as radiation, followed by surgery. Her ova had to be procured and saved for future so that she can have babies. Ruchi describes getting the news she had cancer as shocking, but she says that she didn’t feel scared. “Even though both of us were crying, I was sure I was going to face it with courage”. She knew that she could rely on her husband’s support. She was also sure her parents would also help her in the crisis. She was very determined to remain positive. Surgery, chemotherapy and radiation for rectal cancer Stage 4 rectal cancer has many pathways for treatment depending on quite a few factors. After a tumour board meeting, it was decided to treat her with chemotherapy followed by radiotherapy and then surgery if required. With chemotherapy her liver tumour vanished and rectal tumour became small. After radiotherapy, the rectal tumour was difficult to feel but she had problems with incontinence. So APR surgery was planned for her. In this major surgery the rectum along with back passage is removed and the patient is given a permanent stoma called end colostomy. Ruchi underwent surgery to remove the tumour and got a permanent colostomy, where the end of her colon was brought out through a hole created in the abdomen wall on left lower abdomen. This allows wastes (faecal matter) out of the body, which is collected in a colostomy bag, that has to be emptied regularly. Life with a permanent stoma for rectal cancer surgery Ruchi says that the colostomy bag was a big mental block for her. She had been counselled about her permanent colostomy by a stoma therapist in my team, but Ruchi was still apprehensive. However the stoma therapist had multiple meetings with her and her husband and slowly she adjusted to life with a stoma. Her main focus remained about the cancer being completely eliminated and thus a favourable biopsy report after her surgery elevated her mood. “At that point, I started thinking about a future and that helped me. I was so focussed on my cancer that my communication with my husband were always about my cancer, treatment and outcomes. One month after the surgery, when I was told that the cancer at that stage had been eliminated from the body, I felt so relieved. My liver looked good and thus no further treatment was required.” Ruchi was now learning to live with her stoma and changed life style. We encouraged her to start thinking about normal chores and getting involved in managing her house. We also started her on daily exercises, walks and trips to the park. Ruchi was also counselled about her relationship and sex life. She was encouraged to roll back into the relationship at her pace. Her partner was also counselled about living with a person with a stoma. Having an understanding partner is very important; Ruchi was very lucky on that front. Surveillance for Rectal Cancer We made a 7 year surveillance plan for her so that we remain on the lookout for the cancer coming back. A three monthly visit to the clinic and yearly plan for scans and colonoscopy was planned. No bag after rectal cancer surgery 8 weeks after surgery, the stoma therapist

Cancer, Cancer Screening, Colorectal Cancer Screening, Rectal Cancer

Colorectal Cancer Screening and Surveillance for Prevention

Cancer, Cancer Screening, Colorectal Cancer Screening, Rectal Cancer / kapoorcmc

Colon and rectal cancer is the fourth most common cancer in males and third most common cancer in females in India. Those with a family history of the illness or who have actually had breast, uterine, or ovarian cancer are at a greater threat, as are those who have a history of substantial inflammatory bowel disease, such as ulcerative or Crohn’s colitis. Among the harder aspects of colorectal cancer detection is that, in a lot of cases, the cancers cells or polyps do not initially create any kind of symptoms. The goal is to recognize the possibility for disease as early as feasible, in order to facilitate avoidance or remedy. That’s why testing is so significant; it recognizes whether an asymptomatic person has an illness or condition that could cause cancer. Surveillance, on the other hand, entails screening those with a background of colorectal cancer , or that have actually been identified as being at a higher danger for developing it. Screening for Colorectal Cancer Many people with colon and rectal cancer do not experience any kind of signs and symptoms (consisting of anal blood loss as well as pain in the abdomen) till the cancer is rather progressed– which is why it’s usually described as a “silent” condition. The possibility for a cure is however much lower after signs establish, which is why testing is important. The majority of colorecta cancers begin as polyps (non-cancerous growths). Getting rid of the polyps may lead to stopping the cancer and avoiding the requirement for major surgical procedure. Screening Tests for Colorectal Cancer There are different screening tests that can be carried out. One of the a lot more common tests is called faecal occult blood screening, which includes examining the faeces to detect any kind of blood that might not be visible to the eye. Considering that it only detects cancers as well as polyps that are bleeding at the time of the test, however, faecal occult blood testing is generally used together with other testing methods. Flexible sigmoidoscopy enables your doctor to look straight at the cellular lining of the colon and also rectum. The examination focuses on the cellular lining of the last portion of the colon and anus, where many polyps and cancers cells normally start. Combined with faecal occult blood screening, sigmoidoscopy can find many cancers and also polyps. If an sigmoidoscopy leads to the discovery of a polyp or cancer, or if a person is thought about at a greater risk for having colorectal cancer, after that the physician will likely do a colonoscopy. This treatment permits a full exam of the colorectal cellular lining, in order to diagnose troubles as well as to do biopsies as well as to get rid of polyps. Colonoscopies are typically executed on an outpatient basis. Barium enema, or x-ray of the colon, is an additional treatment made use of to spot big polyps or lumps. It is less exact for smaller sized tumours, and also not quite as effective as a colonoscopy. CT Scan is used in those people, where the suspicion is high but screening tests have not revealed much. When and how often the colorectal cancer screening must be done For people with no determined threats, a digital anal evaluation and screening of the stool for concealed blood are recommended annually beginning at age 40. A colonoscopy should be performed at age 50, or earlier for those with a background of colon cancer in their household. Surveillance for Colorectal Cancer Surveillance is recommended for people in the following risk groups: People who have had any kind of pre-cancerous polyps located as well as surgically removed in the past. A colonoscopy is recommended one to three years after the very first examination. Those with a close loved one (brother or sister, moms and dad, or kid) who has actually had colon cancer or a pre-cancerous polyp. Screening must start at age 40, or five years prior to the age at which the youngest relative was detected. Individuals with a family history of colorectal cancer, including close family members as well as across a number of generations. These people should obtain genetic counselling and consider screening for a problem called genetic nonpolyposis intestines cancer. Colonoscopy is advised every 2 years starting in between ages 20 and 30, and also each year after age 40. Individuals with a family history of an acquired disease called familial adenomatous polyposis (FAP). Counselling and also hereditary screening are advised, to establish if they are carriers for the genetics that triggers the condition. If the gene is spotted, a sigmoidoscopy must be performed every year starting at puberty; if polyposis is present, a total proctocolectomy, which includes removing all the colon and rectum, might be recommended. People with history of colorectal cancer in the past. A total assessment (containing either a colonoscopy is advised within a year after the cancer is initially discovered as well as operatively removed. If exam outcomes are normal, a follow-up test must be carried out within 3 years. People with a background of extensive inflammatory bowel tract disease for a minimum of eight years. A colonoscopy is recommended each to two years. Ladies with a personal history of breast, ovary, or uterine cancer. These people have a 15% lifetime risk of developing colon cancer, as well as should go through a colonoscopy testing every five years, starting at age 40.

Cancer, Cancer Screening, Colorectal Cancer, Diagnostic Procedures, Rectal Cancer

When do I Need a Colonoscopy

Cancer, Cancer Screening, Colorectal Cancer, Diagnostic Procedures, Rectal Cancer / kapoorcmc

What is Colonoscopy? A colonoscopy is a test utilised to find lesions or irregularities in the large intestinal tract (colon) and anus. Throughout a colonoscopy, a long, flexible tube (colonoscope) is placed right into the colon. A tiny camera at the tip of the tube allows the physician to watch the whole colon. Why is Colonoscopy done? Colonoscopy is done for many purposes. It is used to investigate intestinal tract signs and symptoms. A few are listed below: Rectal bleeding Persistent constipation Chronic Diarrhoea Rectal Cancer Colon Cancer Screening for colon cancer Follow-up colonoscopy How does one prepare for Colonoscopy? After the appointment and prior to a colonoscopy, you’ll require to clear out (empty) your colon. One is not to eat solid food the day prior to the examination. Drinks may be restricted to clear fluids– ordinary water, tea and coffee without milk or just a touch of it, broth, and also carbonated beverages. Avoid red fluids, which can be confused with blood throughout the colonoscopy. You are not to consume anything after midnight before the test. Your medical professional will generally advise taking a laxative, in either tablet form or fluid kind. You might be instructed to take the laxative the night prior to your colonoscopy, or you may be asked to utilize the laxative both the evening before as well as the morning of the procedure. Sometimes, you may require to make use of a non-prescription enema package– either the evening before the exam or a few hrs prior to the exam– to empty your colon. Typically it is not recommended as a key way of clearing your colon. Details of the colonoscopy procedure Consent is taken. Risks are explained during consenting. Sedation is normally suggested. Moderate sedative is given as an injection You’ll lie on your side on the table, typically with your knees drawn towards your upper body. The physician will insert a colonoscope right into your anus and do the procedure. When the scope is moved or air/co2 is introduced, you might really feel abdominal cramping or need to have a defecation. The colonoscope likewise has a tiny video camera at its tip. The video camera sends out video to an exterior monitor to ensure that the doctor can study the inside of your colon. If there is a need, tissue samples (biopsies) are taken or polyp is excised to biopsy it. A colonoscopy generally takes around 30 to 60 mins. When can I completely recover after colonoscopy? After the test, it takes an hour to begin to recover from the sedative. You’ll need someone to take you residence because it can take up to a day for the full effects of the sedative to wear off. Don’t drive or make essential decisions or go back to work for the rest of the day. If your physician got rid of a polyp during your colonoscopy, you may be advised to consume an unique diet regimen briefly. You may feel puffed up or pass gas for a couple of hrs after the examination. Strolling might help soothe any type of pain. You may likewise discover a small amount of blood with your very first defecation after the exam. Usually this isn’t peril. Consult your doctor if you continue to pass blood or blood clots or if you have persistent stomach pain or a fever. What is a negative result? A colonoscopy is considered negative if the doctor doesn’t discover any problems in the colon. Your physician may recommend that you have another colonoscopy: • In 10 years, if you have no colon cancer risk elements other than age.• In 5 years, if you have a history of polyps in previous colonoscopy treatments.• In one year, if there was residual faces in the colon that avoided full evaluation of your colon.• If there is a positive result. What is a positive result? A colonoscopy is considered positive if the physician finds any type of polyps or unusual tissue in the colon. Most polyps aren’t cancerous, but some can be precancerous. Polyps are removed during same colonoscopy or in a new session; excised polyps are sent out to a laboratory for evaluation to determine whether they are malignant, precancerous or noncancerous. Depending on the size and number of polyps, you might require to comply with an extra strenuous monitoring routine in the future to try to find even more polyps. Another colonoscopy is advised if: • More than two polyps.• A large polyp– larger than 0.4 inch (1 centimeter).• Polyps as well as also residual stool in the colon that protects against full exam of the colon.• Polyps with specific cell attributes that suggest a greater danger of future cancer.• Malignant polyps. Difficult colonoscopy Sometimes the procedure is not completed because of lot of faecal matter. pain or difficulty in negotiating the entire length of the colon. A repeat colonoscopy in a shorter time is recommended. If your doctor wasn’t able to advance the extent of entire colon, a barium enema or virtual colonoscopy might be suggested to check out the rest of your colon. What are the risks of colonoscopy? Rarely, colonoscopy can have complications. These could be: Adverse response to the sedative used throughout the examination Haemorrhaging from where a tissue example (biopsy) was taken or a polyp or other uncommon cells was removed A tear in the colon or anus wall (perforation). What are the procedures done during colonoscopy? Biopsies of suspicious lesions Polypectomy Stenting of a stricture Argon laser to stop bleeding Laser treatment of proctitis Removal of a foreign body Screening procedure for colorectal cancer Conclusion: Colonoscopy is a very useful diagnostic and therapeutic tool available to evaluate the colon and rectum. It is never done on the behest of a patient but needs to be recommended by a physician. One should never say no to colonoscopy when recommended.

Colorectal Cancer, Colorectal Surgery, General Surgery, Rectal Bleeding, Rectal Cancer

There is Blood in my Stools … What should I Do

Colorectal Cancer, Colorectal Surgery, General Surgery, Rectal Bleeding, Rectal Cancer / kapoorcmc

What is rectal bleeding? Looking down right into a toilet and seeing blood can be alarming. If you’re experiencing rectal bleeding, you might see blood in a couple of various means– on your toilet paper as you wipe, in the water of the commode bowl or in your stools. It can be various shades, ranging from bright red to a dark maroon to black. The shade of blood you see can actually show where the bleeding might be originating from. Bright red blood usually indicates bleeding that’s low in your colon or rectum. Dark red or maroon blood can indicate that you have hemorrhaging from right colon or small intestine. Melena (dark, smelly as well as tar-like stool) typically indicates hemorrhaging in the stomach. In some cases, rectal blood loss isn’t noticeable to the naked eye and can only be seen through a microscope. This type of blood loss is typically discovered during a laboratory test of a faeces sample as a part of screening or test sone to diagnose anemia. Is rectal bleeding of concern? In some cases, anal blood loss can be a small symptom of a problem that can be conveniently dealt with. Piles, as an example, can cause you to experience rectal bleeding. This usually doesn’t last long and piles are frequently very easy to treat. Rectal blood loss can sometimes be a sign of a significant problem like colon or rectal cancer. It’s vital to track any kind of blood loss you are experiencing. If it’s hefty, frequent or triggering you to worry, call your doctor to check it out. How does anal bleeding appear? You may see or experience anal bleeding in a couple of different means, including: Seeing blood on your toilet paper when you clean. Seeing blood in the toilet water of the bathroom when you are making use of the restroom– the water in the bowl may look like it’s been dyed red. Noticing dark red, black or tarry poop while you are having a bowel movement. What are the signs and symptoms of anal bleeding? The symptoms of anal bleeding can differ depending upon what is creating the bleeding. Some signs and symptoms you may have with rectal blood loss can include: Feeling anal discomfort and/or pressure. Seeing bright red blood in or on your stool, undergarments, toilet paper or in the toilet dish. Having stool that’s red, maroon or black in shade. Having stool that has a tar-like appearance. Experiencing fatigue or restlessness. Feeling lightheaded or lightheaded. Fainting. In some very severe instances, anal bleeding can result in shock. The signs and symptoms of shock can include: Experiencing an unexpected decrease in your blood pressure. Having a rapid heart rate. Not being able to urinate. Slipping into unfamiliarity. What creates rectal bleeding? There are several reasons why you might experience rectal blood loss. The sources of rectal blood loss can differ from usual and also moderate conditions to much more severe as well as unusual problems that require immediate clinical therapy. Causes of rectal bleeding can include: Hemorrhoids Anal Fissure Anal abscess Anal Fistula Diverticulosis/Diverticulitis Inflammatory digestive tract condition (IBD) Large polyps Colon Cancer Rectal Cancer Can foods transform the shade of my stool in a similar way to rectal blood loss? There are certain foods that can make your stools an unusual colour. Foods like black licorice, beetroots, dark berries (blueberries and also blackberries) and red jelly can all make your stools appearance extremely dark. This can easily be confused for blood in your stool. If you observe extremely dark poop throughout a bowel movement, think back to what you consumed lately. There’s a chance that what you consumed could be the cause for the usually dark stool. Can constipation and straining result in anal bleeding? Yes it can. Straining can trigger rectal bleeding. This is commonly related to bowel constipation. Really hard faeces can actually cause the skin around your anus to tear, creating you to see blood. Dealing with constipation can aid prevent this from happening. What are the tests required to diagnose the cause of rectal bleeding? There are a number of means your doctor can utilize to review rectal blood loss to help determine the cause. These are: A physical exam of the rectum as well as anus. A colonoscopy. A sigmoidoscopy. A faecal occult blood examination Haemoglobin and other lab tests CT Scan Exactly how do I deal with rectal blood loss? For you, the only instruction is to go and consult a surgeon. For the most part, rectal bleeding can be dealt with by taking care of the cause of the blood loss. Once that condition has actually been dealt with, the bleeding usually quits. Treatment options can vary relying on the condition. Will anal bleeding vanish by itself? Depending on the cause of the bleeding, your rectal blood loss can in fact quit on its own. You need to pay attention to your body and maintain track of the blood loss. If it occurs one-time and then quits, remember of it, yet it more than likely isn’t an emergency. If you have heavy rectal blood loss or are on a regular basis seeing blood, connect to your doctor to get prompt care. Conclusion Blood in your stool could just be due to piles, but it could also be a sign of something more sinister and dangerous. The only way to be sure is to consult your doctor or a surgeon. People tend to be shy about talking of blood in ones stools or giving a stool sample and that may cause significant loss of blood as well as delay in diagnosing the cause. To develop the right treatment plan, a correct history should be provided. Nip the evil in the bud before it can create havoc.

Colorectal Cancer, Rectal Cancer

How to Treat Rectal Cancer

Colorectal Cancer, Rectal Cancer / kapoorcmc

Rectal cancer: An intricate cancer needing specific professionals Cancer happening in the rectum is called rectal cancer. Rectum is the last several inches of the large intestinal tract beginning at the end of the final sector of colon and ends when it gets to the anal canal and opening. Cancer growth or lump inside the rectum (rectal cancer) as well as cancer growth inside the colon (colon cancer) are referred to with each other as “colorectal cancer.” Rectal as well as colon cancers cells are treated very differently. This is mainly because the rectum is located in a very limited area, hardly divided from various other organs and also frameworks therefore making surgery to get rid of rectal cancer complicated. Signs and symptoms of rectal cancer A modification in digestive tract practices like diarrhea, constipation or both; at times there is more-frequent bowel movements Dark maroon or bright red blood in feces Slim stools A sensation that your bowel does not empty totally Discomfort in the abdomen Inexplicable weight-loss Weakness or exhaustion Examinations to detect as well as confirm rectal cancer Rectal cancer can be found throughout a screening examination for intestines cancer or it might be presumed based on signs and symptoms. Nonetheless, specific tests are required to be done to validate cancer and as well as also evaluate the spread of the cancer. These are: Colonoscopy: Colonoscopy is done by utilizing a long, adaptable tube (colonoscope) attached to a camera and display to see your colon and rectum. If cancer is found in your intestine, biopsy i.e. a small piece with a biopsy forceps is taken. The tissue is sent to a lab to be examined as well as confirm cancer cells, aggressiveness and genetics in the cancer cells. These will certainly figure out the treatment options. Tests to seek cancer cells spread: 1. Complete blood count (CBC). A reduced haemoglobin, recommends that a growth is creating blood loss. 2. Liver Function Tests. Abnormal degrees of some of these chemicals may suggest that cancer has spread to the liver. 3. Carcinoembryonic antigen (CEA). Carcinoembryonic antigen (CEA), may be greater than typical in people with colon and rectal cancer. CEA testing is specifically useful in keeping track of success to treatment. 4. CT Scan or PET Scan: It assists figure out whether rectal cancer has actually infected other organs, such as the liver and lungs. 5. MRI of the pelvis. An MRI offers an in-depth picture of the muscular tissues, organs and various other cells surrounding a rectal tumour within the pelvis. An MRI also shows the lymph nodes near the rectum and anus and various layers of tissue in the rectal and anal wall. This is a really crucial examination to make a decision the sort of therapy to begin with. 6. A few other tests might be called for to assess physical fitness for surgery. Staging of rectal cancer The stages of anal cancer are suggested by an array from stages ranging from 0 to IV. The I stage suggests cancer cells that are restricted to the lining of the wall within the lumen of the rectum and anus. By phase IV, the cancer is thought to be complex and also has actually spread out (spread) to various other areas of the body. Treatment of rectal cancer Rectal and anal cancer therapy typically involves a mix of treatments. Surgery is made use of to cut away the cancer. Various other therapies, such as chemotherapy and also radiation treatment, may be used after or before to decrease the danger that cancer will return or make the surgery possible. If doctors are concerned that the cancer can’t be gotten rid of totally without removing nearby organs and also structures, a mix of radiation treatment and chemotherapy treatment as preliminary treatment is advised. These combined treatments reduce the cancer and make it easier to eliminate throughout an operation. Surgery for rectal cancer Surgical procedure is the mainstay of therapy. Which procedure is applicable relies on a particular situation, such as the area as well as stage of cancer, aggressiveness of the cancer cells, general health, and occasionally choices. Workflow used to treat rectal cancer consist of: Extremely small cancers may be gotten rid of utilizing a colonoscope or another specialized sort of scope placed via the rectum (trans anal regional excision). This is utilized in limited scenarios or to get rid of polyps. In some cases, after the biopsy is back, we suggest additional surgical procedure. Bigger rectal cancers that are far sufficient far from the anal opening are eliminated in a procedure (anterior resection) that removes all or part of the rectum. Nearby tissue and also lymph nodes are additionally eliminated. This treatment protects the rectum to make sure that waste can leave the body generally. For rectal and anal cancers that are located near the anal opening, it is not possible to remove the cancer completely without damaging the muscular tissues that control defecation. In these scenarios, we advise a procedure called abdominoperineal resection (APR) to get rid of the anus, rectum and also some part of the colon, along with nearby tissues and also lymph nodes. An opening in the abdominal area is developed and also affixes the remaining colon (colostomy). Waste is discharged with the opening and also accumulates in a bag that affixes to abdomen. Chemotherapy for rectal cancer There are lots of reasons why chemotherapy is required and is called for. These are: Might be recommended after surgical procedure to kill any type of cancer cells that might remain. Radiation treatment integrated with chemmotherapy can also be used prior to a procedure to reduce a huge cancer so that it’s less complicated to eliminate with surgical procedure. Chemotherapy can likewise be made use of for palliation to control symptoms of rectal and anal cancer that cannot be removed with surgery or that has actually spread to other locations of the body. Radiation treatment for rectal cancer Radiation treatment uses powerful energy resources, such as X-rays and also protons,

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