COLORECTAL

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The colon and rectum make up the large intestine (or large bowel), which is part of the digestive system, also called the gastrointestinal (GI) system. Most of the large intestine is made up of the colon, a muscular tube about 5 feet (1.5 meters) long. The parts of the colon are named by which way the food is passing through them.  

The first section of the colon is called the ascending colon. It starts with a pouch named cecum, where undigested food comes in from the small intestine. It proceeds upward on the right side of the abdomen.

The second section of the colon is called the transverse colon. It goes across the body from the right to the left side.

The third section of the colon is called the descending colon because it descends on the left side.

The fourth section is called the sigmoid colon because of its structure. The sigmoid colon joins the rectum, which then attaches to the anus.   

The last 18-20 cm portion of the colon is called the rectum. At the bottom of the rectum are the sphincter muscles.         

Colorectal cancer

Colorectal cancer begins in the colon or the rectum. These cancers can also be called colon cancer or rectal cancer, depending on the area. Most colorectal cancers start as a growth on the inner lining of the colon or rectum. These growths are called polyps.

Dysplasia is another pre-cancerous condition. It means there's an area in a polyp or in the lining of the colon or rectum where the cells look abnormal, but they haven't become cancer. Colorectal surgeons treat cancer and inflammation with surgery.


Types of Colorectal Cancer

There are many kinds of colorectal cancer, the most common is adenocarcinoma. some other types of cancer in the colon and rectum are:

  • Gastrointestinal Stromal Tumors (GIST)
  • Lymphoma
  • Carcinoids
  • Turcot Syndrome
  • Peutz-Jeghers Syndrome (PJS)
  • Familial Colorectal Cancer (FCC)
  • Juvenile Polyposis Coli

 



Signs and symptoms of colorectal cancer

In the early stage of the disease, people have no symptoms. Symptoms may vary depending on infection size and location. The general symptoms of colorectal cancer are abdominal irritation, bloating, and irregular bowel movements. Some commonly experienced symptoms are:

  • Changes in bowel habits
  • Diarrhoea, constipation.
  • Changes in stool consistency.
  • Blood in stool or rectal bleeding.
  • Abdominal discomfort.
  • Weakness or fatigue.
  • Camping in the rectum.
  • Long thin stringy 'pencil stool'.
  • Anaemia because of excessive rectal  bleeding.
  • Weight loss.

 

Causes and Risk factors

  • Reckless lifestyle and food habits are major factors of colon cancer. 
  • The possible causes include
  • Excessive alcohol consumption.
  • Extremely overweight increases colon and rectal cancer risk in both men and women.
  • Processed food such as hot dogs and other luncheon meat increases cancer risk.
  • Eat red meat.
  • High-flow-fibre diet.
  • Radiation therapy directed at the abdomen to treat previous cancers increases the risk of colon cancer.
  • Vitamin D deficiency.
  • Smoking is a common cause of cancer. It is also recognised to cause colorectal cancer.

 

Procedure and treatments

Some common diagnostic tests and procedures that doctors may recommend for diagnosis are :

  • Antigen test.
  • Liver function test.
  •  CEA test.
  •  Endoscopic ultrasound.
  •  colonoscopy and biopsy.


Several kinds of procedures are available to treat colorectal cancer. Treatments are based on the infected area, size, and cancer phases. Common treatments like surgery, chemotherapy and radiation therapy are also recommended to cure. Other treatments are:

  • Colonoscopy (Removing polyps) 
  • Endoscopic mucosal resection. 
  • Minimally invasive surgery (laparoscopic surgery).


Colorectal surgery is useful for earlier-stage cancer that hasn't spread. Therapy for colon cancer usually involves surgery to remove cancer. The three main types of surgery for colorectal cancer are open, laparoscopic, and robotic. Open surgery for colorectal cancer has been the crucial method for removing tumors. Recent modifications in technology are laparoscopic and robotic.


It can also be treated using medications which can be given by mouth or directly into the bloodstream. All the methods of treatment depend on the patient's general health and medical conditions.

 Dr. Suvro Ganguly is one of the best Surgeons in Kolkata in the Department of Oncosurgery with a special interest in Coloproctology. He joined Apollo Gleneagles Hospital in December 2018 and is practicing as a Surgeon in the Department of Oncosurgery with a special interest in Coloproctology. He specializes in colorectal surgery, cancer surgery, advanced laparoscopy, advanced GI surgery and laser proctology.

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