Colon & Rectum

Colorectal cancer is the second most common cause of death from cancer in the United States. Early diagnosis of this disease greatly increases the chances for a cure or prolonged survival. The 5 year survival for patients with early colorectal cancer is 90%. Once the disease has spread to distant sites the 5 year survival rate is only 8 %. The American College of Gastroenterology and the American Cancer Society recommend screening by colonoscopy starting at age 50 in an average risk person in order to detect colon polyps or colon cancer at an early stage. Up to 80% of colon cancer deaths are preventable by current screening methods. In order to make recommendations for individual patients, we must first define the patient’s risk for colorectal cancer.

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What is Diverticulosis?
The term diverticulosis refers to the presence of small pockets, or diverticula in the large intestine. This is a common finding in persons over the age of 40, and in most people, it is an incidental finding which causes no symptoms at all. A diverticulum forms as the result of pressure generated when muscular contractions occur in the colon. There are openings in the muscular wall of the colon where small arteries pass through to provide circulation to the inner lining of the colon. These openings gradually enlarge and the mucosa or lining of the colon bulges through. This creates a thin walled pocket consisting only of the mucosa and the outer membrane over the colon called the serosa.
Diverticulosis is also associated with spasm, usually in the sigmoid colon. This may cause cramping and pain, and can be result in constipation or diarrhea. Extreme thickening of the muscle layer of the colon may occur, and can cause symptoms suggestive of obstruction or blockage.

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Normal Bowel Function
The function of the colon is to reabsorb water, store, and evacuate stool. About two quarts of fluid and residue enter the colon from the small bowel each day. The lining of the colon actively reabsorbs water and minerals, leaving a solid, formed stool. Stool is stored in the left side of the colon. Contractions in the sigmoid colon hold the stool above the rectum. When the colon fills with stool, the stool moves into the rectum. This is sensed as an urge to defecate, and one seeks a bathroom. The anal sphincter muscles relax and a wave of contraction in the colon pushes out a large amount of stool. This is termed a mass movement.

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Rectal pain, itching, discomfort, or bleeding, are often assumed to be due to hemorrhoids. In fact, many different conditions may cause these symptoms. Some of these may be quite serious. For this reason, you should seek medical help to accurately diagnose and treat your problem.     

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Pelvic Muscle Retraining for Patients with Fecal Incontinence.
Kegel exercises are to help strengthen the pelvic floor muscles to help with bladder and bowel leaking, constipation and pelvic and rectal pain.

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Perianal Care:
Treatment of Anal Discomfort or Pain due to hemorrhoids, anal fissures, pruritus ani and other conditions:

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