The following is from another site ... but with presentation so
it may be read a bit more
easily. Very little modification has been made. All contents are
theirs.
When we make any comment, it will be easily discernable.
Such as: "I've been there, done that" is
applicable. Have undergone 2 hemorrhoid
operations in my life time and nearly had the third. This article hits a
lot of things
which I wish I had been told or that I knew about.
Let the contents help you by KNOWING about this area of YOUR BODY !
The Colon and the Rectum
What You Should Know About Them
The original site I created in 2001 (was, ironically, just
10 days before I lost the love of my life, and my life has
been much different since Dec 24, 2001).
I will leave the original text in place, but, I've found even
more
up-to-date and applicable info -- I will list its URL at the
bottom of this site -- so that you too will have the info.
Hemorrhoids are a normal part of everyone’s anatomy. (wow, what a
subject?)
We only treat them when they become symptomatic.
Some thoughts about: Internal hemorrhoids classically
present with bleeding,
either dripping into the toilet or blood on the tissue,
or protruding tissue causing either
mucous staining of underwear or requiring
digital reinsertion.
Many of these internal hemorrhoids can be managed
conservatively or
by office procedures such as rubber banding. As we understand it,
"Only the largest
need be managed surgically".
External hemorrhoids: Swollen lumps outside the anus that may appear after much straining. At times without obvious cause. These can be very painful, but the lumps resolve spontaneously over 6 weeks while the pain will usually improve after 3 days.
The pain characteristically is not aggravated by bowel movements. Considerable relief from the acute pain can be obtained by excision of the clot that causes the swelling in the proctologists office or in the emergency room. Excision of the clot gives better relief than incision with clot extension, the naval emergency room treatment.
Pain aggravated by bowel movements is usually a sign of anal fissure. This is like a paper cut in the anus and often is associated with blood on the fissure. The pain can last for hours after bowel movements. Treatment in most cases is conservative with the use of fiber stool softness, and anal creams. The resistant cases can be managed by a minor outpatient procedure to loosen the spastic anal muscle. Relief with this maneuver can be dramatic.
Throbbing constant pain becoming worse over time and associated with swelling and often fever and chills are the signs of perianal abscess. This is one of the four rectal emergencies and must be managed by a drainage procedure than can often be done as an outpatient.
Relief is instantaneous once the abscess is drained. Antibiotics may reduce local symptom, but will tend to prevent the abscess from persisting, making it more difficult for the surgeon to localize. The abscess can be drained in the office or the emergency room, but will tend to recur over time unless the origin, an infected gland in the anal canal is identified and eradicated. This requires careful examination in the operating room. If you suspect you are developing an abscess, do not eat or drink anything the day you are seeing your proctologist as this will expedite your surgery and relief.
Anesthesiologists don’t like full stomachs.
Should the abscess drain spontaneously or be drained in the office or emergency room, the presence of an anal origin not found will predispose to the development of an anal fistula. This is a tunnel from the infected gland within the anus to the external drainage site. The normal physiological pressures in the rectum will tend to keep this open and draining like a tube of toothpaste with a hole in it. This will not heal without surgical intervention and should it seem to heal externally, this is actually only setting you up for another abscess. Fistulas should be dealt with promptly, though selectively by surgery to prevent abscess recurrence at a time that is inconvenient. Fistula surgery is usually an outpatient procedure and not as painful as hemorrhoid surgery, but sometimes the wounds can be quite complicated and occasionally there is a minor seepage problem after surgery, but this can often be managed by dietary adjustment.
Another painful problem, sometimes confused with perianal abscess but having
nothing to do with the rectum, is the pilonid cyst. This is caused by
loose hair in the buttock crease that drills under the skin surface resulting in
a very painful swelling over the tail bone. This requires drainage and
antibiotics in the office or emergency room followed by a complete unroofing of
the abscess with removal of the hair.
These wounds can be closed or left open. The closed wounds hurt more and tend to break down and cause more loss of time for the patient. The open wounds can sometimes take months to heal, but the patient has little pain and can return to full activity sooner. Because of the proximity to the rectum, this problem is often handled by the proctologist or colon and rectal surgeon.
Another common symptom is perianal itching or pruritus ani. This is often a
result of over meticulous hygiene and in extreme cases can present as burning.
Caffeine, alcohol, and spicy foods and tomato products can aggravate the
problem. The key is to avoid scrubbing and scratching, to avoid soap, and to
avoid aggravating foods and beverages. This with the addition of a topical
steroid cream will usually control the problem. If the itching only occurs at
night, and especially if there are children in the house, one has to think of
pinworms as a possibility and you should consult your family doctor or
proctologist. The treatment is medical.
A collection of cauliflower like growths around the anus which often itch and
sometimes bleed but seldom burst, is the classic presentation of anal
warts. These are caused by a skin virus in many cases caused by direct
contact with an infected person, usually sexual contact. These can sometimes be
treated by topical preparations in the proctologists office, but are a
particularly stubborn problem and often recur. Excision or treatment by
electrocutery or laser is more effective though multiple treatments are often
necessary and virtually all the treatments are painful. The afflicted patient
must avoid repeated contact with his source if he wants to avoid reinnoculation.
If the source is know, he should be treated as well.
Bloody mucus squirting from the rectum several times a day with constant urge to move the bowels and often loose stool is a hallmark of proctitis or nonspecific rectal inflammation. The cause of this condition is not know, but can be a recurring problem aggravated by stress. This is diagnosed by a proctoscopic exam and treated by special enemas, foams, or suppositories. The less severe cases often respond quickly. More severe cases may be associated with involvement of the entire colon and rectum known as an herative colitis. This disease usually requires oral medication on a chronic maintenance basis and in its acute stages can present with frequent diarrhea and weight loss sometimes requiring hospitalization. Sometimes major surgery is necessary to control this disease. In the past, this surgery usually left the patient with a permanent stoma or pouch worn on the abdomen to collect waste as the rectum had to be removed. Today we can often preserve continence by making a new rectum out of small intestine which is unaffected by ulcerative colitis.
A similar but less forgiving disease is
Crohn’s disease which can
affect the small intestine as well. This disease is often complicated by
stubborn anal fistulas unresponsive to surgical treatment. Surgery is reserved
only for complications of this disease. These patients, when the disease is
severe, often end
with a stoma lose the rectum. (? don't understand this ?)
Diverticulosis, a common condition characterized by small hernias or
pockets in the colon wall, is usually asymptotic, but occasionally can present
as heavy bleeding, usually the passage of bright red clots, which should prompt
an urgent call to your physician and a trip to the emergency room. This blood
will often turn the stool black and foul smelling when the active bleeding
stops. Transfusion may be necessary, but usually the bleeding stops
spontaneously. These bleeding sites can be difficult to find and if bleeding
recurs or doesn’t stop at all, emergency colon resertion may be necessary.
Sometimes small spider veins in the colon lining can bleed this way. The
treatment is similar, but sometimes the site can be identified at colonscopy and
controlled by cautery.
When the "pockets" become infected one develops divertienlitis which presents usually as a left sided appendicitis with pain and often fever and occasionally with perforation and peritonitis, a surgical emergency. Short of peritonitis, this problem can often be managed with antibiotics. Once over the crisis, a high fiber diet is recommended to make stool passed easier and reduce colon pressure which hopefully will prevent recurrence. Repeated attacks may lead to scarring and stool narrowing with cramps and constipation. Surgery may be necessary, but can usually be done without need of a colostomy.
A high fiber diet with fiber supplements is also the treatment for
irritable bowel syndrome, a condition of cramps, alternating constipation
and diarrhea without any anatomical abnormality. Often referred to as a nervous
bowel, this problem requires no surgery, but often reassuring and emotional
support of the patient is necessary.
Sometimes there is an associated lactose or milk intolerance, especially if symptomatic are excessive gas and diarrhea. Avoidance of milk or use of lactose free milk will make a big difference in symptoms. This information can usually be obtained by a trial of milk avoidance without a doctor’s visit.
A "nervous" condition that is sometimes associated with irritable bowel syndrome is proctalgia fugax. This is a rectal pain, usually high in the rectum which is secondary to pelvic muscle spasm. It is not easily treated, but is not dangerous. Nevertheless, it should be checked out by a proctologist. A clue that this may be the problem is that the pain is usually relieved, not aggravated, by bowel movements. The pain is usually localized to the patient’s left side. The reason for this is unknown.
People with irritable bowel syndrome often get caught up in a laxative trap
taking laxatives to relieve constipation and then getting frightened when no
stool passes for several days. They end up taking more laxatives and still
nothing happens. This is because the colon is empty and hasn’t had time to fill
or form a new stool. sometimes laxative users develop a lazy colon which won’t
work anymore after a long history of exposure to these drugs. Sometimes the only
thing that can be done is colon removal to return these people to functional
status. Chronic laxative use is not considered to be a good idea. Go to your
proctologist about getting off the laxative habit. There are safer ways to
manage your bowels.
At the other end of the spectrum is incontinence. some of this can be a sign of surgery, infection, trauma, or aging. Sometimes continence can be improved by diet, surgery, or even biofeedback techniques. One particular problem amenable to a surgical approach is rectal prolapse. Here the rectum turns inside out and can protrude like an elephant’s trunk in extreme cases. Overtime, this prolapsing can stretch muscles and damage nerves. The injury to continence may not be reversible if the problem is not addressed quickly. Surgery results are 90% effective if taken care of early. Unless your physician is experienced in these problems, he may mistake this presentation for hemorrhoids. If you think this problem is happening to you, see your proctologist.
Women can develop significant trouble with evacuation if there is vaginal weakness. The rectum will sometimes bulge out of the vagina and act as a trap for stool. Women who have to push the vagina up in order to move their bowels have a symptomatic rectocele and should consider having this repaired by the proctologist, or by the gynecologist if the bladder is dropping as well.
The biggest concern patients seem to have is what to do to detect or prevent
cancer early. Cancer of the colon and rectum may have no symptoms at all
until late in the course of the disease. Yet, when it is found early, it is one
of the most curable of all cancers. Do not make the mistake of thinking that if
colon cancer is found you can opt to do nothing. Cancer of the colon and rectum
will obstruct the fecal channel. If stool cannot get out, the belly will distend
and eventually you will be vomiting waste. This is not compatible with life and
will require emergency surgery, often too late to accomplish anything more than
decompression and a colostomy. All of this can be avoided by early detection and
prompt treatment. Due to early detection, the need for colostomy is becoming
less frequent.
Warning signs may include blood mixed in the stool, narrowing of the stool, and a feeling of fatigue and weight loss. Anemia on a routine blood test is an important warning sign. Stool should be tested yearly for blood by your physician. Ask him to do it if he hasn’t already. The test is cheap and though controversial because it doesn’t find everything and sometimes gives false warnings, there is nothing of comparable value if cost effective. A flexible signoidoscipic exam should be done at least every 3 years after age 40. If your physician doesn’t do it himself, ask for a referral to a proctologist or gastroenterologist for this. A digital rectal exam should also be done yearly. Many low rectal tumors can be picked up with this easy exam.
If there is blood in the stool or a polyp, a benign growth in the rectum which is a cancer precursor, is found, then colonoscopy to look at the whole colon should be done. It is an outpatient procedure and usually done without much discomfort as the patient is sedated.
Polyps can be removed at colonscopy. If they are found to be premalignant, the patient should be placed on regular colonscopic surveillance yearly as long as there are polyps and every 3 years when there are none.
The risk never ends, so if polyps are found, do not become complacent about it. You are fortunate that you have been identified as being in a high risk bracelet. If a first degree relative has colon or rectal cancer, you are also at risk and should also be on surveillance.
Not everyone can be colonscoped, but those who know they are at risk have the advantage of staying right on top of the problem.
That is an ALERT signal ...... if you've taken the time to
read and think about what the contents of
this article have brought to your knowledge, then you can appreciate why I've
taken the time to
make it available to those who MUST KNOW THESE THINGS ...
NOTE: Did you read about why I'm listing the following site?
http://www.healingdaily.com/conditions/detoxification-to-fight-cancer.htm
When you get there --- just "dig in" and check all of it out.
Your knowledge will be increased beneficially!
Even with my personal experiences (over the years = many), I've learned more here.
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Oh, if is now January 12, 2006