Cancer that develops in the colon or rectum, often starting as small growths called polyps that can become malignant over time. Symptoms may include blood in the stool, changes in bowel habits, and abdominal pain.

Symptoms

Changes in bowel habits (diarrhea, constipation, or narrow stools) lasting more than a few days

Rectal bleeding or blood in the stool

Persistent abdominal pain, cramping, or discomfort

A feeling of incomplete bowel emptying

Unexplained weight loss

Fatigue or weakness

Iron-deficiency anemia

Risk Factors

Age: Most cases occur in individuals over 50.

Family History: A family history of colorectal cancer or polyps increases risk.

Personal Medical History: A history of inflammatory bowel disease, such as Crohn's disease or ulcerative colitis.

Diet: High intake of red or processed meats and low fiber diets.

Lifestyle Factors: Sedentary lifestyle, obesity, smoking, and heavy alcohol use.

Genetic Mutations: Conditions like familial adenomatous polyposis (FAP) or Lynch syndrome.

Diabetes: Type 2 diabetes is associated with a higher risk.

Diagnosis

Colonoscopy: Visual examination of the colon and rectum, often with biopsy of suspicious areas.

Fecal Tests: Detect hidden blood in stool or abnormal DNA markers (e.g., FIT, FOBT).

Imaging Tests: CT colonography or barium enema for detailed imaging.

Blood Tests: Check for anemia or tumor markers like carcinoembryonic antigen (CEA).

Treatment Options

Surgery: Removal of the tumor and surrounding tissue.

Radiation Therapy: Often used before surgery to shrink tumors or after surgery to eliminate remaining cancer cells.

Chemotherapy: Drugs used to kill cancer cells, often employed in advanced stages or after surgery to reduce recurrence risk.

Targeted Therapy: Drugs targeting specific molecules involved in cancer growth, such as VEGF or EGFR inhibitors.

Immunotherapy: Stimulates the immune system to fight cancer, often used for cancers with specific genetic mutations.

Palliative Care: For advanced stages, focuses on managing symptoms and improving quality of life.

A chronic functional disorder of the colon characterized by abdominal pain, bloating, and altered bowel habits (diarrhea, constipation, or both). The exact cause is unknown, but stress and certain foods can trigger symptoms.

Symptoms

Abdominal Pain or Cramping: Often relieved by bowel movements.

Bloating: Sensation of fullness or swelling in the abdomen.

Altered Bowel Habits: Diarrhea and constipation

Mucus in Stool: Clear or white mucus in bowel movements.

Gas: Excessive flatulence or discomfort.

Risk Factors

Gender: Women are more likely to develop IBS than men.

Age: Commonly diagnosed in individuals under 50.

Family History: Genetic predisposition may play a role.

Stress: Psychological stress can trigger or worsen symptoms.

Infections: A history of gastrointestinal infections or food poisoning.

Dietary Triggers: Intolerance to certain foods such as gluten, dairy, or high FODMAP foods.

Mental Health Conditions: Anxiety, depression, or other mental health disorders are often linked to IBS.

Diagnosis

IBS is a diagnosis of exclusion, as there is no definitive test for the condition. The following methods are used:

Blood Tests: To rule out infections, celiac disease, or anemia.

Stool Tests: To check for infections or inflammatory markers.

Colonoscopy or Sigmoidoscopy: For patients with alarming symptoms like rectal bleeding or unintended weight loss.

Treatment Options

Antispasmodics: E.g., hyoscine or peppermint oil to relieve cramping.

Laxatives: For constipation (IBS-C).

Anti-diarrheal Agents: E.g., loperamide for IBS-D.

Probiotics: May improve gut flora and symptoms.

Antidepressants: Low doses of tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) for pain and stress relief.

Cognitive Behavioral Therapy (CBT) to manage stress.

Hypnotherapy to reduce gut sensitivity.

A type of inflammatory bowel disease (IBD) causing chronic inflammation and ulcers in the colon and rectum. Symptoms often include diarrhea (sometimes with blood), abdominal pain, and an urgent need to defecate.

Symptoms

Persistent diarrhea, often with blood, pus, or mucus

Abdominal pain or cramping, particularly in the lower left abdomen

Urgency to defecate and a feeling of incomplete bowel evacuation

Fatigue

Weight loss

Fever during flare-ups

Joint pain or swelling

Eye inflammation

Skin rashes or sores

Risk Factors

Age: Commonly diagnosed between ages 15 and 30, though it can occur at any age.

Family History: Higher risk if a close relative has IBD.

Ethnicity: More common in people of Ashkenazi Jewish descent.

Environment: More prevalent in industrialized countries, possibly due to diet or hygiene factors.

Immune System Dysfunction: An overactive immune response attacking the colon lining.

Diagnosis

Medical History and Physical Exam: Review of symptoms and family history of IBD.

Blood Tests: To detect anemia or signs of inflammation.

Stool Tests: To rule out infections and check for inflammatory markers.

Colonoscopy: Direct visualization of the colon, with biopsies of inflamed tissue.

Flexible Sigmoidoscopy: Examination of the lower colon.

CT or MRI Scans: Detailed imaging to assess inflammation and complications.

Capsule Endoscopy: Ingestible camera for further visualization if needed.

Treatment Options

Treatment focuses on reducing inflammation, controlling symptoms, and maintaining remission.

Aminosalicylates (5-ASAs): E.g., mesalamine or sulfasalazine, used to reduce inflammation in mild to moderate cases.

Corticosteroids: For short-term use during severe flare-ups.

Immunomodulators: E.g., azathioprine or methotrexate, to suppress the immune system.

Biologics: Targeted therapies like infliximab or adalimumab to block specific inflammatory pathways.

Janus Kinase (JAK) Inhibitors: E.g., tofacitinib for severe cases.

Proctocolectomy with ileal pouch-anal anastomosis (IPAA): Removal of the colon and rectum, with the creation of a pouch from the small intestine.

Ileostomy: A stoma is created to allow stool to exit the body if an IPAA is not possible.

Another type of IBD that can affect any part of the digestive tract, including the colon. It causes inflammation, deep ulcers, and scarring, often resulting in abdominal pain, diarrhea, weight loss, and fatigue.

Symptoms

Persistent diarrhea, which may be bloody

Abdominal pain or cramping, often in the lower right abdomen

Weight loss and reduced appetite

Nausea and vomiting

Fatigue

Fever

Joint pain or swelling

Eye inflammation

Skin rashes or sores

Mouth ulcers

Risk Factors

Age: Most commonly diagnosed between ages 15 and 35, but it can occur at any age.

Family History: Increased risk if a close relative has IBD.

Smoking: A significant risk factor and can worsen the disease course.

Ethnicity: Higher prevalence among people of Ashkenazi Jewish descent, but it can affect all ethnicities.

Environment: More common in urbanized, industrialized countries, possibly due to diet or lifestyle factors.

Immune System Dysregulation: An abnormal immune response attacking the digestive tract lining.

Diagnosis

Medical History and Physical Exam: Detailed review of symptoms, family history, and any prior episodes.

Blood Tests: To check for anemia, infection, or inflammation (elevated CRP or ESR).

Stool Tests: To rule out infections and check for markers of intestinal inflammation.

Colonoscopy with Biopsy: Allows direct visualization of the colon and terminal ileum, with biopsy samples taken to confirm diagnosis.

Upper Endoscopy: To examine the upper GI tract if symptoms suggest involvement.

CT or MRI Scans: Used to identify inflammation, strictures, fistulas, or abscesses.

Capsule Endoscopy: For visualizing the small intestine if other tests are inconclusive.

Treatment Options

Crohn’s disease treatment aims to reduce inflammation, control symptoms, and maintain remission.

Aminosalicylates (5-ASAs): For mild cases, though less effective in Crohn's than in ulcerative colitis.

Corticosteroids: E.g., prednisone for short-term control of inflammation during flare-ups.

Immunomodulators: E.g., azathioprine or methotrexate to suppress the immune system and maintain remission.

Surgery: Reserved for complications such as strictures, fistulas, abscesses, or severe cases unresponsive to medical treatment.

Swollen veins in the lower rectum or anus, often caused by increased pressure due to straining during bowel movements or pregnancy. Symptoms may include rectal bleeding, itching, and pain.

Symptoms

Painless bleeding during bowel movements (bright red blood on toilet paper or stool)

Prolapse (hemorrhoid pushing through the anus), causing discomfort

Itching or irritation around the anus

Swelling or a lump near the anus

Pain or discomfort, especially during bowel movements

Severe pain and swelling

Hard lump near the anus

Risk Factors

Straining: During bowel movements due to constipation or diarrhea.

Chronic Conditions: Conditions like chronic constipation, diarrhea, or irritable bowel syndrome.

Pregnancy: Increased pressure on pelvic veins during pregnancy.

Obesity: Added pressure on rectal veins.

Aging: Weakening of rectal tissue over time.

Sedentary Lifestyle: Prolonged sitting, especially on the toilet.

Low-Fiber Diet: Leading to constipation and straining.

Heavy Lifting: Regularly lifting heavy objects can increase pressure in the rectum.

Diagnosis

Medical History and Symptoms Review: Discussion of symptoms such as bleeding, itching, or pain.

Physical Exam: Visual inspection for external hemorrhoids or signs of prolapse.

Digital Rectal Exam: Palpation to check for abnormalities in the rectum.

Anoscopy or Proctoscopy: Use of a scope to examine internal hemorrhoids.

Other Tests (if necessary): Colonoscopy or sigmoidoscopy to rule out other causes of rectal bleeding, such as polyps or colorectal cancer.

Treatment Options

Pain Relief: Oral pain relievers (e.g., acetaminophen) for discomfort.

Laxatives or Stool Softeners: To reduce constipation and straining.

Rubber Band Ligation: A small band is placed around the base of an internal hemorrhoid to cut off blood flow.

Sclerotherapy: Injection of a chemical solution to shrink the hemorrhoid.

Coagulation (Infrared, Laser, or Bipolar): Techniques to harden and shrink hemorrhoidal tissue.

Hemorrhoidectomy: Complete removal of hemorrhoids, typically for large or recurrent cases.

Stapled Hemorrhoidopexy: A procedure that repositions the hemorrhoid and reduces blood flow to the tissue.

Small tears in the lining of the anus, often caused by passing hard stools or straining. They can cause pain during bowel movements, itching, and occasional bleeding.

Symptoms

Anal fissures are small tears in the lining of the anal canal, often causing significant discomfort. Common symptoms include:

Pain during bowel movements: Patients often experience a sharp or burning sensation during and after defecation, which can last for several hours.

Visible tear: A noticeable crack or tear in the skin around the anus may be present.

Bleeding: Bright red blood may appear on toilet paper or in the stool, and some may notice blood discoloring toilet water.

Discomfort: This can include cramping around the anus and itchiness in the anal region.

Chronic anal fissures, defined as those lasting more than eight weeks, may present with deeper tears and additional symptoms such as skin tags or fleshy growths near the fissure site.

Risk Factors

Several factors can increase the likelihood of developing anal fissures:

Constipation: Straining during bowel movements due to hard stools is a primary cause.

Diarrhea: Frequent loose stools can also lead to irritation and tearing.

Childbirth: Women may experience anal fissures following delivery due to trauma to the anal area.

Age: Older adults may have reduced blood circulation, increasing susceptibility to fissures.

Inflammatory bowel diseases (IBD): Conditions like Crohn's disease can contribute to fissure formation due to inflammation of the bowel.

Anal intercourse: This can cause trauma and increase the risk of fissures.

Diagnosis

Diagnosis typically involves a physical examination by a healthcare provider, who will assess symptoms and inspect the anal area. The key diagnostic steps include:

Medical history review: Discussing symptoms and bowel habits helps identify potential causes.

Physical examination: A visual inspection often reveals the fissure; in some cases, a digital rectal exam may be performed, although this can be painful and is not always necessary.

If a fissure is located off midline, further evaluation for underlying conditions such as Crohn's disease may be warranted.

Treatment Options

Treatment for anal fissures aims to relieve pain and promote healing. Options include:

Topical treatments: Nitroglycerin ointment or calcium channel blockers (like diltiazem) help relax the anal sphincter and increase blood flow to aid healing.

Botulinum toxin injections: These can temporarily paralyze the sphincter muscle to relieve spasms and pain, allowing the fissure to heal more effectively.

Surgical options: If conservative treatments fail after several weeks, surgical interventions such as lateral sphincterotomy may be considered. This procedure involves cutting part of the sphincter muscle to reduce tension and promote healing

Inflammation or infection of small pouches (diverticula) that form in the walls of the colon. Symptoms include severe abdominal pain (usually in the lower left side), fever, nausea, and changes in bowel habits.

Symptoms

Diverticulitis is characterized by inflammation or infection of diverticula, which are small pouches that can form in the walls of the colon. Common symptoms include:

Abdominal Pain: Typically sharp and located in the lower left abdomen.

Fever: Often accompanying the pain.

Nausea and Vomiting: May occur alongside other symptoms.

Bloating: Distension of the abdomen is common.

Changes in Bowel Habits: This can include constipation or diarrhea.

Blood in Stool: May present as minor bleeding or more significant hemorrhage.

In contrast, diverticulosis, the presence of diverticula without inflammation, is often asymptomatic but can lead to mild symptoms such as bloating, constipation, and occasional abdominal discomfort.

Risk Factors

Several risk factors have been identified for developing diverticulitis:

Age: Higher prevalence in individuals over 50 years old.

Obesity: A body mass index (BMI) greater than 30 increases risk.

Sedentary Lifestyle: Lack of physical activity contributes to risk.

Diet: Low fiber intake and diets high in red meat, sugar, and fat are linked to increased risk.

Family History: Genetic predisposition plays a role.

Smoking and Certain Medications: Use of nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and steroids may increase susceptibility.

Diagnosis

Diagnosis typically involves a combination of medical history review, physical examination, and imaging tests:

CT Scan: The most reliable method for diagnosing diverticulitis; it provides detailed images of the abdomen and can assess the severity of the condition.

Colonoscopy: Used to visualize the colon but generally not performed during an acute episode due to risk of perforation.

Blood Tests: To check for signs of infection, such as elevated white blood cell counts.

Treatment Options

Treatment strategies vary based on the severity of the condition:

Antibiotics: Often prescribed to treat infections associated with diverticulitis. In uncomplicated cases, antibiotics may not be necessary.

Hospitalization: Required for severe diverticulitis where intravenous antibiotics and possibly fluids are administered.

Surgery: Considered for recurrent episodes or complications like abscesses or perforation. Surgical options typically involve resection of the affected segment of the colon.

Growths in the lining of the colon or rectum that can be benign or precancerous. While often asymptomatic, they may cause minor bleeding or changes in bowel habits. Regular screening is essential to prevent progression to colorectal cancer.

Symptoms

Colorectal polyps often do not present any symptoms, making them difficult to detect without screening. When symptoms do occur, they may include:

Rectal bleeding: Blood may appear in the stool, on toilet paper, or in the toilet bowl.

Changes in bowel habits: This can include prolonged constipation or diarrhea lasting more than a week.

Abdominal pain: Discomfort or pain in the belly area.

Fatigue or shortness of breath: These can indicate anemia due to blood loss from the polyps1611.

Risk Factors

Several factors can increase the likelihood of developing colorectal polyps:

Age: Risk increases significantly after age 50.

Family history: A personal or family history of colorectal cancer or adenomatous polyps.

Diet: High intake of red and processed meats is associated with a higher risk.

Obesity and physical inactivity: Being overweight and leading a sedentary lifestyle are contributing factors.

Smoking and alcohol consumption: Both habits are linked to increased risk.

Genetic conditions: Conditions such as familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC) greatly elevate risk.

Diagnosis

Colorectal polyps are typically diagnosed through various screening methods:

Colonoscopy: The most common procedure where a long, flexible tube with a camera is inserted into the rectum to view the colon. Polyps can often be removed during this procedure.

Flexible sigmoidoscopy: Similar to colonoscopy but examines only the lower part of the colon.

Virtual colonoscopy (CT colonography): Uses imaging techniques to visualize the colon but does not allow for polyp removal.

Lower gastrointestinal series: Involves X-rays taken after barium is introduced into the bowel to highlight abnormalities.

Treatment Options

The primary treatment for colorectal polyps is removal, which can often be performed during diagnostic procedures:

Polypectomy: Removal of polyps during a colonoscopy using special tools. This is typically effective for smaller polyps.

Surgery: Larger or difficult-to-remove polyps may require surgical intervention. In cases of extensive polyp growth or genetic conditions, partial or total removal of the colon may be necessary.