INTRODUCTION: The colon is the last part of the intestine; it holds the stool after digestion is complete, and removes excess water from the stool until it is eliminated in a bowel movement. The colon is often affected by problems which require operation. This pamphlet is meant to inform you about some of the diseases of the colon.
CONSTIPATION is a condition which occurs when the stool becomes hard and difficult to eliminate because it does not contain enough water. This can happen if the stool sits in the colon for too long, such as in someone who is sick or injured and not eating, or if the person does not take in enough fluids to keep the stool soft. Fiber helps this condition by acting like a sponge in the stool to keep it moist; the best ways to avoid constipation are to eat plenty of fiber and drink plenty of water.
DIVERTICULOSIS is a very common condition which almost everyone develops as they get older. It usually causes no problems. It consists of small areas of weakening in the wall of the intestine which develop into little pouches about the size of a pea. These are thought to be caused by increased pressure within the bowel. The pressure in the bowel can be lowered by avoiding constipation by the measures described above. Occasionally, infection can develop in one of these pouches; when this happens, diverticulitis is said to be present. This condition causes pain and fever, sometimes diarrhea. If perforation of the infection occurs, severe complications can set in, and emergency operation is often necessary. In most cases, however, diverticulitis can be cured with antibiotics. If the condition recurs repeatedly, then surgical removal of the involved part of the colon is necessary.
COLON POLYPS are growths in the lining of the intestine, which are usually made up of abnormal, rapidly growing mucus glands. Polyps occasionally turn into cancerous growths, especially if they are allowed to get too big (more than half an inch). For that reason, if a polyp is found, it is usually removed. This can frequently be done with colonoscopy. This involves using a long flexible viewing instrument to look at the inside of the colon. Tools can be placed through the instrument in order to remove small growths or to biopsy larger ones. Polyps often show up during investigation of rectal bleeding or diarrhea. These symptoms are also seen in cases of colon cancer.
COLON CANCER is the third most common type of cancer in this country (the first is lung cancer and the second is breast cancer). It is thought to develop from colon polyps, and occurs more often in people who have relatives with the disease and in people with ulcerative colitis. It seems that a low-fat, high-fiber diet helps prevent colon cancer. If cancer develops in the lining of the intestine, it grows into the wall of the intestine, and over time may cause bleeding or blockage of the colon. If the cancer is removed before it has grown through the wall of the intestine or spread to any of the lymph nodes in the area, there is a very good chance of cure. If the cancer has grown through the wall or spread to any of the lymph nodes, the chances of its coming back following surgery are greater.
Sometimes it is difficult to know before the operation exactly what the problem is. Both diverticulitis and cancer can look the same on x-rays and other tests. Both can cause bleeding and blockage of the intestine. Also, large polyps can look like cancer, even though they are benign.
