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Colon

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Colon

The colon is also known as the large bowel or large intestine. It is an organ that is part of the digestive system (also called the digestive tract) in the human body. The digestive system is the group of organs that allow us to eat and to use the food we eat to fuel our bodies.Encyclopedia Entry for Colon :Colon and rectal cancer. In the United States, colorectal cancer is one of the leading causes of deaths due to cancer. Early diagnosis can often lead to a complete cure. Almost all colon cancers start in the lining of the colon and rectum. When doctors talk about colorectal cancer, this is usually what they are talking about. There is no single cause of colon cancer. Nearly all colon cancers begin as noncancerous (benign) polyps, which slowly develop into cancer. You have a higher risk for colon cancer if you: Are older than 60 Are African American or of eastern European descent Eat a lot of red or processed meats Have colorectal polyps Have inflammatory bowel disease ( Crohn disease or ulcerative colitis ) Have a family history of colon cancer Some inherited diseases also increase the risk of developing colon cancer. One of the most common is called familial adenomatous polyposis (FAP). What you eat may play a role in getting colon cancer. Colon cancer may be linked to a high-fat, low-fiber diet and to a high intake of red meat. Some studies have found that the risk does not drop if you switch to a high-fiber diet, so this link is not yet clear. Smoking cigarettes and drinking alcohol are other risk factors for colorectal cancer.Many cases of colon cancer have no symptoms. If there are symptoms, the following may indicate colon cancer: Abdominal pain and tenderness in the lower abdomen Blood in the stool Diarrhea , constipation, or other change in bowel habits Narrow stools Weight loss with no known reason.Through screening tests, colon cancer can be detected before symptoms develop. This is when the cancer is most curable. Your doctor will perform a physical exam and press on your belly area. The physical exam rarely shows any problems, although the doctor may feel a lump (mass) in the abdomen. A rectal exam may reveal a mass in people with rectal cancer, but not colon cancer. A fecal occult blood test (FOBT) may detect small amounts of blood in the stool. This may suggest colon cancer. A sigmoidoscopy , or more likely, a colonoscopy , will be done to evaluate the cause of blood in your stool. Only a full colonoscopy can see the entire colon. This is the best screening test for colon cancer. Colon culture Blood tests may be done for those diagnosed with colorectal cancer, including: Complete blood count (CBC) to check for anemia Liver function tests If you are diagnosed with colorectal cancer, more tests will be done to see if the cancer has spread. This is called staging. CT or MRI scans of the abdomen, pelvic area, or chest may be used to stage the cancer. Sometimes, PET scans are also used. Stages of colon cancer are: Stage 0: Very early cancer on the innermost layer of the intestine Stage I: Cancer is in the inner layers of the colon Stage II: Cancer has spread through the muscle wall of the colon Stage III: Cancer has spread to the lymph nodes Stage IV: Cancer has spread to other organs outside the colon Blood tests to detect tumor markers, such as carcinoembryonic antigen (CEA) may help the doctor follow you during and after treatment. Stages of cancer.Treatment depends on many things, including the stage of the cancer. Treatments may include: Surgery to remove the tumor Chemotherapy to kill cancer cells Radiation therapy to destroy cancerous tissue Targeted therapy to keep cancer from growing and spreading SURGERY Stage 0 colon cancer may be treated by removing the tumor. This is often done using colonoscopy. For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous. This surgery is called colon resection (colectomy). CHEMOTHERAPY Almost all people with stage III colon cancer receive chemotherapy after surgery for 6 to 8 months. This is called adjuvant chemotherapy. Even though the tumor was removed, chemotherapy is given to treat any cancer cells that may be left. Chemotherapy is also used to improve symptoms and prolong survival in people with stage IV colon cancer. You may receive just one type of medicine or a combination of medicines. RADIATION Radiation therapy is sometimes used for colon cancer. For people with stage IV disease that has spread to the liver, treatment directed at the liver can be used. This may include: Burning the cancer (ablation) Delivering chemotherapy or radiation directly into the liver Freezing the cancer (cryotherapy) Surgery TARGETED THERAPY Targeted treatment zeroes in on specific targets (molecules) in cancer cells. These targets play a role in how cancer cells grow and survive. Using these targets, the drug disables the cancer cells so they cannot spread. Targeted therapy may be given as pills or may be injected into a vein. You may have targeted therapy along with surgery, chemotherapy, or radiation treatment.You can ease the stress of illness by joining a colon cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.In many cases, colon cancer is treatable when caught early. How well you do depends on many things, especially the stage of the cancer. When treated at an early stage, many people survive at least 5 years after diagnosis. This is called the 5-year survival rate. If the colon cancer does not come back (recur) within 5 years, it is considered cured. Stages I, II, and III cancers are considered possibly curable. In most cases, stage IV cancer is not considered curable, although there are exceptions.Complications may include: Blockage of the colon, causing bowel obstruction Cancer returning in the colon Cancer spreading to other organs or tissues ( metastasis ) Development of a second primary colorectal cancer.Call your health care provider if you have: Black, tar-like stools Blood during a bowel movement Change in bowel habits Unexplained weight loss.Colon cancer can almost always be caught by colonoscopy in its earliest and most curable stages. Almost all men and women age 50 and older should have a colon cancer screening. People at higher risk may need earlier screening. Colon cancer screening can often find polyps before they become cancerous. Removing these polyps may prevent colon cancer. Changing your diet and lifestyle is important. Medical research suggests that low-fat and high-fiber diets may reduce your risk for colon cancer. Some studies have reported that NSAIDs (aspirin, ibuprofen, naproxen, and celecoxib) may help reduce the risk for colorectal cancer. But these medicines can increase your risk of bleeding and heart problems. Your provider can tell you more about the risks and benefits of the medicines and other ways that help prevent colorectal cancer.Colorectal cancer; Cancer - colon; Rectal cancer; Cancer - rectum; Adenocarcinoma - colon; Colon - adenocarcinoma; Colon carcinoma.Abdominal radiation - discharge Bland diet Changing your ostomy pouch Chemotherapy - what to ask your doctor Ileostomy and your child Ileostomy and your diet Ileostomy - caring for your stoma Ileostomy - changing your pouch Ileostomy - discharge Ileostomy - what to ask your doctor Large bowel resection - discharge Living with your ileostomy Pelvic radiation - discharge Radiation therapy - questions to ask your doctor Small bowel resection - discharge Total colectomy or proctocolectomy - discharge Types of ileostomy.Barium enema Barium enema Colonoscopy Colonoscopy Digestive system Digestive system Rectal cancer, X-ray Rectal cancer, x-ray Sigmoid colon cancer, X-ray Sigmoid colon cancer, x-ray Spleen metastasis - CT scan Spleen metastasis - CT scan Structure of the colon Structure of the colon Stages of cancer Stages of cancer Colon culture Colon polyps Colon cancer - Series Colon cancer - Series Colostomy - Series Colostomy - Series Large bowel resection - Series Large bowel resection - Series Large intestine (colon) Large intestine (colon).Itzkowitz SH, Potack J. Colonic polyps and polyposis syndromes.Encyclopedia Entry for Colon :Colon cancer - resources. Resources - colon cancer.Encyclopedia Entry for Colon :Colon cancer screening. SCREENING TESTS There are several ways to screen for colon cancer. Stool test: Polyps in the colon and small cancers can cause small amounts of bleeding that cannot be seen with the naked eye. But blood can often be found in the stool. This method checks your stool for blood. The most common test used is the fecal occult blood test (FOBT). Two other tests are called the fecal immunochemical test (FIT) and stool DNA test (sDNA). Sigmoidoscopy : This test uses a small flexible scope to view the lower part of your colon. Because the test only looks at the last one third of the large intestine (colon), it may miss some cancers that are higher in the large intestine. Sigmoidoscopy and a stool test may be used together. Colonoscopy Colonoscopy : A colonoscopy is similar to a sigmoidoscopy, but the entire colon can be viewed. Your health care provider will give you the steps for cleansing your bowel. This is called bowel preparation. During a colonoscopy, you receive medicine to make you relaxed and sleepy. Sometimes, CT scans are used as an alternative to a regular colonoscopy. This is called a virtual colonoscopy. Sigmoid colon cancer, X-ray Other test: Capsule endoscopy involves swallowing a small, pill-sized camera that takes a video of the inside of your intestines. The method is being studied, so it is not recommended for standard screening at this time. SCREENING FOR AVERAGE-RISK PEOPLE There is not enough evidence to say which screening method is best. But, colonoscopy is most thorough. Talk to your health care provider about which test is right for you. Both men and women should have a colon cancer screening test starting at age 50. Some providers recommend that African Americans begin screening at age 45. Screening options for people with an average risk for colon cancer: Colonoscopy every 10 years FOBT or FIT every year (colonoscopy is needed if results are positive) sDNA every 1 or 3 years (colonoscopy is needed if results are positive) Flexible sigmoidoscopy every 5 to 10 years, usually with stool testing FOBT done every 1 to 3 years Virtual colonoscopy every 5 years SCREENING FOR HIGHER-RISK PEOPLE People with certain risk factors for colon cancer may need earlier (before age 50) or more frequent testing. More common risk factors are: A family history of inherited colorectal cancer syndromes, such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (HNPCC). A strong family history of colorectal cancer or polyps. This usually means close relatives (parent, sibling, or child) who developed these conditions younger than age 60. A personal history of colorectal cancer or polyps. A personal history of long-term (chronic) inflammatory bowel disease (for example ulcerative colitis or Crohn disease ). Screening for these groups is more likely to be done using colonoscopy.Screening for colon cancer; Colonoscopy - screening; Sigmoidoscopy - screening; Virtual colonoscopy - screening; Fecal immunochemical test; Stool DNA test; sDNA test; Colorectal cancer - screening; Rectal cancer - screening.Ulcerative colitis - discharge.Colonoscopy Colonoscopy Large intestine anatomy Large intestine anatomy Sigmoid colon cancer, X-ray Sigmoid colon cancer, x-ray Fecal occult blood test Fecal occult blood test.Itzkowitz SH, Potack J. Colonic polyps and polyposis syndromes.Encyclopedia Entry for Colon :Colonoscopy discharge. This is what the procedure involved: You were likely given medicine into a vein (IV) to help you relax. You should not feel any pain. The colonoscope was gently inserted through the anus and was carefully moved into the large intestine. Air was inserted through the scope to provide a better view. Tissue samples ( biopsy or polyps ) may have been removed using tiny tools inserted through the scope. Photos may have been taken using the camera at the end of the scope.You will be taken to an area to recover right after the test. You may wake up there and not remember how you got there. The nurse will check your blood pressure and pulse. Your IV will be removed. Your doctor will likely come to talk to you and explain the results of the test. Ask to have this information written down, as you may not remember what you were told later on. Final results for any tissue biopsies that were done may take up to 1 to 3 weeks.Medicines you were given can change the way you think and make it harder to remember for the rest of the day. As a result, it is NOT safe for you to drive a car or find your own way home. You will not be allowed to leave alone. You will need a friend or family member to take you home.You will be asked to wait 30 minutes or more before drinking. Try small sips of water first. When you can do this easily, you should begin with small amounts of solid foods. You may feel a little bloated from air pumped into your colon, and burp or pass gas more often over the day. If gas and bloating bother you, here are some things you can do: Use a heating pad Walk around Lie on your left side.DO NOT plan to return to work for the rest of the day. It is not safe to drive or handle tools or equipment. You should also avoid making important work or legal decisions for the rest of the day, even if you believe your thinking is clear. Keep an eye on the site where the IV fluids and medicines were given. Watch for any redness or swelling. Ask your doctor which medicines or blood thinners you should start taking again and when to take them. If you had a polyp removed, your provider may ask you to avoid lifting and other activities for up to 1 week.Call your provider if you have: Black, tarry stools Red blood in your stool Vomiting that will not stop or vomiting blood Severe pain or cramps in your belly Chest pain Blood in your stool for more than 2 bowel movements Chills or fever over 101 F (38.3 C) No bowel movement for more than 3 to 4 days.Lower endoscopy.Blanke CD, Faigel DO. Neoplasms of the small and large intestine.Encyclopedia Entry for Colon :Colonoscopy. Colonoscopy is done most often in a procedure room at your doctor's office. It can also be done in the outpatient department of a hospital or medical center. You will be asked to change out of your street clothes and wear a hospital gown for the procedure. You will likely be given medicine into a vein (IV) to help you relax. You should not feel any pain. You may be awake during the test and may even be able to speak. You will probably not remember anything. You lie on your left side with your knees drawn up toward your chest. The scope is gently inserted through the anus. It is carefully moved into the beginning of the large intestine. The scope is slowly advanced as far as the lowest part of the small intestine. Air is inserted through the scope to provide a better view. Suction may be used to remove fluid or stool. The doctor gets a better view as the scope is moved back out. So, a more careful exam is done while the scope is being pulled back. Tissue samples ( biopsy ) or polyps may be removed using tiny tools inserted through the scope. Photos may be taken using the camera at the end of the scope. If needed, procedures, such as laser therapy , are also done.Your bowel needs to be completely empty and clean for the exam. A problem in your large intestine that needs to be treated may be missed if your intestines are not cleaned out. Your health care provider will give you the steps for cleansing your bowel. This is called bowel preparation. Steps may include: Using enemas Not eating solid foods for 1 to 3 days before the test Taking laxatives You need to drink plenty of clear liquids for 1 to 3 days before the test. Examples of clear liquids are: Clear coffee or tea Fat-free bouillon or broth Gelatin Sports drinks without added color Strained fruit juices Water You will likely be told to stop taking aspirin, ibuprofen, naproxen, or other blood-thinning medicines for several days before the test. Keep taking your other medicines unless your doctor tells you otherwise. You will need to stop taking iron pills or liquids a few days before the test, unless your provider tells you it is OK to continue. Iron can make your stool dark black. This makes it harder for the doctor to view inside your bowel.The medicines will make you sleepy so that you may not feel any discomfort or have any memory of the test. You may feel pressure as the scope moves inside. You may feel brief cramping and gas pains as air is inserted or the scope advances. Passing gas is necessary and should be expected. After the exam, you may have mild abdominal cramping and pass a lot of gas. You may also feel bloated and sick to your stomach. These feelings will soon go away. You should be able to go home about 1 hour after the test. You must plan to have someone take you home after the test, because you will be woozy and unable to drive. The providers will not let you leave until someone arrives to help you. When you are home, follow instructions on recovering from the procedure. These may include: Drink plenty of liquids. Eat a healthy meal to restore your energy. You should be able to return to your regular activities the next day. Avoid driving, operating machinery, drinking alcohol, and making important decisions for at least 24 hours after the test.Colonoscopy may be done for the following reasons: Abdominal pain, changes in bowel movements, or weight loss Abnormal changes (polyps) found on sigmoidoscopy or x-ray tests ( CT scan or barium enema ) Anemia due to low iron (usually when no other cause has been found) Blood in the stool , or black, tarry stools Follow-up of a past finding, such as polyps or colon cancer Inflammatory bowel disease ( ulcerative colitis and Crohn disease ) Screening for colorectal cancer.Normal findings are healthy intestinal tissues.Abnormal test results may mean any of the following: Abnormal pouches on the lining of the intestines, called diverticulosis Areas of bleeding Cancer in the colon or rectum Colitis (a swollen and inflamed intestine) due to Crohn disease, ulcerative colitis, infection, or lack of blood flow Small growths called polyps on the lining of your colon (which can be removed through the colonoscope during the exam).Risks of colonoscopy may include any of the following: Heavy or ongoing bleeding from biopsy or removal of polyps Hole or tear in the wall of the colon that requires surgery to repair Infection needing antibiotic therapy (very rare) Reaction to the medicine you are given to relax, causing breathing problems or low blood pressure.Colon cancer - colonoscopy; Colorectal cancer - colonoscopy; Colonoscopy - screening; Colon polyps - colonoscopy; Ulcerative colitis - colonoscopy; Crohn disease - colonoscopy; Diverticulitis - colonoscopy; Diarrhea - colonoscopy; Anemia - colonoscopy; Blood in stool - colonoscopy.Colonoscopy Colonoscopy Colonoscopy Colonoscopy.Chernecky CC, Berger BJ. Colonoscopy - diagnostic.