Colon polyps are fleshy round tumors which arise from the lining of the colon and gradually enlarge. They are initially benign (negative for cancer), but in time, some can become malignant (positive for cancer). Most colon cancers begin as benign polyps, thus the importance of colon screening and polyp removal. Polypectomy is the technique used to remove a polyp in which a snare (wire lasso) is placed around the polyp and squeezed down on as electric current is applied to cut through and seal off the polyp. The polyp is then collected and sent to the laboratory to determine its cell type. The cell type of the polyp determines when a repeat colonoscopy will be recommended or if further treatment is required. If you are found to have polyp(s), you should inform your immediate relatives (parent, siblings, children) so they can schedule colonoscopy in a timely manner as well.
Biopsy Analysis and Interpretation
A biopsy is the microscopic examination of a tissue sample to determine the presence or cause of a disease. Biopsy analysis requires the skill of a highly trained doctor called a Pathologist. A Pathologist is a physician who specializes in the diagnosis of disease based on the analysis (inspection) of these small tissue samples called a biopsy.
If a biopsy is obtained, the tissue is processed and an extremely thin slice of tissue is removed and attached to a glass slide. The remaining tissue is stored for further studies, if required. Because they are very small (microscopic), the slide is stained with special dyes that allow the Pathologist to see them more clearly. This process is very technical and is performed in a specialized laboratory. Based on the findings, the Pathologist prepares a written report that will list any abnormalities or important findings. These results are sent to the doctor who performed your examination and a plan for your treatment will be discussed with you.
Colorectal cancer is cancer that occurs anywhere in the colon or rectum. A person's lifetime chance of having colon cancer is 6 in 100. If there is a family history of colon cancer/polyps or other conditions, the risk is even higher. The colon is the lowest portion of the large intestine and is the last part of the digestive system through which food passes. The rectum is the final section of the colon, through which solid wastes are eliminated from the body. It usually begins as a benign growth on the lining of the colon or the rectum (also known as polyps) over time, these polyps may begin to grow at a rapid rate. When this happens, they become malignant.
Colorectal cancer is one of the most common forms of cancer. It ranks third in frequency behind lung and prostate cancer in men in the United States. It is also third in frequency behind lung and breast cancer in women. Colorectal cancer accounts for about 10 percent of all new cases of cancer each year in the United States.
Strictures / Dilatation
Esophageal Dilatation is performed when a patient has difficulty swallowing. A common complaint from the patient is that of food "sticking" upon swallowing and possibly not going down into the stomach very easily. This complaint needs the care of a Gastroenterologist who can help the patient so this problem does not become an emergency. There are several possible causes of this complaint, and most frequently seen is a stricture of the Esophagus. This is a narrowing in the "swallowing tube." It is a separate place from where the patient takes air into his or her lungs. During upper endoscopy, the Gastroenterologist is able to look down into the swallowing tube by first sedating the patient, and then passing a soft flexible tube (endoscope), into the esophagus. By direct visualization, the doctor can usually tell if there is a narrowing that needs treatment. While the patient is still asleep, the narrowing can be stretched by passing a balloon or a dilator down to the narrowed location. This will stretch the narrowed part of the esophagus, and let the patient swallow normally again. In some cases this procedure needs to be repeated at some point in the future. This is generally a painless procedure and may give instant relief from the original complaint.
The colon, or large intestine, can also develop a stricture, or narrowing after surgery which may need to be stretched. This happens at the place where one side of the colon was connected to the other side during surgery. A patient who has this narrowing will complain of constipation, and need therapy from a Gastroenterologist, who will perform a therapeutic Colonoscopy. During Colonoscopy, the patient is sedated and a soft flexible tube is passed into the colon from the rectum. The doctor can then pass a Dilator Balloon (made for treatment of this problem) through the Colonoscope to the stricture. While the patient is still sedated, the narrowing will be stretched, resulting in easier passage of stool along the colon and resolution of the constipation.
Crohn’s disease is an inflammatory bowel disease that results from the swelling of the digestive tract anywhere from the mouth to the anus, but most commonly affects the lower part of the small intestine, or the ileum. Symptoms include abdominal pain, fever, diarrhea, and blood in the stool. Crohn’s disease can affect both men and women through all age groups, but the disease tends to be diagnosed between the ages of 20 to 30. There is a higher risk of developing this disease if a blood relative has already been diagnosed. There is no known cure for this disease, but with the proper therapies you can greatly reduce the signs and symptoms.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome is a common disorder that affects the large intestine (colon). Irritable bowel syndrome commonly causes cramping, abdominal pain, bloating, gas, diarrhea and constipation. Despite these uncomfortable signs and symptoms, IBS does not cause permanent damage to your colon.
Most people with IBS find that symptoms improve as they learn to control their condition. Only a small number of people with irritable bowel syndrome have severe signs and symptoms.
Fortunately, unlike more serious intestinal diseases such as Ulcerative Colitis and Crohn's disease, irritable bowel syndrome does not cause inflammation or changes in bowel tissue or increase your risk of colorectal cancer. In many cases, you can control IBS by managing your diet, lifestyle and stress.
Reflux Disease (GERD)
GERD (gastroesophageal reflux disease) is a condition in which the patient experiences the presence of stomach acids flowing up into the esophagus. This condition can produce symptoms of burning, chest pain, nausea, and sour taste in mouth. Untreated GERD can lead to Barrett's esophagus, which can increase the risk of Esophageal Cancer. This can be diagnosed by an upper endoscopy.
Hiatal hernia occurs when a weakness develops in your diaphragm which is the muscle that separates your abdominal organs (including stomach) from your chest organs (including esophagus). Normally, the stomach sits below the diaphragm and the esophagus above. In the presence of hiatal hernia, the stomach slips/slides up through the weakened area in the diaphragm and into the chest cavity. This can produce pain, discomfort, bloating, belching, reflux, and heartburn. Hiatal hernia and related symptoms can be worsened by excessive weight, pregnancy, wearing tight fitting clothing, coughing, straining, vomiting, or sudden physical exertion which causes increased pressure in the abdomen.
Ulcerative Colitis (UC) is a disease that causes inflammation and ulcers in the lining of the colon and rectum. The inflammation kills the normal lining of the colon causing ulcers which then bleed and produce pus. This causes the bowel to empty frequently resulting in diarrhea. Ulcerative colitis differs from Crohn's disease in that Crohn's extends deeper into the lining of the intestine and can occur anywhere in the GI tract. There are several theories as to what causes Ulcerative Colitis, though none have been proven. It is thought to be caused by an altered immune response from the body which sees certain food, bacteria, and other substances as foreign thus causing the body to attack the "invaders" leading to the accumulation of white blood cells which then causes inflammation and subsequent ulcers. Ulcerative colitis usually develops between the ages of 15 and 30. It affects males and females equally and tends to run in families. Symptoms of UC include abdominal pain and bloody diarrhea, but patients may also experience anemia fatigue, weight loss, and loss of appetite, joint pain, and skin lesions.
Barrett's esophagus is a condition in which cells normally found in the small intestine are displaced and begin to migrate into the esophagus. This occurs secondary to acid reflux or GERD. The significance of this condition is that there is a potential for the development of esophageal cancer (0.5% per year). Thus, regular screening (EGD w/ biopsies) is required in patients who are diagnosed w/ Barrett's esophagus.