Trusted Care for Colorectal Disorders

Diagnosing Colorectal Disorders

If you or your doctor suspect you are suffering from a colorectal problem, tests may be performed:

• Traditional colonoscopy — A small tube with a camera attached is inserted into your rectum while you are asleep to allow a visual inspection of your colon. Any and all polyps are easily removed and/or biopsied. This is the most thorough and complete evaluation that can be done, and it has a very low percentage of missed tumors or pre-cancerous polyps.‍
• Flexible sigmoidoscopy — This procedure also uses a small tube and camera, but it examines only the rectum and lower part of the colon, and is used to help diagnose rectal issues. This evaluation does NOT examine the entire colon, and therefore can miss tumors/cancers or pre-cancerous polyps in other parts of the colon. ‍
• Virtual colonoscopy or CT colonography— The colon is examined using computer imaging. The procedure is less invasive than a traditional colonoscopy. However, you are exposed to radiation and any polyps or growths seen cannot be removed and would require a traditional colonoscopy to remove any polyps or growths.‍
• Barium enema — Like a virtual colonoscopy, this procedure is not as invasive as other tests. A contrast dye is inserted into the rectum via a tube, while completely awake, so that any abnormalities can be seen by X-ray. However, you are exposed to radiation and any polyps or growths seen cannot be removed and would require a traditional colonoscopy for removal.‍
• Stool sample tests — Performed ONLY on individuals with average risk for colorectal cancer. It is NOT to be performed on individuals of high risk. 
• Highly sensitive fecal immunochemical test (FIT) — 1-3 stool samples are tested for microscopic blood. This can be a sign of a bleeding polyp, cancerous polyp, or colorectal cancer. This test should be performed annually. It does not require a prep, is easy to perform, and requires no special diet. However, there can be false-negatives. And if positive, it will require a traditional colonoscopy. Also, people in high risk categories can NOT utilize this test. ‍
• Multi-targeted stool DNA test (MT-sDNA) (i.e., Cologuard®) — 1 stool sample is tested for altered DNA in the stool or blood in the stool. This can be a sign of a bleeding polyp, cancerous polyp, or colorectal cancer. This test can be performed every 3 years. It does not require a prep, is easy to perform, and requires no special diet. However, there can be false-negatives. And if positive, it will require a traditional colonoscopy. Also, people in high risk categories can NOT utilize this test. ‍
• Highly sensitive guaiac-based fecal occult blood test (gFOBT) — Multiple stool samples are taken over a period of 3 days. It detects microscopic blood in the stool. This can be a sign of a bleeding polyp, cancerous polyp, or colorectal cancer. This test should be performed annually. It does not require a prep, and it is easy to perform. However, there can be false-negatives and a special diet is required. If positive, it will require a traditional colonoscopy. Also, people in high risk categories can NOT utilize this test.
  

High Risk Categories for Colorectal Cancer

• A personal history of colorectal cancer or certain types of precancerous polyps, such as adenomas 
• A family history of colorectal cancer
• A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
• A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
• A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer

Medical and Surgical Solutions

• Lifestyle changes — For issues such as IBS, Crohn’s disease, and diverticulosis, diet and exercise can be helpful at reducing symptoms.
• Prescription medication — Can be useful to reduce inflammation, pain, and infection.
• Polyp removal during colonoscopy — These are completely removed and by being removed, it can prevent the development of colorectal cancer. 
• Cancer treatments — Will include surgical colon resection and possibly other medical approaches, including chemotherapy, if indicated.

Recovery Time

A simple colonoscopy is an outpatient procedure. You will take a colon prep the day before the procedure and recuperate the rest of the day of the procedure at home. 

If a surgical procedure is required, the recovery process will be somewhat longer. However, minimally invasive surgical techniques and other modalities are utilized to minimize recovery, pain, and complications. 

Some conditions such as IBS and diverticulosis may last throughout your life but can be managed with medication and lifestyle changes.

Recommended Diet and Lifestyle Changes 

Adjusting your diet can be helpful for eliminating minor colorectal issues and preventing complications of colorectal diseases.

• Eliminate unhealthy foods — Foods high in saturated or trans fats, processed foods, and refined carbohydrates, such as white bread and white rice
• Eat a healthy high-fiber diet — Fruits, vegetables, fiber, low-fat dairy products, dark leafy greens, tofu, beans, lentils, nuts, fish
• Exercise daily — A sedentary lifestyle adds to colorectal issues. Do something daily to move around — walking, jogging, biking, swimming, etc.