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Colon

What does the colon do?
The colon is a tube like structure in your body that processes the waste from your stomach and small intestine. The colon absorbs nutrients from digested foods and absorbs them into the body. Then the colon stores and solidifies waste until it is expelled from your rectum as stool. Your colon may change over time as you age and several conditions may result.

Without enough water and fiber your digestive is forced to work harder to move stools through your colon. The resulting pressure can cause the lining of the colon wall to bulge out into pouches called diverticula. This disease is called diverticulosis. When the diverticula become infected or inflamed the disease becomes known as diverticulitis.

A growth may form on the colon lining. A benign growth is called a polyp and can vary in size. Early removal of benign polyps may prevent them from becoming cancers. A cancer is made up of abnormal cells that grow out of control. Cancers tend to be larger than polyps and need to be removed as soon as they are discovered.If cancer cells break off from a cancerous growth, they may travel through the colon lining into the lymph glands and blood vessels. In some cases the cancerous cells are carried to other organs and start new cancers, which is called metastasis.

Treatment
The first step in diagnosing a colon problem is to receive a thorough evaluation to help control your condition. The examination may also include such tests as a digital rectal exam to detect rectal cancers; a sigmoidoscopy to view the part of the colon closest to the rectum to find polyps; a barium enema (liquid barium fills the colon so an x-ray can make abnormalities more visible); or a colonoscopy to view the entire colon and diagnose growths and to confirm results from other tests.

Diverticulosis
The main ways to control diverticulosis are liquids and fiber (roughage). Fiber absorbs water as it travels through the colon and helps stool to stay soft. Over-the-counter stool bulking agents may help as may stool softeners or antispasmodic medications for pain in more severe cases. Exercise may also be a help.

Diverticulitis
Treatment for this condition often begins with a temporary diet and oral antibiotics. If the condition becomes severe you may need hospitalization and intravenous antibiotics. Surgery may become necessary if these treatments do not control your problem, or if complications develop. If surgery becomes required, the procedure may be performed through open surgery or laparoscopy. You should discuss with your surgeon which approach is appropriate for you. To remove the problem area the affected section of the colon is taken out and the remaining ends of the colon are reattached. In some cases a separate procedure called a colostomy is necessary to create a temporary opening for waste elimination. After the body has sufficiently healed the colostomy can be reversed so the bowel can again function normally.The most common risks and complications associated with surgical solutions to diverticulosis and diverticulitis are rare but include bleeding, infection, or injury to the surrounding nerves. After surgery you can help keep your colon healthy with the proper diet. This will include plenty of high-fiber fruits, vegetables, and whole grains in you meals, along with plenty of liquids such as water and juice.

Colon Cancer
Treatment for colon cancer begins much the same way as with diverticulosis and diverticulitis with the need to identify exactly where the cancer is located, its size and whether the cancer cells may have spread. In order to do this the tests again may include digital rectal exam, sigmoidoscopy, barium enema, or colonoscopy. In addition, tests may also include a chest x-ray to check the lungs, CT scans of the abdomen and pelvis and blood tests. Next, you will need to prepare for surgery by stopping smoking, stopping taking blood thinners such as aspirin, and receiving a thorough checkup to assess your heart and lungs. These steps will help in reducing the risks of bleeding and infection. Your prior medical history and other present conditions may also require clearance from various specialists before surgery can take place, or may require you to be admitted to the hospital the day before surgery. Just before surgery you will be required to go on a clear liquid diet, to take a bowel preparation to clean the system of stool, receive directions as to which medications you should stop and which you should continue taking before and after surgery. The anesthesiologist will also talk with you about the anesthetic to be used and to answer your questions.

The surgery is performed using an open or laparoscopic approach. The surgery that resects the colon is called a colectomy and uses various names (right, transverse, left, sigmoid) to identify the portion of the colon where the growth has been found. The growth and surrounding piece of colon is removed and the two new ends are stapled or stitched together. The point where the ends are joined together is called the anastomosis. The resected colon is designed to keep the colon's tubelike shape so that waste can easily pass through and maintain a normal bowel function. Sometimes a colostomy is created to assist with waste elimination. With a colostomy, the colon is brought out through an opening in the abdomen and formed into a stoma. After recovery, stool passes through the stoma into a colostomy bag or appliance. If you have a colostomy, you will receive training on the care of your stoma, and how to change a colsotomy bag.

The risks and complications associated with a colectomy include infection, anastomosis leak or breakdown, injury to nearby organs, blood clots, possible colostomy, or risk from anesthesia. Recovery from colon surgery is monitored by several means. During surgery a catheter may be inserted in to your bladder to collect urine and to measure the amount of fluids you are putting out. Also a nasogastric (NG) tube going from your nose to your stomach may be used for a few days to keep your stomach empty. You will be fed intravenously for a few days. When you pass gas, it will be a sign that your colon has begun working. Next you will be placed on a liquid diet followed by soft low fiber foods until the healing process is complete.

If you have colon cancer, your doctor may advise more types of treatments to stop the spread of cancer or to reduce the chances of its recurrence. Some colon cancer patients receive chemotherapy or radiation therapy or both. Treatment may start three to six weeks before or after surgery. You should discuss with you doctor about these treatments and any side effects you may expect.


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