Surgical Facts

Colon Information

Feeling Concern and Discomfort.........
It's normal to worry if your doctor suspects you may have a growth in your colon. You may be anxious about whether the growth is cancerous or not. You may also have many questions about the treatment that could lie ahead or your prospects for recovery, But the fact is most colon growths can be removed swiftly. And, even if the growth is cancerous, with early medical treatment your outlook can be very positive.

Detecting Colon Growth.........

Maybe you've had symptoms of a colon growth. These symptoms may include abdominal or rectal pain, rectal bleeding, a change in bowel habits that lasted longer than a week, or fatigue. More likely, though, it was your doctor who noticed that unhealthy changes might be happening. That's because checkups are one of the surest ways of detecting colon growths. And, if you medical professional spots a problem early, chances of successful treatment and recovery are greatly enhanced.

Seeking Early Treatment.........

Do you suspect that you have a colon growth? Get prompt medical treatment. By seeing your physician immediately, you really increase the odds of successful recovery. You and your doctor can work as a team to diagnose and treat your colon problem before it becomes worse.

Your Evaluation: A prompt evaluation is the key to diagnosing a colon growth. A medical history, thorough exam, and tests help your physician diagnose your colon problem and plan the right treatment.
Surgical Treatment: The next stage, if required, is surgery. The colon growth is removed. If cancer is present, further treatment may be needed. This may include chemotherapy or radiation to reduce the odds of the cancer returning.
Follow-up Care: After your recovery from surgery and any other treatments you may have, you can slowly return to your daily activities. Follow-up examinations, good diet, and help from loved ones can soon help you get back to your old routine.

The Colon's Function.........

The muscular colon "tube" is five to six feet long. It is lined to protect your body from digestive wastes. The food you eat arrives at the colon after passing through the stomach and small intestine. Once food enters the colon, fluids are absorbed into the blood stream. Stool is then compacted and stored, and muscles push the stool down to the anus for elimination.

Inside Your Colon.........

The colon (the large bowel or large intestine) is the tube like part of your digestive tract that stores stool and pushes it out from your body. A healthy colon has a smooth, protective wall and acts like a pipeline, moving digestive wastes around, and out of your system. Colon tissue can undergo changes. Growths can occur on the colon wall. All growths need to be removed quickly. Some growths can develop into cancer.

Growths in the Colon Lining.........

Sometimes tissue in the colon changes - perhaps because of genetics, a high-fat, low-fiber diet, or exposure to cancer-causing substances. As this tissue changes, growths may form on the colon lining.

• Polyps: A benign polyp is a non-cancerous growth. It can be as small as a pea or as large as a half-dollar. The larger the polyp, the greater the odds of it turning into cancer. Early removal of the non-cancerous polyps may prevent them from turning into cancer.

• Cancers: A cancer is made up of abnormal cells that are growing out of control. Cancers are most often the size of a mushroom or bigger. They can grow into the colon lining and spread to other parts of the body. The quicker that cancers are removed, the greater the chance of preventing it from spreading.

• Cancer Spread: If cancer cells break off, they may travel through the colon lining into the lymph and blood vessels. These vessels may carry the cells to the lymph glands, liver, lungs, or other organs, starting new cancers. This cancer spread is called metastasis.

History and Examination.........

Your health history gives your doctor clues to your diagnosis. People with a personal or family history of bowel disease have a higher risk of colon cancer. Your physician may ask you questions about your symptoms, diet, and whether you or any family members have ever had cancer. Your doctor also conducts a thorough examination and may check your stool for blood.

Diagnostic Tests and Your Evaluation.........

Your physician may order one of several testing procedures available for detection of growths. Each test gives information about a specific part of your colon. These tests can help locate any problems you may be experiencing. They involve only a small amount of pain. They may be performed in your physician's office or in the hospital on an outpatient basis.

• Digital Rectal Exam: In this simple test, your physician inserts a gloved finger into the rectum to inspect it for signs of tissue change. The examination takes less than a minute, But it can detect many easily overlooked rectal cancers.

• Sigmoidoscopy: Your physician checks the health of your lower colon by inserting into your anus a sigmoidoscope, a lighted tube, to view the sigmoid colon and remove tissue samples. This procedure requires no sedation, causes little discomfort, and only takes a few minutes. However, it can detect about only 50 percent of all colon cancers.

• Barium Enema: This test gives a picture of your entire colon. A radiologist fills your colon with liquid barium. Then x-rays are taken. Air may also be pumped inside the colon to make a small abnormalities more visible. The test is done on a outpatient basis at a hospital or radiology center. You'll need a special bowel prep to cleanse your colon beforehand.

Colonoscopy.........

Colonoscopy is an advanced technique for viewing the whole colon. A Screen or eyepiece may be used. The colonoscope is a thin, lighted flexible tube that is moved through your colon. Colonoscopy is used both to diagnose growths and to confirm findings of other tests. It can also be used to remove small polyps and to collect tissue samples for analysis. You will be slightly sedated when this procedure is performed. Risks and possible complications of the Sigmoidoscopy and Colonoscopy: 1) Puncturing the colon; 2) Bleeding.

Diagnosing the Findings.........

After your evaluation, your physician will discuss your diagnosis with you. Your physician will also explain surgery or any other treatments that may be required.

Your Treatment Plan.........

If your physician has detected a large polyp or cancer, colon surgery may be needed to remove the growth. If surgery is performed early, it may be all the treatment you need to correct the problem. If colon cancer has been diagnosed, your doctor may conduct a special test before surgery, This is to see whether, or how far, the cancer cells may have spread. These tests help your doctor plan your surgery and any other treatment.

• Polyps Treatment: Removal of the growth is the main way of treating polyps. Often, polyps are removed through a colonoscope. A polyp in the rectum, however, may be surgically removed through the anus. A polyp in the colon that is large, flat, or can't be removed with a colonoscope may require abdominal surgery.

• Cancer Treatment: If you have a colon cancer, your doctor may test to see if it has spread. Tests may include a chest x-ray to check the lungs, CT scan of the abdomen and pelvis, and blood tests. After these tests are done, your physician surgically removes the cancerous portions of your colon and reconnects the healthy parts. You may also need more treatment, such as radiation or chemotherapy, before or after surgery.

In Preparation for Surgery...........

You can take steps to help prepare for surgery. These steps range from speaking with your anesthesiologist or nurse anesthetist to cutting back on smoking. Following these steps - and any other instructions provided by your doctor - helps make your surgery and recovery successful. These steps may also help reduce the risks of bleeding and infection. You may be admitted to the hospital the day before or the day of your surgery.

A Few Weeks Before The Surgery.........

Quit Smoking: Smoking adds risk to surgery and recovery. Smokers will be asked to stop.
No Blood Thinners: Your physician will instruct you to stop taking aspirin or any other blood-thinning drugs.
Medical Checkup: Your physician will give you a thorough checkup before surgery to asses the health of your heart and lungs.

Right Before Your Surgery.........

• Clear Liquid Diet: For 24 hours before your surgery, you may eat only clear liquids, such as broth, coffee, gelatin, and clear fruit juice. No food or drink, including coffee and water, may be taken after midnight before your surgery.
• Bowel Preparation: To make sure the colon is thoroughly clean, you'll be asked to drink a laxative solution to completely clean your system of stool.
• Taking Medications: Ask your doctor about which medications you should stop taking before and after surgery. You may also be given antibiotics. These help reduce the chance of infection.
• Preparation for Anesthesia: Before surgery, the anesthesiologist or nurse anesthetist will discuss the anesthetic to be used. Any questions you may have will be answered at that time.

Your Surgery.........

The idea of having part of your colon removed may sound scary. But the fact is that part or all of the colon can be removed without causing serious problems. Most colon surgeries remove the affected piece (resection). Then the two new ends are stitched or stapled together (anastomosis). If you have colon cancer, surgery removes the cancer and the surrounding tissue and lymph glands to reduce the risk of the cancer returning. Whether you have cancer or a large polyp, the resection is designed to keep the colon's tube-like shape. This is so that waste can pass through easily, and you'll still have normal bowel function. Complications and Risks: 1) Infection; 2) Injury to nearby organs; 3) Anastomosis that leaks or separates; 4) Blood clot; 5) Possible colostomy; 6) Risks from anesthesia.

In The Hospital After Your Surgery.........

You may be surprised at how quickly you'll be up and walking around again after colon surgery. Once you leave the recovery room, where blood pressure, breathing, and pulse are closely monitored, you will be brought back to your room. Without complications, expect to be in the hospital from 4 to 8 days after your surgery. During your stay, you'll be watched closely to make sure that you're healing well and that your colon has started working again.

• Checking the Progress: During surgery, a catheter may be inserted into your bladder. The catheter remains for the first several days after surgery to collect urine. This helps your doctor measure the amount of fluids you are putting out and monitor your body's return to normal. Loose stools are common just after bowel function returns.
• Starting to Eat Again: A nasogastic (NG) tube going from your nose to your stomach may be used for a few days to keep your stomach empty. You'll be fed intravenously for a few days. When you pass gas, it's a sign that your colon is working again. Then you'll start a liquid diet. After that, eat soft, low fiber foods until your healing is complete.
• Becoming Active Again: Walking after surgery helps your circulation and bowel function return to normal. You'll also do breathing exercises to make sure you're taking in enough oxygen, since breathing can be painful after surgery. At first, you'll be given pain medication by injection or IV. After you're back on food, you'll receive medication orally.
• Caring for a Stoma: If you've had a colostomy, your stoma training may have begun before your surgery. It continues during your recovery. A stoma therapist teaches you how to handle and change a colostomy bag or how to irrigate the stoma so that a bag may not even be necessary. You'll stay in the hospital or move to a skilled nursing facility until you've mastered the techniques.

The Home Recovery Process.........

You'll likely see your doctor about seven to ten days after you've left the hospital. After six weeks or so, you should begin to feel like yourself again. Still, you'll probably tire easily for several months. Your body is using a lot of energy to heal itself. Make a point of resting when you feel tired. Usually, you can resume your full range of activities after a couple of months, when you're fully healed, But, expect to be off work for one to three months or until your energy level returns to normal.

• Resuming Everyday Activities: Be active when you feel up to it, but avoid heavy lifting and strenuous exercise for about six weeks. Walking, climbing stairs, showering, and bathing are fine. You may drive again as soon as you're no longer taking pain medication and you feel able. Ask your doctor about any special diet you should follow during your first few weeks at home.
• Call Your Doctor If You Have Any of The Following: 1) A fever over 100°F, 2) Nausea or vomiting, 3) unusual redness, swelling, or pain around your incision, 4) Constipation, diarrhea, or bloating, 5) Difficulty controlling your bowel movements.

Possible Additional Treatments: If you have colon cancer, your physician may advise more types of treatment. The goal is to stop the cancer's spread or to reduce the chances of its return. Some colon surgery patients receive chemotherapy or radiation therapy or both. Either therapy can be effective. Treatment may start 3 to 6 weeks before or after surgery. You and your physician can discuss these treatments and any side effects you may expect.

• Chemotherapy: Chemotherapy uses drugs to attack cancer cells throughout the body, wherever they exist. Side effects may include nausea, diarrhea, hair loss, and fatigue.
• Radiation Therapy: High-energy beams of radiation are used to attack cancer cells in precise areas of the body. Patients are given doses of radiation on an outpatient basis, five days a week for four to six weeks. Side effects may include bowel, skin and anal irritation, nausea, and fatigue.

See Your Physician Regularly.........

Colon problems often have no symptoms. That's why regular checkups are the best way to ensure your colon's health. If you've had colon cancer, your doctor will likely see you often in the first year, and regularly thereafter. If you had a polyp, your doctor will want to watch the colon to check for further polyps.

Eat High-Fiber, Low-Fat Foods.........

A high-fiber, low-fat diet may decrease your risk of getting colon cancer or help keep it from recurring. Eat whole grains, vegetables, and fruits. Drink lots of water. And lower your fat intake. Following this healthy eating style for life can help prevent colon problems in the future.

Have Your Family Screened.........

Those with a family history of colon cancer are more likely to develop the disease. Your family members should be screened by a physician. This is especially important if they've ever had cancer or bowel disease. Colon health really is a family matter.

Getting Support.........

Support groups can be helpful resource if you have colon cancer. Get more information by calling these organizations:

American Cancer Society - (800) 227-2345
United Ostomy Association - (800) 826-0826
Wound Ostomy and Continence Nurses Society (WOCN) - (714) 476-0268

NOTE: The material presented here is provided for informational and reference of the condition stated, and is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem.