PATIENT EDUCATION

Medical Services/Procedures offered:

Screening and Surveillance are the best approach to Early Detection and Cure of Colorectal Cancer as well as other Diseases of the Colon, Rectum and Anus.

Screening and Surveillance:

• COLONOSCOPY: (THE GOLD STANDARD, PROVEN BETTER THAN EITHER FLEXIBLE SIGMOIDOSCOPY AND BARIUM ENEMA OR VIRTUAL COLONOSCOPY)
  
  A Colonoscopy is considered the “Gold Standard” for examining the Entire Colon and Rectum. Colonoscopy’s biggest advantages are the ability to biopsy and/or remove most polyps from the entire lining of the Colon and Rectum without having to undergo abdominal surgery.
  
  Surveillance starts at Age 50, then every 5 – 10 years. (Surveillance starts earlier if patient is considered High Risk)

COLONOSCOPY CONSENT, PREPARATION, AND INFORMATION FORM
(Click above to download form.)


• FLEXIBLE SIGMOIDOSCOPY AND BARIUM ENEMA:
  
  The Flexible Sigmoidoscopy examines the Lower 1/3 of the Colon and Rectum. This is where the majority of Colon Polyps and Cancers are found.
  
  Surveillance starts at Age 50, then every 5 – 10 years. (Surveillance starts earlier if patient is considered High Risk)
  Barium Enema when combined with a Flexible Sigmoidoscopy allows for a full examination of the Upper and Lower Colon and Rectum. These two tests combined are equivalent to a Colonoscopy. However, biopsies or polyp removal of the Upper Colon cannot be performed with either a Flexible Sigmoidoscopy or a Barium Enema. Barium Enemas are also less accurate in detecting small polyps and tumors.
  
  Surveillance starts at Age 50, then every 5 – 10 years. (Surveillance starts earlier if patient is considered High Risk)

• COLORECTAL CANCER:
  Colorectal Cancer is a Silent Disease and may occur at any age. People who have colorectal cancer or who are at High Risk often presents without any signs or symptoms (Asymptomatic). Usually, when signs and symptoms are present (Symptomatic), rectal bleeding or abdominal pain, this suggests that the cancer has grown and becomes difficult to cure. Therefore, with Screening and Surveillance, Early Detection and Cure of Colorectal Cancers are possible.

• COLON POLYPS:
  Some Polyps are flat (Sessile) or have a stalk (Pedunculated) and can occur anywhere in the Large Bowel (Colon) or Rectum.
  
  Polyps are often Benign (Non-Cancer) abnormal tissue growth or mass producing no signs and symptoms (Asymptomatic).
  Other Polyps can become Malignant (Cancer) and produce late signs and symptoms (Symptomatic) which includes: Rectal Bleeding, Anal Pain, or Abdominal Pain.
  
  The majority of polyps are incidental findings on routine screening exams such as a Flexible Sigmoidoscopy, Double Contrast Barium Enema, or Colonoscopy.
  
  Therefore, with Screening and Surveillance, especially for those patients who are at High Risk, allows for Early Detection and Cure for patients with Colon Polyps or Colorectal Cancers
• PATIENTS AT HIGH RISK FOR COLON POLYPS OR COLORECTAL CANCERS INCLUDE:
  • Previous History of Colon Polyps or Colorectal Cancer.
  • Family History of Colon Polyps or Colorectal Cancer.
    -Immediate Family Members. (Parents/Siblings/Children)
    (For Example: If mom is age 39 at diagnosis of colon cancer or polyps, Then screening of immediate family members will need to begin in every member at 29.)
    -Extended Family Members. (Aunts/Uncles/Cousins)
  • History of Familial Adenomatous Polyposis (FAP).
  • History of Inflammatory Bowel Disease
    -Ulcerative Colitis.
    -Crohn’s Disease.
  • Women with a History of Breast Cancer, Ovarian Cancer, or Uterine Cancer

OTHER DISEASES OF THE COLON, RECTUM, AND ANUS:

• DIVERTICULAR DISEASE:
  
  Diverticular Disease is due to a Low-Fiber Diet Intake that occurs over a number of years. The Low-Fiber in one’s diet leads to an increase in colonic pressure. Eventually a weakness in the Colon occurs resulting in the formation of a Diverticula or Out-Pouching which develops due to a weakness in the Colon Wall. Symptoms may include: Left Lower Quadrant Abdominal Pain, Cramps, Diarrhea, Change in one’s Bowel Habits, and/or Increased Rectal Bleeding. The Sigmoid Colon is most often involved, although the entire Colon may also be involved.
  
  Diverticulitis results from an Infection, Inflammation, or Perforation of one or more Diverticulum. Symptoms may include: Fever, Chills, Pain, and Change in one’s Bowel Habits.
  
  Treatment of Diverticular Disease Include:

  • Increasing Fiber in Diet.
  • Medication to control symptoms.
  • +/-Antibiotics. (Moderate/Severe Symptoms)
  • +/-Hospitalization. (Moderate/Severe Symptoms)
  • Sigmoid Resection is indicated for Recurrent Diverticulitis unresponsive to Medical Therapy.

• HEMORRHOIDS/BULGE FROM ANUS/BLEEDING:
  
  Everyone has Hemorrhoids and No they do not cause Cancer. However, symptoms associated with Hemorrhoids particularly Anal/Rectal Bleeding needs further consultation and evaluation with a Colon and Rectal Surgeon in order to rule out Cancer as well as other diseases of the Colon, Rectum, and Anus.
  
  Hemorrhoids are blood vessels located in the Anus and Lower Rectum.
  
  Hemorrhoids become problematic when they start to enlarge and begin to bulge from the Anus and Lower Rectum.
  
  Based on location, Hemorrhoids are either External (Outside) or Internal (Inside):
  • External Hemorrhoids (Outside) are covered by sensitive skin and are found near the anal opening. Usually a blood clot forms in one of them resulting in painful anal swelling. Bleeding occurs when the External Hemorrhoids ruptures.
  • Internal Hemorrhoids (Inside) are covered by intestinal lining and are painless. They are formed within the upper anal canal and the rectum. Some Internal Hemorrhoids pop out during bowel movements and pop back in (Reducible). Others pop out and stay out (Prolapsing). Symptoms include: Painless Anal/Rectal Bleeding and/or Prolapse during bowel movements.

  Cause: (Unknown)
  
  Contributing Factors Include:
  *IncreaseD Age.
  *Pregnancy.
  *Constipation or Diarrhea.
  *Prolonged Straining on the toilet.
  *Heredity.
  *Laxative/Enema Abuse.
  
  Treatment for External Hemorrhoids:
  *Increasing Fiber and Fluids in the diet.
  *Small External Hemorrhoids tend to resolve over time.
  *Excision, if Anal Pain is severe or persistent.
  
  Treatment for Internal Hemorrhoids:
  *Same as above, plus additional procedures.
  *Rubber Band Ligation.
  *Hemorrhoidectomy.
  *Laser Surgery.
  *Stapled Rectopexy.

• ANAL FISSURE/PAIN WITH STOOLING AND BLEEDING:
  
  An Anal Fissure is a tiny cut or small tear in the skin that lines the anus causing anal pain and/or bleeding.
  
  Symptoms include: Increased Anal Pain and/or Bleeding with Bowel Movements.
  
  Causes:
  *Constipation.
  *Diarrhea.
  *Inflammation of the Anus/Rectal Area.
  
  Treatments:
  *Acute Fissure is treated conservatively with High Fiber Diets, Fiber Supplements, Stool Softeners, and Increased Fluid Intake.
  *Sitzs Baths or warm water soaks done twice daily or after each bowel movement.
  *Medicated creams for anal pain.
  *Chronic Fissure may require an examination under anesthesia to determine cause for poor healing.
  *Surgery, Lateral Internal Sphincterotomy allows a Chronic Fissure to heal by decreasing the amount of pain and spasm.

• ANAL ABSCESS/ANAL FISTULA/CONSTANT PAIN OF ANUS:
  
  An Anal Abscess is an infected, pus filled cavity sometimes found near or around the Anus or Rectum.
  
  An Anal Fistula is a small tract or tunnel most often caused by a previous Anal Abscess. These Fistulas can either be Superficial or Deep.
  *An Anal Abscess may recur if the outside opening of the Anal Fistula heals.
  
  Symptoms Include: Anal/Rectal Pain, Swelling, Irritation, Inflammation, Pus Drainage, Fever, and Malaise.
  
  Treatment of an Anal Abscess:
  *Incision and Drainage of the Anal Abscess.
  *+/- Hospitalization (Serious Infection/Decreased Immunity).
  
  Treatment of an Anal Fistula:
  *Fistula Surgery is necessary to cure an Anal Fistula.

• ANAL WARTS/ PAINLESS BUMPS OF ANUS:
  
  Condyoma acuminata, otherwise known as Anal Warts are relatively contagious and are believed to be caused by the Human Papilloma Virus.
  
  The Human Papilloma Virus can be transmitted via direct contact from person to person.
  
  Anal Warts generally affect the anus and genital areas.
  
  Usually Anal Warts start out small, causing no pain or discomfort, so patients who have them are unaware that they are present.
  
  Anal Warts, if not removed, will tend to enlarge and multiply. Evidence suggests that if left untreated Anal Warts can become cancerous.
  
  Treatment of Anal Warts: (A quick cure is not a guarantee, a patient may require multiple treatments)
  *Topical Medication or Chemical Solution.
  *Electrical Cautery.
  *Surgical Removal.
  *Laser Surgery.
  

• PRURITUS ANI/ANAL ITCHING:
  
  Pruritus Ani is a common condition referring to extreme itching around the anal area.
  
  Patients with Pruritus Ani have an increase urge to scratch, often occurring at night or after a bowel movement.
  
  Causes:
  *Excessive cleaning of anal area.
  *Moisture around the anal area.
  *Excessive sweating.
  *Moist, sticky stools.
  *High fluid intake, resulting in loose and/or irritating stools.
  *Beer, Caffeinated Drinks, Citrus Fruit Juices.
  *Fruits, Chocolate, Popcorn, Nuts, and Tomatoes.
  *Pinworm, Hemorrhoids, Anal Fissures, Infections, Allergies. (Rare causes)
  
  Treatment of Pruritus Ani Includes:
  *Stop scratching, this avoids further trauma around the anal area.
  *Keep anal area free of moisture.
  *Only use medications prescribed by your Colon and Rectal Surgeon.
  *Limit excess amounts of fluids as well as certain foods.
  *Cure usually comes approximately 4 – 6 weeks.

• PILONIDAL DISEASE/PAIN NEAR TAIL BONE:
  
  Pilonidal Disease is a chronic condition in which the skin at the buttock crease area becomes infected.
  
  Occurs more in men than women, between puberty to 40 years of age.
  
  Symptoms:
  *Small to large painful mass.
  *Fluid drainage is either: Clear, Bloody, or Pus.
  *May have fever, nausea, body aches.
  *Acute abscess develops into a Pilonidal Sinus/Tract.
  *Recurrent infection of the Pilonidal Sinus/Tract.
  
  Treatment:
  *Acute abscess requires Incision & Drainage.
  *More Complex or Recurrent infection requires surgical management.

• OTHER COLON AND RECTAL PROBLEMS THAT DR. MCCONNEL AND STAFF TREAT:

  • CONSTIPATION
  • BOWEL INCONTINENCE
  • RECTAL PROLAPSE
  • RECTOCELE
  • IRRITABLE BOWEL SYDROME
  • ULCERATIVE COLITIS
  • CROHN’S DISEASE