Colorectal Cancer

Colorectal cancer is one of the most common gastrointestinal cancers and its incidence has increased significantly in recent years. It is now increasingly seen in younger adults.

The colon is divided into four parts — ascending colon, transverse colon, descending colon and sigmoid colon. Cancer can develop in any of these segments, and symptoms vary depending on the location.

• Right-sided colon cancer: Often presents with anemia, weakness and fatigue due to slow bleeding.
• Left-sided colon cancer: Usually presents with constipation or intestinal obstruction.
• Rectal cancer: Often presents with fresh blood in stool and difficulty in passing stools.

Patients suspected of colorectal cancer should undergo a full-length colonoscopy. This allows visualization of the tumor and detection of additional lesions if present. Biopsy confirms the diagnosis.

CT scan of the abdomen is performed for staging. If the tumor is operable, curative surgery is performed.

CEA blood test is performed before surgery and used during follow-up. Rising CEA levels may indicate tumor recurrence.

Surgical Treatment

Surgery is the primary treatment for colorectal cancer. The type of surgery depends on the tumor location.

• Radical colectomy for colon cancer
• Laparoscopic surgery whenever feasible
• Low Anterior Resection (LAR) for rectal cancer
• Ultra-low anterior resection for low rectal tumors

Studies show that laparoscopic surgery provides results comparable to open surgery when performed using proper oncological techniques.

Advanced Rectal Cancer Treatment

Patients with locally advanced rectal cancer often benefit from pre-operative chemo-radiotherapy, which improves survival rates and surgical outcomes.

Specialized colorectal surgeons perform these procedures using advanced surgical techniques.

Modern circular stapling devices have significantly improved outcomes by allowing safe anastomosis deep within the pelvis with lower leak rates.

Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disease affecting the lining of the colon and rectum. The disease typically starts in the rectum and gradually spreads to the rest of the colon.

Patients often present with bleeding per rectum and diarrhea. Early disease limited to the rectum may sometimes be mistaken for hemorrhoids.

Colonoscopy with biopsy is essential to confirm the diagnosis.

Medical Treatment

The first line treatment of ulcerative colitis is medical therapy.

• Steroids during active disease
• Maintenance medications
• Immunosuppressive therapy

Maintenance therapy should be continued to prevent disease recurrence.

Surgical Treatment

Surgery is recommended when medical treatment fails or complications develop.

• Total proctocolectomy
• Ileal pouch reconstruction
• Restoration of bowel continuity

This procedure removes the diseased colon and rectum and connects the small intestine to the anal canal.