How to treat colorectal polyps/ cancer without permanent colostomy.

Rectal bleeding is not only the common symptom of hemorrhoids, but colorectal polyps/ cancer. Due to the similarity of clinical manifestations, colorectal cancer is often misunderstood for hemorrhoids, leading to delayed diagnosis and ineffective treatments. Therefore being aware of the specific warning signs and symptoms of these diseases results in early detection and appropriate treatments. 

Get to know “rectum”

The rectum is the last part of the large intestine. The rectum, approximately 6 inches long, is a continuation of the sigmoid colon and connects to the anus. The rectum follows the shape of the sacrum and ends in an expanded section called the rectal ampulla, where feces are stored before their release via the anal canal. 

Colorectal polyps/ cancers

Colorectal polyps are small clumps of cells that form on the lining of the colon and rectum. Colorectal cancer is the development of cancer cells from the colon or rectum. Sometimes polyps or cancerous tumors develop relatively close to the anal canal, a short tube at the end of the rectum through which stool leaves body, resulting in complicated treatment which essentially requires highly experienced multidisciplinary team to achieve the best possible treatment outcomes. 

The rectum regulates the defecation process. It is consisted of an anal sphincter, a group of muscles at the end of the rectum that controls the release of stool, thereby maintaining continence. There are two sphincter muscles: internal and external sphincter muscles. Furthermore, sphincter muscles are regularly controlled by nervous systems.  If polyps or tumors are found in the rectum fairly close to the anal canal, it usually requires rectal surgery that the entire rectum and sphincter muscles must be removed, causing difficulties in defecation. After surgery, patients have to be undergone “permanent colostomy” to make a permanent opening called a stoma for passing the stool out of the body. 

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Warning signs and symptoms of colorectal polyps/ cancers

Signs and symptoms might include:

• Rectal bleeding or blood in your stool
• Irregular stool patterns such separate hard lumps
• Persistent changes in bowel habits including diarrhea or constipation, or alternating bouts of diarrhea and constipation
• A feeling of incomplete defecation 
• Abdominal discomfort such as cramps or pain
• Weakness or fatigue
• Unexplained weight loss

Diagnosis

Early diagnosis plays a major role to increase the chances of successful treatments. Diagnostic tests and procedures involve: 

• Colonoscopy: Using a scope to examine the inside of the colon. A long, flexible and slender tube attached to a video camera and monitor is inserted through the anus to view the entire colon and rectum. 
• Biopsy: If any suspicious areas are found during colonoscopy, the specialists pass surgical tools through the tube to take tissue samples (biopsy) for analysis and remove polyps.
• If cancer is suspected, imaging tests are used for disease staging. 
• After receiving all investigational results, customized treatments are collectively planned by multidisciplinary team consisting of colorectal surgeons, diagnostic radiologists, radiation oncologists, medical oncologists and pathologists. 

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Treatment of colorectal cancer

Treatment of colorectal cancer must be given by highly specialized multidisciplinary team consisting of colorectal surgeons, diagnostic radiologists, radiation oncologists, medical oncologists and pathologists. Supported by cutting-edge surgical technology, minimally invasive colorectal surgery with sphincter-saving technique significantly increases chances of being cured, resulting in preserved sphincter functions required for bowel movements and improved quality of life.

More importantly, clinical researches suggest that to achieve the best possible treatment outcomes, not only advanced technology in treatment, but multidisciplinary team with patient-centric approach is a major contributing factor. 

It has been widely acknowledged that radiation treatment and chemotherapy prior to the surgery largely helps reducing chances to perform colorectal surgery with permanent colostomy. In addition, minimally invasive surgery with sphincter-saving technique must be performed by highly skilled and well-trained surgeons in order to prevent possible complications during surgery. 

Minimally invasive colorectal surgery with sphincter-saving technique 

In case that colorectal cancer has been diagnosed, it can be treated by “minimally invasive colorectal surgery with sphincter saving technique”. This procedure helps to preserve sphincter muscles and regulate bowel movements as well as reduce chances of having permanent colostomy. Superior advantages might include less pain, fewer complications and faster recovery time that leads to a quick return to daily life and activities.   

If there is the presence of rectal bleeding during bowel movement, immediate medical care must be provided in order to get it accurately diagnosed, resulting in timely and effective treatments that eventually enhance quality of life.