Colo-Rectal Disorders

Ads

The Intestines
The intestines are the long tube by which food leaves the stomach and is eventually excreted from the body. The tube is made up of sheaths of muscle, coated on the inside with mucous membrane. The small intestine leads directly from the stomach. It is about 22 feet long, and up to 1½ inches wide. It continues the process, begun in the stomach, of absorbing nutrients from the food.

The large intestine (the "colon") follows on from this. It is about 6 feet long and up to 2½ inches wide. Its main function is the absorption of water from the waste products ("faeces").

Many physiological disorders may affect the small intestine, eg, bacterial infection, or fever. It can also be a site for ulcers and cancer.

However, the term "bowels" refers mainly to the large intestine - and often simply to the last 6 to 8 inches (the "rectum") and the surface opening (the "anus") through which the waste products are excreted, usually in a fairly solid form known as "stools". This is another potential cancer site. But it is also affected by certain well known disorders, linked with the physical process of waste evacuation, and dealt with on these pages.

Diarrhoea and Constipation
These common complaints are both usually caused by the failure of the colon to carry out its job of controlling the level of water in the feces. This may be due to any one of many causes: a change of eating habits; gastritis (inflammation of the stomach); gastro-enteritis (inflammation of stomach and intestine); or bacterial or viral infection of the intestine.

Diarrhoea
Diarrhoea is the excessive discharge of watery feces. The primary danger in serious cases is body dehydration, and this can be combated by an increased intake of fluid.

Constipation
Constipation is infrequent or absent defecation. It is usually caused by a poor diet, expecially one lacking in roughage. But it may follow diarrhoea in the course of an infection and is also sometimes caused by intestinal obstruction. However, much imagined constipation is only the consequence of judging bowel habits by an excessive norm of "regularity". In fact, "normal" bowel motions may occur as often as three times a day, or as infrequently as once every three or four days, depending on the individual.

Hemorrhoids (Piles)
Hemorrhoids (piles) come about through the enlargement of veins in the wall of the rectum or in the anus.
This may be due to acute constipation, or overstraining during excretion. It can also result from tumors.
The swellings cause the mucous membrane to press against passing faeces, causing discomfort, pain, and sometimes bleeding.
Internal hemorrhoids occur at or before the rectum's junction with the anus. If they protrude beyond the anal opening the pressure of the anal muscle (the "sphincter") often causes great and constant pain - this is known as "strangulation."
External hemorrhoids occur under the skin just outside the anus. In addition to the usual causes, they can also result from a ruptured vein, leading to a hemorrhage.
Internal hemorrhoids may eventually develop "polyps." This is a condition in which the hemorrhoidal protrusion becomes fibrous and elongated.

Colitis
Colitis is inflammation of the colon - often with an associated ulcer. The symptoms are abdominal discomfort, diarrhoea, blood in the faeces; and fever. Anemia and even emaciation result. The first (acute) phase can be fatal if untreated. More usually, a prolonged (chronic) phase develops.

The causes are unknown, but may be linked in different individuals with: infection; allergy; deficiency of vitamin B and certain proteins; or simply nervous stress. Sometimes several causes occur together. Treatment involves bedrest until the fever has passed; and also careful dietary control using highly nutritious foods, high in protein. Steroids may be used. Relapses are frequent. In extreme cases surgery is needed.

Rectal Prolapse
This is the collapse of the rectal wall. It occurs mostly in young babies and the aged. It is caused by excessive straining during excretion, and (in the old) by weak rectal and anal muscles. In severe cases an entire area of the rectal wall passes through the anal sphincter. Extreme pain from strangulation results.

Abscesses
An abscess is caused by bacterial infection. In order to combat the bacteria, bodily fluid and white blood corpuscles collect in the tissue spaces, and form pus. A painful swelling results that continues to grow until it bursts and discharges its fluid.

To avoid discomfort and the possibility of further complications abscesses are usually drained surgically. Anorectal and perianal abscesses are extremely painful, because of the pressure of the anal sphincter, the passage of feces, and the constant irritation due to their anatomical positioning.

Fissure-In-Ano
This is splitting of the walls of the anus. It is usually due to the passing of an exceptionally large stool. An "acute" fissure involves only the outer surface of the wall (the mucous membrane). If it does not disappear after a few days, it develops into a "chronic" fissure, which is deeper. This causes great pain and needs intensive treatment.

Additional Resource:
Colorectal Disorders: Oregon Health & Science University

Similar of Colo-Rectal Disorders