Colorectal Disorders - Types and Treatment

Introduction

Colorectal disorders are conditions impacting the colon or the rectum and their functionality. These conditions include constipation, fecal incontinence, colorectal cancer, colon polyps, colitis, anal fissures, diverticulitis, anal fistulae, and inflammatory bowel diseases like Crohn’s disease and ulcerative colitis.

What Is Constipation?

Constipation can be defined as having less than three bowel movements a week. It occurs when bowel movements are not happening very often and are difficult to pass. Some key features that define constipation-

• Hard and dry stools.

• Painful bowel movement and difficult to pass stools.

• The feeling of not having fully emptied the bowel.

Constipation occurs because the large intestine or colon absorbs too much water from waste, making the stools dry in consistency and difficult to push out of the body. To back it up a bit, normally, nutrients are absorbed when the food moves through the digestive tract. The waste or the partially digested food moves from the small intestine to the large intestine, where the water is absorbed and creates a solid matter called stool. If the individual has constipation, food will move slowly through the digestive tract, giving more time to the large intestine to absorb water from the waste, making it more dry, hard, and difficult to pass.

What Is Fecal Incontinence?

Fecal incontinence or anal incontinence is the uncontrolled bowel movement that results in the leaking of stool unexpectedly from the rectum. This leakage occurs when the person does not want it to happen. The following situations suggest fecal incontinence:

• While passing gas, the stool leaks out.

• During physical exercise, stool leaks out.

• After a normal bowel movement, the stool is seen on the underwear.

• Feeling to go to the washroom but not making it on time, and stool leaks out.

• Complete loss of bowel control.

Fecal incontinence occurs may be because of improper functioning of the muscles of the rectum and anus or when the person is incapable of recognizing the signal to pass the bowel. Fecal incontinence may be accompanied by problems such as diarrhea, gas, and bloating.

What Is Diverticulitis?

Diverticulitis is the swelling and inflammation of the diverticula. Diverticula are small bulges or pockets present in the wall of the large intestine. Normally, diverticula are formed inside the colon due to increased pressure that causes the pockets to bulge out in the weakened areas of the wall of the colon. Diverticula are usually found in the S-shaped segment of the colon or sigmoid colon.

Diverticulitis is believed to be caused by an infection due to the bacteria in the stool that enters the diverticula. Diverticulitis is associated with the following symptoms:

• Mild cramps in the lower abdomen.

• Painful and tender affected area.

• Bloating or swelling of the abdomen.

• High body temperature (fever) and chills.

• Nausea and vomiting.

• Rectal bleeding.

What Is Irritable Bowel Syndrome?

Irritable bowel syndrome is the condition or symptoms that affect the gastrointestinal or digestive tract. It is a very common disorder. This syndrome makes the digestive tract very sensitive. They also affect the bowel muscles and their contraction, resulting in diarrhea, constipation, and pain in the abdomen.

Different types of irritable bowel syndrome are:

• Irritable Bowel Syndrome With Diarrhea (IBS-D) - The stool or poop is watery and loose.

• Irritable Bowel Syndrome With Constipation (IBS-C) - The stool is lumpy, dry, and hard.

• Irritable Bowel Syndrome With Mixed Bowel Habits (IBS-M) - The stools are hard and lumpy and loose and watery on the same day.

Irritable bowel syndrome is caused due to miscommunication between the nerves in the brain and digestive tract or due to extra sensitive nerves in the gastrointestinal tract.

What Are Anal Fissures?

An anal fissure can be defined as a tear in the lining of the anus due to trauma caused by hard stools or diarrhea. The person feels an intense burning sensation and bleeding after a bowel movement. The pain is usually caused because of the exposure of the sphincter muscle to the air by this tear. This pain has been described as the feeling of passing razor blades. These anal fissures often get healed on their own, and if they do not get healed, the doctor will prescribe ointment or medication to relieve pain. Even surgery is recommended in case the tear does not heal due to excessive spasms of the sphincter.

What Is Inflammatory Bowel Disease?

Inflammatory bowel diseases are disorders that cause inflammation (swelling and pain) of the digestive tract. Inflammatory bowel disease is different from irritable bowel syndrome in terms that irritable bowel syndrome does not damage or inflame intestines like inflammatory bowel diseases.

Inflammatory bowel diseases are caused by genetics, immune system response, and environmental triggers. The signs and symptoms include:

• Pain in the abdomen.

• Diarrhea.

• Upset stomach.

• Gas and bloating (belly feels full and tight due to gas).

• Loss of appetite or weight loss.

• Mucus or blood in the stool.

Types of inflammatory bowel disease:

• Crohn’s Disease: This causes swelling and pain in the digestive tract. It can affect any part from the mouth to the anus. It usually affects the small intestine and the upper part of the large intestine.

• Ulcerative Colitis - This causes sores and swelling in the large intestine.

• Microscopic Colitis - This causes intestinal inflammation that can be detected with a microscope.

What Is Colitis?

Colitis can be defined as the inflammation of the inner lining of the large intestine. Colitis is present with symptoms like diarrhea, abdominal cramps, rectal bleeding, and increased urgency to use the bathroom.

Different types of colitis are:

• Ischemic colitis (caused due to insufficient blood supply to the large intestine).

• Infectious colitis (caused due to an infection affecting the large intestine).

• Radiation colitis (caused after radiation therapy done for rectal, prostate, or gynecological cancer).

• Ulcerative colitis.

• Crohn’s disease.

What Are Colon Polyps?

A colon polyp is a flat, raised, or stalked growth on the inner lining of the large intestine or colon and rectum. These colon polyps have the capacity to grow uncontrollably and cause cancer. It is believed to be caused by genetic changes in the cells of the inner lining of the large intestine that affects the normal cell cycle.

The associated symptoms are:

• Rectal bleeding.

• Iron deficiency anemia or weight loss.

• Change in the pattern of normal bowel movement.

• Rarely, abdomen pain.

What Is Colorectal Cancer?

Colorectal cancer is the cancer of the large intestine or colon and rectum. Depending on where the cancer starts, it is called colon cancer or rectal cancer. These two are clubbed together because they have similar signs or symptoms.

Colorectal cancer occurs due to abnormal and uncontrollable growth of the cells that line the colon or the rectum. Most colorectal cancers arise from colon polyps. These polyps can undergo mutations that arise in their cellular DNA.

The symptoms are often visible after cancer has reached the advanced stage. Some colorectal cancer is present without any signs and symptoms. Hence, the patient should get regular colorectal examinations to detect problems early.

Common signs and symptoms associated with colorectal cancer are:

• Changes in bowel habits like constipation, diarrhea, incomplete evacuation, and bowel incontinence.

• Blood in the stool.

• Unexplained weight loss.

• Vomiting.

• Abdominal pain.

• Unexplained anemia (decrease in red blood cells).

What Are Anal Fistulae?

An anal fistula is a small tunnel that connects an opening on the skin around the anus and an infected gland inside the anus. Inside the anus, there are a lot of glands that make mucus. These glands can get clogged and get infected, resulting in an abscess (a pocket filled with pus). These abscesses may develop into a fistula.

An anal fistula is present with the following symptoms:

• Swelling and pain around the anus.

• Pain with bowel movements.

• Foul-smelling or bloody drainage (pus) from the opening around the anus.

• Skin irritation around the anus from drainage.

• High body temperature (fever) and chills.

What Are the Treatment Options for Colorectal Disorders?

The treatment options for colorectal conditions depend on the severity and type of the problem. Common approaches include:

• Medications are given to reduce inflammation or help regain normal bowel functionality.

• Surgery is done to remove polyps or cancerous cells.

• Lifestyle and dietary changes.

Conclusion

Colorectal disorders are diseases of the colon or rectum that affect their functionality. The chances of developing these diseases are lowered if people take care of their health by eating more vegetables, fruits, calcium, folate, whole grains, and less fat. People should avoid drinking too much alcohol, stop smoking, and should exercise every day. A lot of colorectal diseases can be prevented or treated if diagnosed early and given prompt medical care.