Tour the Colon Part 2/2
Dr. Jeffrey Sherman: We have the ulcers and colitis, but as well, we have something called Crohn’s disease, which is a similar disease to ulcerative colitis. And Crohn’s disease can be an inflammation skipping around the colon, so you may not see it right away as you enter the colon during the colonoscopy. You see this finger like projections called pseudopolyps which can cause bleeding and discomfort. The symptoms are similar to colitis where you get bloody diarrhea, abdominal pain, sometimes even nausea and vomiting from a bowel disruption. This Crohn’s disease could occur in the colon and if you can sneak into the small intestines during the colonoscopy, you would look for the signs of Crohn’s disease, as well as in the small intestine.
But probably, the most common finding that you would detect during the colonoscopy, there are these growths, mound-shaped, growths come from the wall of the colon that are either directly attached to the surface of the colon, or on a stock, it looks like a little tree with the leaves coming out. These are detected both in the early part of the colon or the late. Flexible sigmoidoscopy will not detect polyps deeper into the colon. That’s the key reason we do colonoscopy to detect polyps, which can turn into colon cancer. There are removed easily with a little forces where we can just pull it straight off the wall of the colon or a lasso snare where we can surround it and burn it off. Polyps are often or most commonly asymptomatic. We don’t realize we have them. They don’t result in any pain or change in bowel habits.
Polyps can turn into a more polyphoid advance form of themselves or a tumor coming in from the sidewall of the colon. It can be asymptomatic, but also, you see blood in the stool, maybe a change in bowel habits, whether it be diarrhea or constipation, depending on where the cancer is, but it can take up a good part of the sidewall of the colon. We see it, it is irregularly shaped, friable, a slight touch of the tissue with the biopsy forceps will make it bleed tremendously, and we just take small little surface bites of this, send it to the pathology lab and come up with a diagnosis.
Early detection is best, however, when cancer has been growing for a period of time, it not only grows through the center of the colon lumen, but can grow outside or deeper into the colon wall and even in worst cases, perforate the wall of the colon, creating a hole in the colon, escaping gas, bad infection, and in that situation, the colon cancer is most likely spread to the lymph nodes and liver.
Dr. Travis Stork: Thank you so much for our virtual tour, Dr. Sherman, stay with us. And for everyone at home, the reason early detection is so important, so you can get that cancers growth out before it spreads.
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