Colorectal Conditions & Treatments
PIH Health colorectal surgeons offer the latest in diagnosis and treatment for complex colon and rectal, or colorectal, disorders. Our colorectal surgeons work closely with colleagues in a multi-disciplinary fashion to ensure that you receive comprehensive and innovative care. We offer a full range of non-surgical and surgical treatments and provide a treatment plan that will meet your unique needs.
Conditions We Treat:
Colorectal surgeons perform minimally invasive surgery, including laparoscopic and robotic options. Some surgical treatments include complex reoperative procedures; surgery for Inflammatory Bowel Disease (IBD), including pouch surgery and revision; and techniques to preserve continence after other surgeries, including sacral nerve stimulation.
Colorectal cancer starts in the colon or the rectum. It is one of the most common and aggressive cancers, but also one of the most preventable and curable. It is the fourth most common cancer diagnosed in the U.S. with almost 150,000 cases diagnosed annually.
Colorectal Tests & Treatments
The best way to prevent colorectal cancer is by examining the large intestine by a screening procedure called a colonoscopy. The American Cancer Society (ACS) currently recommends that people with an average risk for colorectal cancer have a screening test beginning at age 45. Colorectal cancer screening is important because most patients with early stage cancer do not have any symptoms. The primary treatment for cancers of the colon and rectum is surgery. For cancers that have not spread, surgery alone often provides a cure.
Our diagnostic and treatment approaches include minimally invasive laparoscopic surgery – which is the standard of care for the majority of colorectal procedures and results in less postoperative pain due to smaller incisions, faster healing and quicker return to home; robotic surgery, another minimally invasive surgical option; Transanal Endoscopic Microsurgery (TEMS) a surgical technique that has become a valuable option for certain colorectal conditions like the removal of rectal polyps and tumors on an outpatient basis; as well as traditional open surgery with a larger incision in situations where the disease is more complex or in certain reoperative settings where a minimally invasive approach may not be possible.
Anal dysplasia is a condition in which some of the cells within the anus have transformed into abnormal precancerous cells. If the abnormal cells (which often cannot be seen or felt) are left untreated, they can turn into cancerous tumors. Anal dysplasia is caused by the human papillomavirus, or HPV. Similar to how pap smears are used to screen for HPV changes in the cervix, we use anal pap smears to screen for HPV changes in the anorectal area as well. Your primary care provider will help you decide if obtaining an anal pap smear is right for you.
If abnormal cells are detected during an anal pap smear, high resolution anoscopy (HRA) will allow a more careful and comprehensive assessment of the anorectal area.
HRA entails the use of a small diameter anoscope with a light source and magnification. Abnormalities are then detected using acetic acid (vinegar) and iodine. HRA provides a clear picture of the anal canal, allowing the doctor to see any abnormal cells.
If any lesions are discovered, a biopsy can be performed during the procedure. A biopsy is the only way to make an actual diagnosis of anal dysplasia. Pain after a biopsy is minimal, and most patients only require over the counter medications like Tylenol or Advil for pain relief. If a biopsy is performed, the cells will be examined by a pathologist to determine if they represent precancerous lesions. Cancerous cells may also be identified. This is a very different procedure from a colonoscopy or a sigmoidoscopy, neither of which can adequately examine the anal canal for HPV changes.
Pelvic Floor Health
Fecal incontinence is the inability to control bowel movements, causing stool (feces) to leak unexpectedly from the rectum. This is also called bowel incontinence. Fecal incontinence ranges from an occasional leakage of stool while passing gas to a complete loss of bowel control.
Common causes of fecal incontinence include diarrhea, constipation, and muscle or nerve damage. The muscle or nerve damage may be associated with aging or with giving birth.
Whatever the cause, fecal incontinence can be embarrassing, and this common problem should be discussed with your doctor. Our doctors can provide treatments that will help improve fecal incontinence, and your quality of life.
Our colorectal specialists can help diagnose and provide comprehensive treatment options for patients with fecal incontinence to improve their quality of life. These include both non-surgical options as well as surgical procedures.
- Non-surgical options include diet modification, medications and/or pelvic floor or bowel retraining. Our specialists are trained in biofeedback which can help strengthen the sphincter muscles and improve bowel sensation.
- Surgical options include sacral nerve stimulation which provides significant and durable improvement for people with fecal incontinence. Our surgeons are also trained in minimally invasive robotic surgery.