Colorectal Disease

What is Colorectal Disease?

The colon has a vital function in the operation of the digestive system. The colon, also referred to as the large intestine or large bowel, performs an important role in absorbing water, nutrients, and electrolytes from semi-digested food and processing waste. Most vitamins and nutrients are absorbed and digested in the small intestine/small bowel with help from the pancreas, while the remaining liquid mostly goes into the colon. Colorectal diseases are conditions that impact the normal functioning of the colon, rectum or anal canal, all of which form the large bowel/large intestine. Certain colorectal diseases present identifiable symptoms such as abdominal pain and rectal bleeding, while others progress gradually without showing any symptoms.

Importance of Colorectal Health

It is essential to keep the colon and rectum healthy to maintain overall well-being because they are important for digestion, waste removal, and regulating the body's fluid and electrolyte levels. It is crucial to prioritise colorectal health for overall physical well-being and quality of life. There are numerous reasons why colorectal health is significant.

Digestive health: The main role of the colon is to break down semi-digested food & remove waste. When the colon health is affected for any reason constipation, gas, and bloating may occur.
Nutrient balance: The colon absorbs vital nutrients, and electrolytes from semi-digested food. When the colon isn't working properly it results in malnutrition, low blood pressure, weight loss, etc.
Overall health: A healthy colon helps maintain the right nutrient & enzyme balance and ensures effective waste removal and helps keep up a healthy weight, have more energy, and fight off disease.

Common Types of Colorectal Disease:

Colorectal Cancer:

Colorectal cancer is a disease where cancer forms in the colon or rectum. It is also referred to as rectum cancer or colon cancer depending on where they start. According to the World Health Organisation (WHO), colorectal cancer accounts for 10% of cancer cases and is the third most common cancer worldwide. It begins with abnormal growth of tissues in the organ, which gradually evolves into cancer if left untreated. The common symptoms that may occur include diarrhoea, constipation, blood in the stool, abdominal pain, etc. Prompt diagnosis and treatment of colorectal cancer can result in a full recovery. Colorectal cancer may be caused by a combination of genetic factors and lifestyle factors like high consumption of red meat, processed meats, physical inactivity, obesity, smoking, etc.

Inflammatory Bowel Disease (IBD):

Inflammatory bowel disease leads to inflammation and irritation within the digestive system. Inflammatory bowel disease majorly affects the intestine and makes it hard for the body to absorb food properly. It's a condition where the immune system attacks the digestive system's healthy components rather than defending the body. IBD is considered a lifelong disease as there are no treatments that can cure IBD, it can only be managed with medications, diet changes, lifestyle changes, etc. Constipation, diarrhoea, nausea, vomiting, and abdominal pain may develop as the inflammation slowly triggers. IBD is of two types: Both types of Inflammatory bowel disease cause inflammation in the digestive system, but Crohn's disease can effect any part of the digestive system with patchy inflammation, whereas Ulcerative Colitis involves persistent inflammation that is limited to the colon and rectum.

Diverticulosis and Diverticulitis:

Diverticulosis It is a situation where tiny pouches known as diverticula develop on the colon's wall. Diverticula is common, especially in adults over 50 years and usually appears in the lower colon. This condition is usually asymptomatic. Diverticulitis This is a condition in which the bulging pouches get inflamed. Pain, fever, nausea, and bowel changes are the common symptoms of diverticulitis.

Condition	Diverticulosis	Diverticulitis
Appearance	Bulging pouches develop on the colon walls	Bulging pouches get infected or inflamed
Signs	Usually asymptomatic or mild bloating	Pain, fever, bowel changes, nausea
Treatment	High-fibre diet, exercise, hydration	Rest, antibiotics, surgery in some cases

Colonic Polyps

Colonic polyps are abnormal tissue growths that form on the inner lining of the colon and rectum. Typically, these unusual tissues are of a small size. While most polyps are harmless, some have the potential to develop into cancer. Polyps are removed through colonoscopy to prevent them from becoming cancerous. Changes in bowel habits, changes in stool colour, iron deficiency, etc are all symptoms of colonic polyps.

Irritable Bowel Syndrome (IBS)

It is a common gastrointestinal condition that impacts the function of the large intestine. Constipation, cramps, gas, bloating, diarrhoea, and stomach pain are all indications of Irritable Bowel Syndrome. IBS does not result in severe intestinal damage and isn't considered a serious, life-threatening condition. Medication, probiotics, dietary modifications, and lifestyle adjustments can all help with the condition.

Causes and Risk Factors of Colorectal Disease:

Colorectal diseases are caused by a variety of factors, including genetics, lifestyle, and environmental triggers. These factors can impair the normal functioning of the colon and rectum, including:

Category	Details
Causes	Genetic factors, diet & lifestyle, obesity, polyps
Risk Factors	Non-modifiable factors like old age, family history of colorectal disease, modifiable factors like diet - consumption of red & processed meats, physical inactivity, smoking

Symptoms of Colorectal Disease:

The importance of colorectal health is often overlooked until symptoms appear, despite the fact that it plays a significant role in overall well-being. The signs of colorectal diseases may range from mild symptoms such as abdominal pain to more alarming indicators like blood in the stool. Some of the common symptoms include:

Changes in bowel habits: An early indicator of discomfort in the colon or rectum is indicated through persistent changes in bowel habits such as diarrhoea, constipation, etc.
Abdominal discomfort: A common noticeable sign of colorectal issues is mild to intense abdominal pain, cramps, bloating, etc.
Blood in stool: Rectal bleeding or blood in the stool is an apparent indicator of colorectal disorder.
Weight loss & fatigue: Unexpected weight loss, weakness, or exhaustion are evident signs of abdominal problems.
Other symptoms: Jaundice, presence of mucus in the stool, constant tiredness, excessive gas/bloating, recurrent abdominal pain, etc.

Treatment for Colorectal Disease:

Treatment and cure for colorectal issues depend on a number of aspects, such as the specific condition, its severity, and overall individual health. Approaches for treatment can be a mix of specific treatment strategies involving surgeries and general treatment strategies like lifestyle changes. Early detection or diagnosis ensures a complete cure or effective management of these issues. Also, a multidisciplinary approach, i.e. consulting surgeons, gastroenterologists, dietitians, etc.

General Treatment Strategies	Specific Treatment Strategies
Dietary changes	Chemotherapy
Medications	Radiation therapy
Lifestyle modifications	Targeted therapy
Colonoscopy	Immunotherapy

Preventing Colorectal Disease:

A variety of approaches must be implemented to prevent colorectal disease; implementing these changes can help prevent colorectal problems. However, if there is a family history of colorectal diseases or age factors that make colorectal problems more likely to occur in people over 50, timely screening may help prevent or cure colorectal problems early. Common preventive measures include:

Healthy dietary changes
Regular physical activity
Maintaining a healthy weight
Supplements
Regular screening
Stress management

FAQs Around Colorectal Disease

Colon cancer/colorectal cancer occurs due to the growth of abnormal cells in the colon or rectum. Factors that increase the risk of colon cancer are genetics, age, lifestyle factors, etc.

Preventive measures to reduce the risk of colorectal disease include lifestyle modifications, adoption of healthy dietary changes, regular screening, etc.

Yes, colon cancer can be genetic, but the majority of colon cancer conditions develop due to genetic mutations and lifestyle factors.

A colonoscopy helps detect a variety of conditions like inflammation, cancer, polyps, bleeding, diverticula, etc. in the colon and rectum.

Yes, colon cancer is a life-threatening disease. However, if detected in the early stages colon cancer is highly treatable.