Colon |
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The Colon is the main part of the large intestine, which passes from the cecum to the rectum and absorbs water and electrolytes from food that has remained undigested. Its parts are called the ascending, transverse, descending, and sigmoid colon.
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Colon Issues
Irritable bowel syndrome
Irritable bowel syndrome (IBS) is a disorder that leads to abdominal pain and bowel changes.
IBS is not the same as inflammatory bowel disease (IBD).
CausesThe reasons why IBS develops are not clear. It can occur after an infection of the intestines. This is called postinfectious IBS. There may also be other triggers, including stress.
The intestine is connected to the brain using hormone and nerve signals that go back and forth between the bowel and the brain. These signals affect bowel function and symptoms. The nerves can become more active during stress. This can cause the intestines to be more sensitive and contract more.
IBS can occur at any age. Often, it begins in the teen years or early adulthood. It is twice as common in women as in men.
About 1 in 6 people in the United States have symptoms of IBS. It is the most common intestinal problem that causes people to be referred to a bowel specialist (gastroenterologist).
SymptomsIBS symptoms vary from person to person, and range from mild to severe. Most people have mild symptoms. You are said to have IBS when symptoms are present for at least 3 days a month for a period of 3 months or more.
The main symptoms include:
People with IBS may go back and forth between having constipation and diarrhea or have or mostly have one or the other.
You may also lose your appetite if you have IBS. However, blood in stools and unintentional weight loss are not a part of IBS in most cases.
Exams and TestsThere is no test to diagnose IBS. Most of the time, your health care provider can diagnose IBS based on your symptoms. Eating a lactose-free diet for 2 weeks may help the provider identify lactase deficiency (or lactose intolerance).
The following tests may be done to rule out other problems:
In some cases of IBS, lifestyle changes can help. For example, regular exercise and improved sleep habits may reduce anxiety and help relieve bowel symptoms.
Dietary changes can be helpful. However, no specific diet can be recommended for IBS because the condition differs from one person to another.
The following changes may help:
No one medicine works for everyone. Some that your provider may suggest include:
Outlook (Prognosis)IBS may be a lifelong condition. For some people, symptoms are disabling and interfere with work, travel, and social activities.
Symptoms often get better with treatment.
IBS does not cause permanent harm to the intestines. Also, it does not lead to a serious disease, such as cancer.
When to Contact a Medical ProfessionalCall your provider if you have symptoms of IBS or if you notice changes in your bowel habits that do not go away.
IBS is not the same as inflammatory bowel disease (IBD).
CausesThe reasons why IBS develops are not clear. It can occur after an infection of the intestines. This is called postinfectious IBS. There may also be other triggers, including stress.
The intestine is connected to the brain using hormone and nerve signals that go back and forth between the bowel and the brain. These signals affect bowel function and symptoms. The nerves can become more active during stress. This can cause the intestines to be more sensitive and contract more.
IBS can occur at any age. Often, it begins in the teen years or early adulthood. It is twice as common in women as in men.
About 1 in 6 people in the United States have symptoms of IBS. It is the most common intestinal problem that causes people to be referred to a bowel specialist (gastroenterologist).
SymptomsIBS symptoms vary from person to person, and range from mild to severe. Most people have mild symptoms. You are said to have IBS when symptoms are present for at least 3 days a month for a period of 3 months or more.
The main symptoms include:
- Abdominal pain
- Gas
- Fullness
- Bloating
- Change in bowel habits
People with IBS may go back and forth between having constipation and diarrhea or have or mostly have one or the other.
- If you have IBS with diarrhea, you will have frequent, loose, watery stools. You may have an urgent need to have a bowel movement, which may be hard to control.
- If you have IBS with constipation, you will have a hard time passing stool, as well as fewer bowel movements. You may need to strain with a bowel movement and have cramps. Often, only a small amount or no stool at all will be passed.
You may also lose your appetite if you have IBS. However, blood in stools and unintentional weight loss are not a part of IBS in most cases.
Exams and TestsThere is no test to diagnose IBS. Most of the time, your health care provider can diagnose IBS based on your symptoms. Eating a lactose-free diet for 2 weeks may help the provider identify lactase deficiency (or lactose intolerance).
The following tests may be done to rule out other problems:
- Blood tests to see if you have celiac disease or a low blood count (anemia)
- Stool cultures to check for an infection
- Symptoms began later in life (over age 50)
- You have symptoms such as weight loss or bloody stools
- You have abnormal blood tests (such as a low blood count)
- Celiac disease
- Colon cancer (cancer rarely causes typical IBS symptoms, unless symptoms such as weight loss, blood in the stools, or abnormal blood tests are also present)
- Crohn disease or ulcerative colitis
In some cases of IBS, lifestyle changes can help. For example, regular exercise and improved sleep habits may reduce anxiety and help relieve bowel symptoms.
Dietary changes can be helpful. However, no specific diet can be recommended for IBS because the condition differs from one person to another.
The following changes may help:
- Avoiding foods and drinks that stimulate the intestines (such as caffeine, tea, or colas)
- Eating smaller meals
- Increasing fiber in the diet (this may improve constipation or diarrhea, but make bloating worse)
No one medicine works for everyone. Some that your provider may suggest include:
- Anticholinergic medicines (dicyclomine, propantheline, belladonna, and hyoscyamine) taken about a half-hour before eating to control intestinal muscle spasms
- Bisacodyl to treat constipation
- Loperamide to treat diarrhea
- Low doses of tricyclic antidepressants to help relieve intestinal pain
- Lubiprostone for constipation symptoms
- Rifaximin, an antibiotic
Outlook (Prognosis)IBS may be a lifelong condition. For some people, symptoms are disabling and interfere with work, travel, and social activities.
Symptoms often get better with treatment.
IBS does not cause permanent harm to the intestines. Also, it does not lead to a serious disease, such as cancer.
When to Contact a Medical ProfessionalCall your provider if you have symptoms of IBS or if you notice changes in your bowel habits that do not go away.
Colon polyps
What are colon polyps?
Colon polyps are extra pieces of tissue that grow on the lining of the colon or rectum. The colon and rectum are parts of the large intestine. The large intestine absorbs water from stool and changes it from a liquid to a solid form. Stool is the solid waste that passes through the rectum and anus as a bowel movement.
Colon polyps can be raised or flat. Raised colon polyps are growths shaped like mushrooms. They look as though they are on a stem or stalk. Flat colon polyps look like a bed of moss. Sometimes, a person can have more than one colon polyp.
Who develops colon polyps?
Anyone can develop colon polyps; however, some people are more likely to develop them than others. You may have a greater chance of developing polyps if
If you’re African American, you are more likely to develop cancerous polyps. You are also more likely to develop cancerous polyps before age 50. People with certain health problems are more likely to develop polyps. You may have a greater chance of developing polyps if you have
You may also be more likely to develop colon polyps if you
Who should be screened for colon polyps?
Most people should start colon polyp screening at age 50. African Americans should start screening at age 45. Screening is testing for diseases when you have no symptoms. Finding and removing polyps can help prevent cancer of the colon or rectum.
Your doctor may recommend screening before age 45 or 50 if
Most people with colon polyps do not have symptoms. However, some people do have signs and symptoms, such as
How does my doctor know if I have colon polyps?
Your doctor may use the following to find out if you have colon polyps:
Doctors may also find polyps while testing for other problems.
Medical and Family History
Taking a medical and family history is one of the first things a doctor may do to help determine which test is best for you.
Physical Exam
After taking a medical and family history, your doctor will perform a physical exam. During a physical exam, a doctor usually
Stool Test
A stool test is the analysis of a sample of stool. Your doctor will give you a test kit and instructions. For some tests, you may need to change your diet for a few days before the test. You return the test kit to your doctor or to a commercial facility that will send the sample to a lab for analysis. Stool tests can show the presence of blood or other signs of colon polyps.
Flexible Sigmoidoscopy
Flexible sigmoidoscopy is a test that uses a flexible, narrow tube with a light and tiny camera on one end to look inside the rectum and the lower colon. This tube is called a sigmoidoscope. The test can show irritated or swollen tissue, ulcers, and polyps. A doctor performs this test at a hospital, a health care facility, or an office. Most people will not need a sedative for the test.
For the test, you will lie on a table while your doctor inserts a flexible tube into your anus. A small camera on the tube sends a video image of the intestinal lining to a computer screen. The tube has a tool that can remove polyps. Your doctor usually removes polyps found during flexible sigmoidoscopy. A pathologist—a doctor who specializes in diagnosing diseases—will check the tissue for cancer.
Colonoscopy
Colonoscopy is a test that uses a long, flexible, narrow tube with a light and tiny camera on one end to look inside the rectum and entire colon. This tube is called a colonoscope. Colonoscopy can show irritated or swollen tissue, ulcers, and polyps. A gastroenterologist--a doctor who specializes in digestive diseases—performs this test at a hospital or an outpatient center. In most cases, you will receive sedation and pain medicines to help you relax for the test.
For the test, you will lie on a table while your doctor inserts a flexible tube into your anus. A small camera on the tube sends a video image of the intestinal lining to a computer screen. The tube has a tool that can remove polyps. Your doctor usually removes polyps found during colonoscopy. A pathologist will check the tissue for cancer.
Virtual Colonoscopy
This test uses computerized tomography (CT) to look inside the rectum and colon. CT machines use a combination of x rays and computer technology to create images. Virtual colonoscopy can show irritated or swollen tissue, ulcers, and polyps. A radiologist--a doctor who specializes in medical imaging—performs the test at a hospital or an outpatient center.
For the test, you will lie on a table while the radiologist inserts a thin tube into your anus and rectum. The tube inflates the intestine with air for a better view. The table will slide into a tunnel-shaped device where the radiologist takes x rays.
Lower Gastrointestinal Series
A lower GI series uses x rays and a chalky liquid called barium to look at your large intestine. An x-ray technician performs the test at a hospital or an outpatient center.
For the test, you will lie on a table while your doctor inserts a flexible tube into your anus. A radiologist will fill your large intestine with barium and air, which makes polyps show up more clearly on x rays.
Barium liquid in your GI tract causes stools to be white or light colored for a few days after the test. Your doctor will tell you about eating and drinking after the test.
A radiologist will review the x rays and send the results to your doctor.
How are colon polyps treated?
Doctors treat colon polyps by removing them. In most cases, the doctor uses special tools to remove colon polyps during colonoscopy or flexible sigmoidoscopy. Doctors may use a special method called endoscopic mucosal resection to remove some larger polyps, especially large flat polyps. Doctors can remove almost all polyps without surgery.
After the doctor removes polyps, he or she sends them for testing to find out if they are cancerous.
If you have colon polyps, your doctor will ask you to have regular testing in the future.
How can I prevent colon polyps?
Researchers don’t know of one sure way to prevent colon polyps. However, you might be able to lower your chances with
- eating, diet, and nutrition changes
- healthy lifestyle choices
- aspirin
Eating, Diet, and Nutrition
You may lower your chances of developing polyps by
- losing weight if you’re overweight
- eating more fruits and vegetables
- eating less fatty food, red meat, and processed meat
Some research suggests that calcium and vitamin D may lower your chances of developing polyps. Some foods rich in calcium are milk, cheese, yogurt, and broccoli. Foods that contain vitamin D include eggs, liver, and certain kinds of fish, such as salmon. Some companies add vitamin D to milk and milk products. Also, being outside in the sunlight helps your body make vitamin D. You can also talk with your doctor about taking calcium or vitamin D supplements.
For safety reasons, talk with your doctor before using dietary supplements or any other nonmainstream medicine together with or in place of the treatment your doctor prescribes. Read more at www.ods.od.nih.gov and www.nccam.nih.gov.
Healthy Lifestyle Choices
You can make the following healthy lifestyle choices to help lower your chances of colon polyps:
exercise most days of the week
don’t smoke cigarettes
avoid drinking alcohol
Aspirin
Taking a low dose of aspirin every day might help prevent polyps. However, taking aspirin daily may cause side effects, such as bleeding in the stomach or intestines. Talk with your doctor before starting to take aspirin daily.
Points to Remember
Colon polyps are extra pieces of tissue that grow on the lining of the colon or rectum. The colon and rectum are parts of the large intestine. The large intestine absorbs water from stool and changes it from a liquid to a solid form. Stool is the solid waste that passes through the rectum and anus as a bowel movement.
Colon polyps can be raised or flat. Raised colon polyps are growths shaped like mushrooms. They look as though they are on a stem or stalk. Flat colon polyps look like a bed of moss. Sometimes, a person can have more than one colon polyp.
Who develops colon polyps?
Anyone can develop colon polyps; however, some people are more likely to develop them than others. You may have a greater chance of developing polyps if
- you’re 50 years of age or older
- you’ve had polyps before
- someone in your family has had polyps or cancer of the colon or rectum
If you’re African American, you are more likely to develop cancerous polyps. You are also more likely to develop cancerous polyps before age 50. People with certain health problems are more likely to develop polyps. You may have a greater chance of developing polyps if you have
- inflammatory bowel disease--the general name for diseases that cause inflammation and irritation in the intestines. The most common types of inflammatory bowel disease are ulcerative colitis and Crohn’s disease.
- type 2 diabetes. Diabetes means your blood glucose, also called blood sugar, is too high. Type 2 diabetes, formerly called adult-onset diabetes, is the most common form of diabetes.
- a history of breast, uterine, or ovarian cancer.
You may also be more likely to develop colon polyps if you
- weigh too much
- eat a lot of fatty foods; red meats, such as beef and pork; or processed meats, such as bacon, sausage, hot dogs, and lunch meats
- don’t exercise
- smoke cigarettes
- drink alcohol
Who should be screened for colon polyps?
Most people should start colon polyp screening at age 50. African Americans should start screening at age 45. Screening is testing for diseases when you have no symptoms. Finding and removing polyps can help prevent cancer of the colon or rectum.
Your doctor may recommend screening before age 45 or 50 if
- you have symptoms
- someone in your family has had polyps or cancer of the colon or rectum
- you have other factors that increase your chances for developing polyps
Most people with colon polyps do not have symptoms. However, some people do have signs and symptoms, such as
- bleeding from the rectum. You might notice blood on your underwear or on toilet paper after you’ve had a bowel movement.
- blood in your stool. Blood can make stool look black, or blood can show up as red streaks in your stool.
- feeling tired because you have anemia--fewer red blood cells than normal—and a lack of iron in your body. Bleeding from colon polyps can lead to anemia and a lack of iron.
How does my doctor know if I have colon polyps?
Your doctor may use the following to find out if you have colon polyps:
- medical and family history
- physical exam
- stool test
- flexible sigmoidoscopy
- colonoscopy
- virtual colonoscopy
- lower gastrointestinal (GI) series
Doctors may also find polyps while testing for other problems.
Medical and Family History
Taking a medical and family history is one of the first things a doctor may do to help determine which test is best for you.
Physical Exam
After taking a medical and family history, your doctor will perform a physical exam. During a physical exam, a doctor usually
- examines your body
- uses a stethoscope to listen to sounds in your abdomen--the area between the chest and hips
- taps on specific areas of your body
Stool Test
A stool test is the analysis of a sample of stool. Your doctor will give you a test kit and instructions. For some tests, you may need to change your diet for a few days before the test. You return the test kit to your doctor or to a commercial facility that will send the sample to a lab for analysis. Stool tests can show the presence of blood or other signs of colon polyps.
Flexible Sigmoidoscopy
Flexible sigmoidoscopy is a test that uses a flexible, narrow tube with a light and tiny camera on one end to look inside the rectum and the lower colon. This tube is called a sigmoidoscope. The test can show irritated or swollen tissue, ulcers, and polyps. A doctor performs this test at a hospital, a health care facility, or an office. Most people will not need a sedative for the test.
For the test, you will lie on a table while your doctor inserts a flexible tube into your anus. A small camera on the tube sends a video image of the intestinal lining to a computer screen. The tube has a tool that can remove polyps. Your doctor usually removes polyps found during flexible sigmoidoscopy. A pathologist—a doctor who specializes in diagnosing diseases—will check the tissue for cancer.
Colonoscopy
Colonoscopy is a test that uses a long, flexible, narrow tube with a light and tiny camera on one end to look inside the rectum and entire colon. This tube is called a colonoscope. Colonoscopy can show irritated or swollen tissue, ulcers, and polyps. A gastroenterologist--a doctor who specializes in digestive diseases—performs this test at a hospital or an outpatient center. In most cases, you will receive sedation and pain medicines to help you relax for the test.
For the test, you will lie on a table while your doctor inserts a flexible tube into your anus. A small camera on the tube sends a video image of the intestinal lining to a computer screen. The tube has a tool that can remove polyps. Your doctor usually removes polyps found during colonoscopy. A pathologist will check the tissue for cancer.
Virtual Colonoscopy
This test uses computerized tomography (CT) to look inside the rectum and colon. CT machines use a combination of x rays and computer technology to create images. Virtual colonoscopy can show irritated or swollen tissue, ulcers, and polyps. A radiologist--a doctor who specializes in medical imaging—performs the test at a hospital or an outpatient center.
For the test, you will lie on a table while the radiologist inserts a thin tube into your anus and rectum. The tube inflates the intestine with air for a better view. The table will slide into a tunnel-shaped device where the radiologist takes x rays.
Lower Gastrointestinal Series
A lower GI series uses x rays and a chalky liquid called barium to look at your large intestine. An x-ray technician performs the test at a hospital or an outpatient center.
For the test, you will lie on a table while your doctor inserts a flexible tube into your anus. A radiologist will fill your large intestine with barium and air, which makes polyps show up more clearly on x rays.
Barium liquid in your GI tract causes stools to be white or light colored for a few days after the test. Your doctor will tell you about eating and drinking after the test.
A radiologist will review the x rays and send the results to your doctor.
How are colon polyps treated?
Doctors treat colon polyps by removing them. In most cases, the doctor uses special tools to remove colon polyps during colonoscopy or flexible sigmoidoscopy. Doctors may use a special method called endoscopic mucosal resection to remove some larger polyps, especially large flat polyps. Doctors can remove almost all polyps without surgery.
After the doctor removes polyps, he or she sends them for testing to find out if they are cancerous.
If you have colon polyps, your doctor will ask you to have regular testing in the future.
How can I prevent colon polyps?
Researchers don’t know of one sure way to prevent colon polyps. However, you might be able to lower your chances with
- eating, diet, and nutrition changes
- healthy lifestyle choices
- aspirin
Eating, Diet, and Nutrition
You may lower your chances of developing polyps by
- losing weight if you’re overweight
- eating more fruits and vegetables
- eating less fatty food, red meat, and processed meat
Some research suggests that calcium and vitamin D may lower your chances of developing polyps. Some foods rich in calcium are milk, cheese, yogurt, and broccoli. Foods that contain vitamin D include eggs, liver, and certain kinds of fish, such as salmon. Some companies add vitamin D to milk and milk products. Also, being outside in the sunlight helps your body make vitamin D. You can also talk with your doctor about taking calcium or vitamin D supplements.
For safety reasons, talk with your doctor before using dietary supplements or any other nonmainstream medicine together with or in place of the treatment your doctor prescribes. Read more at www.ods.od.nih.gov and www.nccam.nih.gov.
Healthy Lifestyle Choices
You can make the following healthy lifestyle choices to help lower your chances of colon polyps:
exercise most days of the week
don’t smoke cigarettes
avoid drinking alcohol
Aspirin
Taking a low dose of aspirin every day might help prevent polyps. However, taking aspirin daily may cause side effects, such as bleeding in the stomach or intestines. Talk with your doctor before starting to take aspirin daily.
Points to Remember
- Colon polyps are extra pieces of tissue that grow on the lining of the colon or rectum.
- Colon and rectal cancer usually start from polyps. Over time, some polyps can become cancerous. Removing polyps can help prevent cancer of the colon and rectum.
- Most people should start colon polyp screening at age 50. African Americans should start screening at age 45. Finding and removing polyps can help prevent cancer of the colon or rectum.
- Most people with colon polyps do not have symptoms.
- Your doctor may use the following to find out if you have colon polyps:
- medical and family history
- physical exam
- stool test
- flexible sigmoidoscopy
- colonoscopy
- virtual colonoscopy
- lower gastrointestinal (GI) series
- Doctors treat colon polyps by removing them.
Colonoscopy
What is Colonoscopy? Colonoscopy is a procedure in which a trained specialist uses a long, flexible, narrow tube with a light and tiny camera on one end, called a colonoscope or scope, to look inside your rectum and colon. Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancerExternal Link Disclaimer.
How is virtual colonoscopy different from colonoscopy?Virtual colonoscopy and colonoscopy are different in several ways. Virtual colonoscopy is an X ray test, takes less time, and doesn’t require a doctor to insert a colonoscope into the entire length of your colon. However, virtual colonoscopy may not be as effective as colonoscopy at detecting certain polyps. Also, doctors cannot treat problems during virtual colonoscopy, while they can treat some problems during colonoscopy. Your health insurance coverage for virtual colonoscopy and colonoscopy may also be different.
Why do doctors use colonoscopy?A colonoscopy can help a doctor find the cause of unexplained symptoms, such asDoctors also use colonoscopy as a screening tool for colon polyps and cancerExternal Link Disclaimer. Screening is testing for diseases when you have no symptoms. Screening may find diseases at an early stage, when a doctor has a better chance of curing the disease.
Screening for Colon and Rectal CancerYour doctor will recommend screening for colon and rectal cancer at age 50 if you don’t have health problems or other factors that make you more likely to develop colon cancer.1
Risk factors for colorectal cancer include
If you are older than 75, talk with your doctor about whether you should be screened. For more information, read the currentcolorectal cancer screening guidelinesExternal Link Disclaimer from the U.S. Preventive Services Task Force (USPSTF).
Government health insurance plans, such as Medicare, and private health insurance plans sometimes change whether and how often they pay for cancer screening tests. Check with your insurance plan to find out how often your insurance will cover a screening colonoscopy.
Visit the National Cancer Institute to learn more about colon and rectal cancerExternal Link Disclaimer
How do I prepare for a colonoscopy?To prepare for a colonoscopy, you will need to talk with your doctor, arrange for a ride home, clean out your bowel, and change your diet.
Talk with your doctorYou should talk with your doctor about any medical conditions you have and all prescribed and over-the-counter medicines, vitamins, and supplements you take, including:
Clean out your bowel and change your dietA health care professional will give you written bowel prep instructions to follow at home before the procedure. A health care professional orders a bowel prep so that little to no stool is present in your intestine. A complete bowel prep lets you pass stool that is clear. Stool inside your colon can prevent your doctor from clearly seeing the lining of your intestine.
You may need to follow a clear liquid diet for 1 to 3 days before the procedure and avoid drinks that contain red or purple dye. The instructions will provide specific direction about when to start and stop the clear liquid diet. In most cases, you may drink or eat the following:
A health care professional will ask you to follow the directions for a bowel prep before the procedure. The bowel prep will cause diarrhea, so you should stay close to a bathroom.
Different bowel preps may contain different combinations of laxatives, pills that you swallow or powders that you dissolve in water and other clear liquids, and enemas. Some people will need to drink a large amount, often a gallon, of liquid laxative over a scheduled amount of time—most often the night before the procedure. You may find this part of the bowel prep difficult; however, completing the prep is very important. Your doctor will not be able to see your colon clearly if the prep is incomplete.
Call a health care professional if you have side effects that prevent you from finishing the prep.
How do doctors perform a colonoscopy?A trained specialist performs a colonoscopy in a hospital or an outpatient center.
A health care professional will place an intravenous (IV) needle in a vein in your arm to give you sedatives, anesthesia, or pain medicine so you can relax during the procedure. The health care staff will monitor your vital signs and keep you as comfortable as possible.
For the procedure, you’ll be asked to lie on a table while the doctor inserts a colonoscope into your anus and slowly guides it through your rectum and into your colon. The scope pumps air into your large intestine to give the doctor a better view. The camera sends a video image of the intestinal lining to a monitor, allowing the doctor to examine your intestinal tissues. The doctor may move you several times on the table to adjust the scope for better viewing. Once the scope has reached the opening to your small intestine, the doctor slowly withdraws it and examines the lining of your large intestine again.
How is virtual colonoscopy different from colonoscopy?Virtual colonoscopy and colonoscopy are different in several ways. Virtual colonoscopy is an X ray test, takes less time, and doesn’t require a doctor to insert a colonoscope into the entire length of your colon. However, virtual colonoscopy may not be as effective as colonoscopy at detecting certain polyps. Also, doctors cannot treat problems during virtual colonoscopy, while they can treat some problems during colonoscopy. Your health insurance coverage for virtual colonoscopy and colonoscopy may also be different.
Why do doctors use colonoscopy?A colonoscopy can help a doctor find the cause of unexplained symptoms, such asDoctors also use colonoscopy as a screening tool for colon polyps and cancerExternal Link Disclaimer. Screening is testing for diseases when you have no symptoms. Screening may find diseases at an early stage, when a doctor has a better chance of curing the disease.
Screening for Colon and Rectal CancerYour doctor will recommend screening for colon and rectal cancer at age 50 if you don’t have health problems or other factors that make you more likely to develop colon cancer.1
Risk factors for colorectal cancer include
- someone in your family has had polyps or cancer of the colon or rectum
- a personal history of inflammatory bowel disease, such as ulcerative colitis and Crohn's disease
- other factors, such as if you weigh too much or smoke cigarettes1
If you are older than 75, talk with your doctor about whether you should be screened. For more information, read the currentcolorectal cancer screening guidelinesExternal Link Disclaimer from the U.S. Preventive Services Task Force (USPSTF).
Government health insurance plans, such as Medicare, and private health insurance plans sometimes change whether and how often they pay for cancer screening tests. Check with your insurance plan to find out how often your insurance will cover a screening colonoscopy.
Visit the National Cancer Institute to learn more about colon and rectal cancerExternal Link Disclaimer
How do I prepare for a colonoscopy?To prepare for a colonoscopy, you will need to talk with your doctor, arrange for a ride home, clean out your bowel, and change your diet.
Talk with your doctorYou should talk with your doctor about any medical conditions you have and all prescribed and over-the-counter medicines, vitamins, and supplements you take, including:
- aspirin or medicines that contain aspirin
- nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen
- arthritis medicines
- blood thinners
- diabetes medicines
- vitamins that contain iron or iron supplements
Clean out your bowel and change your dietA health care professional will give you written bowel prep instructions to follow at home before the procedure. A health care professional orders a bowel prep so that little to no stool is present in your intestine. A complete bowel prep lets you pass stool that is clear. Stool inside your colon can prevent your doctor from clearly seeing the lining of your intestine.
You may need to follow a clear liquid diet for 1 to 3 days before the procedure and avoid drinks that contain red or purple dye. The instructions will provide specific direction about when to start and stop the clear liquid diet. In most cases, you may drink or eat the following:
- fat-free bouillon or broth
- strained fruit juice, such as apple or white grape—doctors recommend avoiding orange juice
- water
- plain coffee or tea, without cream or milk
- sports drinks in flavors such as lemon, lime, or orange
- gelatin in flavors such as lemon, lime, or orange
A health care professional will ask you to follow the directions for a bowel prep before the procedure. The bowel prep will cause diarrhea, so you should stay close to a bathroom.
Different bowel preps may contain different combinations of laxatives, pills that you swallow or powders that you dissolve in water and other clear liquids, and enemas. Some people will need to drink a large amount, often a gallon, of liquid laxative over a scheduled amount of time—most often the night before the procedure. You may find this part of the bowel prep difficult; however, completing the prep is very important. Your doctor will not be able to see your colon clearly if the prep is incomplete.
Call a health care professional if you have side effects that prevent you from finishing the prep.
How do doctors perform a colonoscopy?A trained specialist performs a colonoscopy in a hospital or an outpatient center.
A health care professional will place an intravenous (IV) needle in a vein in your arm to give you sedatives, anesthesia, or pain medicine so you can relax during the procedure. The health care staff will monitor your vital signs and keep you as comfortable as possible.
For the procedure, you’ll be asked to lie on a table while the doctor inserts a colonoscope into your anus and slowly guides it through your rectum and into your colon. The scope pumps air into your large intestine to give the doctor a better view. The camera sends a video image of the intestinal lining to a monitor, allowing the doctor to examine your intestinal tissues. The doctor may move you several times on the table to adjust the scope for better viewing. Once the scope has reached the opening to your small intestine, the doctor slowly withdraws it and examines the lining of your large intestine again.
During the procedure, the doctor may remove polyps and send them to a lab for testing. Colon polyps are common in adults and are harmless in most cases. However, most colon cancer begins as a polyp, so removing polyps early is an effective way to prevent cancer.
The doctor may also perform a biopsy. You won’t feel the biopsy.
Colonoscopy typically takes 30 to 60 minutes.
What should I expect after a colonoscopy?After a colonoscopy, you can expect the following:
What are the risks of colonoscopy?The risks of colonoscopy include
A study of screening colonoscopies found roughly two serious complications for every 1,000 procedures.2
Seek Care Right AwayIf you have any of the following symptoms after a colonoscopy, seek medical care right away:
The doctor may also perform a biopsy. You won’t feel the biopsy.
Colonoscopy typically takes 30 to 60 minutes.
What should I expect after a colonoscopy?After a colonoscopy, you can expect the following:
- You’ll stay at the hospital or outpatient center for 1 to 2 hours after the procedure.
- You may have abdominal cramping or bloating during the first hour after the procedure.
- The sedatives or anesthesia takes time to wear off completely.
- You should expect a full recovery by the next day, and you should be able to go back to your normal diet.
- After the procedure, you—or a friend or family member—will receive instructions on how to care for yourself after the procedure. You should follow all instructions.
- A friend or family member will need to drive you home after the procedure.
What are the risks of colonoscopy?The risks of colonoscopy include
- bleeding
- perforation of the colon
- abnormal reaction to the sedative, including respiratory or cardiac problems
- abdominal pain
- death, although this risk is rare
A study of screening colonoscopies found roughly two serious complications for every 1,000 procedures.2
Seek Care Right AwayIf you have any of the following symptoms after a colonoscopy, seek medical care right away:
- severe abdominal pain
- fever
- continued bloody bowel movements or continued bleeding from the anus
- dizziness
- weakness
Colon Cancer
Colon Cancer
General Information About Colon Cancer
KEY POINTS
Gastrointestinal stromal tumors can occur in the colon. See the PDQ summary onGastrointestinal Stromal Tumors Treatment for more information.
See the PDQ summary about Unusual Cancers of Childhood Treatment for information about colorectal cancer in children.
Health history can affect the risk of developing colon cancer.Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors include the following:
Signs of colon cancer include blood in the stool or a change in bowel habits.These and other signs and symptoms may be caused by colon cancer or by other conditions. Check with your doctor if you have any of the following:
Barium enema : A series of x-rays of the lower gastrointestinal tract. A liquid that contains barium (a silver-white metallic compound) is put into the rectum. The barium coats the lower gastrointestinal tract and x-rays are taken. This procedure is also called a lower GI series.
Sigmoidoscopy : A procedure to look inside the rectum and sigmoid (lower) colon for polyps (small areas of bulging tissue), other abnormal areas, or cancer. Asigmoidoscope is inserted through the rectum into the sigmoid colon. A sigmoidoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.
Colonoscopy : A procedure to look inside the rectum and colon for polyps, abnormal areas, or cancer. A colonoscope is inserted through the rectum into the colon. A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.
KEY POINTS
- Colon cancer is a disease in which malignant (cancer) cells form in the tissues of the colon.
- Health history can affect the risk of developing colon cancer.
- Signs of colon cancer include blood in the stool or a change in bowel habits.
- Tests that examine the colon and rectum are used to detect (find) and diagnose colon cancer.
- Certain factors affect prognosis (chance of recovery) and treatment options.
Gastrointestinal stromal tumors can occur in the colon. See the PDQ summary onGastrointestinal Stromal Tumors Treatment for more information.
See the PDQ summary about Unusual Cancers of Childhood Treatment for information about colorectal cancer in children.
Health history can affect the risk of developing colon cancer.Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors include the following:
- A family history of cancer of the colon or rectum.
- Certain hereditary conditions, such as familial adenomatous polyposis and hereditary nonpolyposis colon cancer (HNPCC; Lynch Syndrome).
- A history of ulcerative colitis (ulcers in the lining of the large intestine) or Crohn disease.
- A personal history of cancer of the colon, rectum, ovary, endometrium, or breast.
- A personal history of polyps (small areas of bulging tissue) in the colon or rectum.
Signs of colon cancer include blood in the stool or a change in bowel habits.These and other signs and symptoms may be caused by colon cancer or by other conditions. Check with your doctor if you have any of the following:
- A change in bowel habits.
- Blood (either bright red or very dark) in the stool.
- Diarrhea, constipation, or feeling that the bowel does not empty all the way.
- Stools that are narrower than usual.
- Frequent gas pains, bloating, fullness, or cramps.
- Weight loss for no known reason.
- Feeling very tired.
- Vomiting.
- Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
- Digital rectal exam : An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the rectum to feel for lumps or anything else that seems unusual.
- Fecal occult blood test : A test to check stool (solid waste) for blood that can only be seen with a microscope. Small samples of stool are placed on special cards and returned to the doctor or laboratory for testing.
Barium enema : A series of x-rays of the lower gastrointestinal tract. A liquid that contains barium (a silver-white metallic compound) is put into the rectum. The barium coats the lower gastrointestinal tract and x-rays are taken. This procedure is also called a lower GI series.
Sigmoidoscopy : A procedure to look inside the rectum and sigmoid (lower) colon for polyps (small areas of bulging tissue), other abnormal areas, or cancer. Asigmoidoscope is inserted through the rectum into the sigmoid colon. A sigmoidoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.
Colonoscopy : A procedure to look inside the rectum and colon for polyps, abnormal areas, or cancer. A colonoscope is inserted through the rectum into the colon. A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.
- Virtual colonoscopy : A procedure that uses a series of x-rays called computed tomography to make a series of pictures of the colon. A computer puts the pictures together to create detailed images that may show polyps and anything else that seems unusual on the inside surface of the colon. This test is also called colonography or CT colonography.
- Biopsy : The removal of cells or tissues so they can be viewed under a microscope by apathologist to check for signs of cancer.
- The stage of the cancer (whether the cancer is in the inner lining of the colon only or has spread through the colon wall, or has spread to lymph nodes or other places in the body).
- Whether the cancer has blocked or made a hole in the colon.
- Whether there are any cancer cells left after surgery.
- Whether the cancer has recurred.
- The patient’s general health.
Stages of Colon Cancer
KEY POINTS
The following tests and procedures may be used in the staging process:
The following stages are used for colon cancer:Stage 0 (Carcinoma in Situ)
Stage 0 (colon carcinoma in situ). Abnormal cells are shown in the mucosa of the colon wall.In stage 0, abnormal cells are found in the mucosa (innermost layer) of the colon wall. These abnormal cells may become cancer and spread. Stage 0 is also called carcinoma in situ.
Stage I
Stage I colon cancer. Cancer has spread from the mucosa of the colon wall to the muscle layer.In stage I, cancer has formed in the mucosa (innermost layer) of the colon wall and has spread to the submucosa (layer of tissue under the mucosa). Cancer may have spread to the muscle layer of the colon wall.
Stage II
Stage II colon cancer. In stage IIA, cancer has spread through the muscle layer of the colon wall to the serosa. In stage IIB, cancer has spread through the serosa but has not spread to nearby organs. In stage IIC, cancer has spread through the serosa to nearby organs.Stage II colon cancer is divided into stage IIA, stage IIB, and stage IIC.
Stage IIIStage III colon cancer is divided into stage IIIA, stage IIIB, and stage IIIC.
Stage IIIA colon cancer. Cancer has spread through the mucosa of the colon wall to the submucosa and may have spread to the muscle layer, and has spread to one to three nearby lymph nodes or tissues near the lymph nodes. OR, cancer has spread through the mucosa to the submucosa and four to six nearby lymph nodes.In stage IIIA:
Stage IIIB colon cancer. Cancer has spread through the muscle layer of the colon wall to the serosa or has spread through the serosa but not to nearby organs; cancer has spread to one to three nearby lymph nodes or to tissues near the lymph nodes. OR, cancer has spread to the muscle layer or to the serosa, and to four to six nearby lymph nodes. OR, cancer has spread through the mucosa to the submucosa and may have spread to the muscle layer; cancer has spread to seven or more nearby lymph nodes.In stage IIIB:
Stage IIIC colon cancer. Cancer has spread through the serosa of the colon wall but not to nearby organs; cancer has spread to four to six nearby lymph nodes. OR, cancer has spread through the muscle layer to the serosa or has spread through the serosa but not to nearby organs; cancer has spread to seven or more nearby lymph nodes. OR, cancer has spread through the serosa to nearby organs and to one or more nearby lymph nodes or to tissues near the lymph nodes.In stage IIIC:
Stage IV
Stage IV colon cancer. The cancer has spread through the blood and lymph nodes to other parts of the body, such as the lung, liver, abdominal wall, or ovary.Stage IV colon cancer is divided into stage IVA and stage IVB.
- After colon cancer has been diagnosed, tests are done to find out if cancer cells have spread within the colon or to other parts of the body.
- There are three ways that cancer spreads in the body.
- Cancer may spread from where it began to other parts of the body.
- The following stages are used for colon cancer:
- Stage 0 (Carcinoma in Situ)
- Stage I
- Stage II
- Stage III
- Stage IV
The following tests and procedures may be used in the staging process:
- CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen or chest, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injectedinto a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the colon. A substance called gadolinium is injected into the patient through a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- PET scan (positron emission tomography scan): A procedure to find malignanttumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
- Chest x-ray : An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- Surgery : A procedure to remove the tumor and see how far it has spread through the colon.
- Lymph node biopsy : The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells.
- Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
- The number of red blood cells, white blood cells, and platelets.
- The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
- The portion of the blood sample made up of red blood cells.
- Carcinoembryonic antigen (CEA) assay : A test that measures the level of CEA in the blood. CEA is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of colon cancer or otherconditions.
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
- Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
- Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The following stages are used for colon cancer:Stage 0 (Carcinoma in Situ)
Stage 0 (colon carcinoma in situ). Abnormal cells are shown in the mucosa of the colon wall.In stage 0, abnormal cells are found in the mucosa (innermost layer) of the colon wall. These abnormal cells may become cancer and spread. Stage 0 is also called carcinoma in situ.
Stage I
Stage I colon cancer. Cancer has spread from the mucosa of the colon wall to the muscle layer.In stage I, cancer has formed in the mucosa (innermost layer) of the colon wall and has spread to the submucosa (layer of tissue under the mucosa). Cancer may have spread to the muscle layer of the colon wall.
Stage II
Stage II colon cancer. In stage IIA, cancer has spread through the muscle layer of the colon wall to the serosa. In stage IIB, cancer has spread through the serosa but has not spread to nearby organs. In stage IIC, cancer has spread through the serosa to nearby organs.Stage II colon cancer is divided into stage IIA, stage IIB, and stage IIC.
- Stage IIA: Cancer has spread through the muscle layer of the colon wall to the serosa(outermost layer) of the colon wall.
- Stage IIB: Cancer has spread through the serosa (outermost layer) of the colon wall but has not spread to nearby organs.
- Stage IIC: Cancer has spread through the serosa (outermost layer) of the colon wall to nearby organs.
Stage IIIStage III colon cancer is divided into stage IIIA, stage IIIB, and stage IIIC.
Stage IIIA colon cancer. Cancer has spread through the mucosa of the colon wall to the submucosa and may have spread to the muscle layer, and has spread to one to three nearby lymph nodes or tissues near the lymph nodes. OR, cancer has spread through the mucosa to the submucosa and four to six nearby lymph nodes.In stage IIIA:
- Cancer has spread through the mucosa (innermost layer) of the colon wall to thesubmucosa (layer of tissue under the mucosa) and may have spread to the muscle layer of the colon wall. Cancer has spread to at least one but not more than 3 nearbylymph nodes or cancer cells have formed in tissues near the lymph nodes; or
- Cancer has spread through the mucosa (innermost layer) of the colon wall to the submucosa (layer of tissue under the mucosa). Cancer has spread to at least 4 but not more than 6 nearby lymph nodes.
Stage IIIB colon cancer. Cancer has spread through the muscle layer of the colon wall to the serosa or has spread through the serosa but not to nearby organs; cancer has spread to one to three nearby lymph nodes or to tissues near the lymph nodes. OR, cancer has spread to the muscle layer or to the serosa, and to four to six nearby lymph nodes. OR, cancer has spread through the mucosa to the submucosa and may have spread to the muscle layer; cancer has spread to seven or more nearby lymph nodes.In stage IIIB:
- Cancer has spread through the muscle layer of the colon wall to the serosa (outermost layer) of the colon wall or has spread through the serosa but not to nearby organs. Cancer has spread to at least one but not more than 3 nearby lymph nodes or cancercells have formed in tissues near the lymph nodes; or
- Cancer has spread to the muscle layer of the colon wall or to the serosa (outermost layer) of the colon wall. Cancer has spread to at least 4 but not more than 6 nearby lymph nodes; or
- Cancer has spread through the mucosa (innermost layer) of the colon wall to thesubmucosa (layer of tissue under the mucosa) and may have spread to the muscle layer of the colon wall. Cancer has spread to 7 or more nearby lymph nodes.
Stage IIIC colon cancer. Cancer has spread through the serosa of the colon wall but not to nearby organs; cancer has spread to four to six nearby lymph nodes. OR, cancer has spread through the muscle layer to the serosa or has spread through the serosa but not to nearby organs; cancer has spread to seven or more nearby lymph nodes. OR, cancer has spread through the serosa to nearby organs and to one or more nearby lymph nodes or to tissues near the lymph nodes.In stage IIIC:
- Cancer has spread through the serosa (outermost layer) of the colon wall but has not spread to nearby organs. Cancer has spread to at least 4 but not more than 6 nearbylymph nodes; or
- Cancer has spread through the muscle layer of the colon wall to the serosa (outermost layer) of the colon wall or has spread through the serosa but has not spread to nearby organs. Cancer has spread to 7 or more nearby lymph nodes; or
- Cancer has spread through the serosa (outermost layer) of the colon wall and has spread to nearby organs. Cancer has spread to one or more nearby lymph nodes or cancer cells have formed in tissues near the lymph nodes.
Stage IV
Stage IV colon cancer. The cancer has spread through the blood and lymph nodes to other parts of the body, such as the lung, liver, abdominal wall, or ovary.Stage IV colon cancer is divided into stage IVA and stage IVB.
- Stage IVA: Cancer may have spread through the colon wall and may have spread to nearby organs or lymph nodes. Cancer has spread to one organ that is not near the colon, such as the liver, lung, or ovary, or to a distant lymph node.
- Stage IVB: Cancer may have spread through the colon wall and may have spread to nearby organs or lymph nodes. Cancer has spread to more than one organ that is not near the colon or into the lining of the abdominal wall.
Treatment Option Overview
KEY POINTS
Six types of standard treatment are used:SurgerySurgery (removing the cancer in an operation) is the most common treatment for allstages of colon cancer. A doctor may remove the cancer using one of the following types of surgery:
Radiofrequency ablationRadiofrequency ablation is the use of a special probe with tiny electrodes that kill cancercells. Sometimes the probe is inserted directly through the skin and only local anesthesia is needed. In other cases, the probe is inserted through an incision in the abdomen. This is done in the hospital with general anesthesia.
CryosurgeryCryosurgery is a treatment that uses an instrument to freeze and destroy abnormal tissue. This type of treatment is also called cryotherapy.
ChemotherapyChemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).
Chemoembolization of the hepatic artery may be used to treat cancer that has spread to the liver. This involves blocking the hepatic artery (the main artery that supplies blood to the liver) and injecting anticancer drugs between the blockage and the liver. The liver’s arteries then deliver the drugs throughout the liver. Only a small amount of the drug reaches other parts of the body. The blockage may be temporary or permanent, depending on what is used to block the artery. The liver continues to receive some blood from the hepatic portal vein, which carries blood from the stomach and intestine.
The way the chemotherapy is given depends on the type and stage of the cancer being treated.
See Drugs Approved for Colon and Rectal Cancer for more information.
Radiation therapyRadiation therapy is a cancer treatment that uses high-energy x-rays or other types ofradiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
Targeted therapyTargeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
Types of targeted therapies used in the treatment of colon cancer include the following:
New types of treatment are being tested in clinical trials.Information about clinical trials is available from the NCI website.
Patients may want to think about taking part in a clinical trial.For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.
Follow-up tests may be needed.Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer hasrecurred (come back). These tests are sometimes called follow-up tests or check-ups.
- There are different types of treatment for patients with colon cancer.
- Six types of standard treatment are used:
- Surgery
- Radiofrequency ablation
- Cryosurgery
- Chemotherapy
- Radiation therapy
- Targeted therapy
- New types of treatment are being tested in clinical trials.
- Patients may want to think about taking part in a clinical trial.
- Patients can enter clinical trials before, during, or after starting their cancer treatment.
- Follow-up tests may be needed.
Six types of standard treatment are used:SurgerySurgery (removing the cancer in an operation) is the most common treatment for allstages of colon cancer. A doctor may remove the cancer using one of the following types of surgery:
- Local excision: If the cancer is found at a very early stage, the doctor may remove it without cutting through the abdominal wall. Instead, the doctor may put a tube with a cutting tool through the rectum into the colon and cut the cancer out. This is called a local excision. If the cancer is found in a polyp (a small bulging area of tissue), the operation is called a polypectomy.
- Resection of the colon with anastomosis: If the cancer is larger, the doctor will perform a partial colectomy (removing the cancer and a small amount of healthy tissue around it). The doctor may then perform an anastomosis (sewing the healthy parts of the colon together). The doctor will also usually remove lymph nodes near the colon and examine them under a microscope to see whether they contain cancer.
ENLARGE
Resection of the colon with anastomosis. Part of the colon containing the cancer and nearby healthy tissue is removed, and then the cut ends of the colon are joined. - Resection of the colon with colostomy: If the doctor is not able to sew the 2 ends of the colon back together, a stoma (an opening) is made on the outside of the body for waste to pass through. This procedure is called a colostomy. A bag is placed around the stoma to collect the waste. Sometimes the colostomy is needed only until the lower colon has healed, and then it can be reversed. If the doctor needs to remove the entire lower colon, however, the colostomy may be permanent.
ENLARGE
Colon cancer surgery with colostomy. Part of the colon containing the cancer and nearby healthy tissue is removed, a stoma is created, and a colostomy bag is attached to the stoma.
Radiofrequency ablationRadiofrequency ablation is the use of a special probe with tiny electrodes that kill cancercells. Sometimes the probe is inserted directly through the skin and only local anesthesia is needed. In other cases, the probe is inserted through an incision in the abdomen. This is done in the hospital with general anesthesia.
CryosurgeryCryosurgery is a treatment that uses an instrument to freeze and destroy abnormal tissue. This type of treatment is also called cryotherapy.
ChemotherapyChemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).
Chemoembolization of the hepatic artery may be used to treat cancer that has spread to the liver. This involves blocking the hepatic artery (the main artery that supplies blood to the liver) and injecting anticancer drugs between the blockage and the liver. The liver’s arteries then deliver the drugs throughout the liver. Only a small amount of the drug reaches other parts of the body. The blockage may be temporary or permanent, depending on what is used to block the artery. The liver continues to receive some blood from the hepatic portal vein, which carries blood from the stomach and intestine.
The way the chemotherapy is given depends on the type and stage of the cancer being treated.
See Drugs Approved for Colon and Rectal Cancer for more information.
Radiation therapyRadiation therapy is a cancer treatment that uses high-energy x-rays or other types ofradiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
- External radiation therapy uses a machine outside the body to send radiation toward the cancer.
- Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
Targeted therapyTargeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
Types of targeted therapies used in the treatment of colon cancer include the following:
- Monoclonal antibodies: Monoclonal antibodies are made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.
- Angiogenesis inhibitors: Angiogenesis inhibitors stop the growth of new blood vesselsthat tumors need to grow.
New types of treatment are being tested in clinical trials.Information about clinical trials is available from the NCI website.
Patients may want to think about taking part in a clinical trial.For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.
Follow-up tests may be needed.Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer hasrecurred (come back). These tests are sometimes called follow-up tests or check-ups.
More Information
For more information from the National Cancer Institute about colon cancer, see the following:
- Colorectal Cancer Home Page
- Colorectal Cancer Prevention
- Colorectal Cancer Screening
- Tests to Detect Colorectal Cancer and Polyps
- Unusual Cancers of Childhood Treatment
- Cryosurgery in Cancer Treatment
- Drugs Approved for Colon and Rectal Cancer
- Targeted Cancer Therapies
- Genetic Testing for Hereditary Cancer Syndromes
Inguinal Hernia
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What is an inguinal hernia?
An inguinal hernia happens when contents of the abdomen—usually fat or part of the small intestine—bulge through a weak area in the lower abdominal wall. The abdomen is the area between the chest and the hips. The area of the lower abdominal wall is also called the inguinal or groin region. Two types of inguinal hernias are
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What are the signs and symptoms of an inguinal hernia?
The first sign of an inguinal hernia is a small bulge on one or, rarely, on both sides of the groin—the area just above the groin crease between the lower abdomen and the thigh. The bulge may increase in size over time and usually disappears when lying down.
Other signs and symptoms can include
The first sign of an inguinal hernia is a small bulge on one or, rarely, on both sides of the groin—the area just above the groin crease between the lower abdomen and the thigh. The bulge may increase in size over time and usually disappears when lying down.
Other signs and symptoms can include
- discomfort or pain in the groin—especially when straining, lifting, coughing, or exercising—that improves when resting
- feelings such as weakness, heaviness, burning, or aching in the groin
- a swollen or an enlarged scrotum in men or boys
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites
