Sigmoidoscopy Health Dictionary

Chronic in?ammation of the lining of the COLON and RECTUM. The disease affects around 50 people per 100,000; it is predominantly a disease of young and middle-aged adults.

Symptoms The onset may be sudden or insidious. In the acute form there is severe diarrhoea and the patient may pass up to 20 stools a day. The stools, which may be small in quantity, are ?uid and contain blood, pus and mucus. There is always fever, which runs an irregular course. In other cases the patient ?rst notices some irregularity of the movement of the bowels, with the passage of blood. This becomes gradually more marked. There may be pain but usually a varying amount of abdominal discomfort. The constant diarrhoea leads to emaciation, weakness and ANAEMIA. As a rule the acute phase passes into a chronic stage. The chronic form is liable to run a prolonged course, and most patients suffer relapses for many years. SIGMOIDOSCOPY, BIOPSY and abdominal X-RAYS are essential diagnostic procedures.

Treatment Many patients may be undernourished and need expert dietary assessment and appropriate calorie, protein, vitamin and mineral supplements. This is particularly important in children with the disorder. While speci?c nutritional treatment can initiate improvement in CROHN’S DISEASE, this is not the case with ulcerative colitis. CORTICOSTEROIDS, given by mouth or ENEMA, help to control the diarrhoea. Intravenous nutrition may be required. The anaemia is treated with iron supplements, and with blood infusions if necessary. Blood cultures should be taken, repeatedly if the fever persists. If SEPTICAEMIA is suspected, broad-spectrum antibiotics should be given. Surgery to remove part of the affected colon may be necessary and an ILEOSTOMY is sometimes required. After recovery, the patient should remain on a low-residue diet, with regular follow-up by the physician, Mesalazine and SULFASALAZINE are helpful in the prevention of recurrences.

Patients and their relatives can obtain help and advice from the National Association for Colitis and Crohn’s Disease.... ulcerative colitis

Arises from premalignant adenoma. About one in ten adenomatous polyps develop into a carcinoma. Simple excision of polyps with in situ carcinoma sometimes leads to complete cure.

Symptoms: bleeding, with alteration of bowel habit. Common in diverticular disease where large polyps may be undetected. Early detection by flexible sigmoidoscopy at hospital is essential to accurate diagnosis. Sudden episodes of unexplained diarrhoea and constipation.

The term refers to cancers of the ascending colon, caecum, transverse colon, hepatic flexure, descending colon, splenic flexure, sigmoid colon and rectum. The large bowel tumours are almost wholly adeno-carcinoma.

Common causes: ulcerative colitis, Crohn’s disease, necrotic changes in polyps. The colon is at risk from cancer on a diet high in protein, fat and alcohol and which is low in fibre. An exception is the average diet in Finland where a high fat intake is present with a low incidence of cancer. Strong evidence advanced, includes the heavy consumption of yoghurt (acidophylus lacto bacillus) by the population.

A study of 8006 Japanese men living in Hawaii revealed the close relationship between cancer of the rectum and alcohol consumption. A family history of pernicious anaemia predisposes.

A 19-year prospective study of middle-aged men employed by a Chicago electric company reveals a strong correlation between colorectal cancer and Vitamin D and calcium deficiency. Results “support the suggestion that Vitamin D and calcium may reduce the risk of colorectal cancer”. (Lancet, 1985, Feb 9, i, 307)

Patients with ulcerative colitis of more than 10 years standing carry the increased risk of developing colorectal cancer. There is evidence that malignancy in the bowel may be reduced by saponins. Alternatives of possible value. Inoperable lesions may respond to: Bayberry, Goldenseal, Echinacea, Wild Yam, Stone root, Black root, Mistletoe, Clivers, Marshmallow root, Violet leaves, Chickweed, Red Clover, Thuja.

Tea. Equal parts: Red Clover, Gotu Kola, Violet leaves. 2-3 teaspoons to each cup boiling water; infuse 15 minutes. Freely, as tolerated.

Tablets/capsules. Echinacea, Goldenseal, Wild Yam.

Formula. Echinacea 2; Bayberry 1; Wild Yam 1; Stone root 1; Goldenseal half; Liquorice quarter. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily and at bedtime.

Mistletoe: Injections of fresh plant (Iscador). (Dr Rudolph Steiner Institute, Switzerland)

Violet leaves: Daily irrigations of strong infusion.

Chickweed: Bathe rectum with strong infusion. Follow with Chickweed ointment.

Chinese Herbalism. (1) Tea – Pan-chih-lien (Scutellaria barbarta), 2 liang. (2) Tea. Feng-wei ts’ao (Pteris multifida) 1 liang, and po-chi (water chestnut) 2 liang. (3) Concoction of suitable amount of ts’ang-erh ts’ao, for bathing affected area. (Barefoot Doctor’s Manual)

Diagnosis. Exploration of proctosigmoidoscope to confirm.

Diet. Special emphasis on yoghurt which is conducive to bowel health; orally and by enema. A vegan uncooked raw food diet has been shown to reduce the body’s production of toxins linked with colon cancer. A switch from conventional Western cooked diet to an uncooked vegan diet reduced harmful enzymes produced by gut bacteria. (Journal of Nutrition)

A substance has been found in fish oil believed to prevent cancer of the colon. Mackerel, herring and sardines are among fish with this ingredient. Bowel cancer and additives. See: CROHN’S DISEASE (Note).

Preventive care. All 55-year-olds with this predisposing condition should be screened by sigmoidoscopy. Regular faecal occult blood tests advised.

Regular exercise helps prevent development of bowel cancer. (Nottingham University researchers) Treatment by general medical practitioner or oncologist. ... cancer-colorectal

A short, muscular tube that forms the lowest part of the large intestine and connects it to the anus.

Rectal disorders are diagnosed by rectal examination and proctoscopy or by sigmoidoscopy.... rectum

n. see sigmoidoscopy.... sigmoidoscope

Inflammation of the colon causing diarrhoea, usually with blood and mucus. Other symptoms may include abdominal pain and fever. Colitis may be due to infection by various types of microorganism, such as camphlobacter and shigella bacteria, viruses, or amoebae. A form of colitis may be provoked by antibiotic drugs destroying bacteria that normally live in the intestine and allowing CLOSTRIDIUM DIFFICILE, a bacteria that causes irritation, to proliferate. Colitis is a feature of ulcerative colitis and Crohn’s disease.

Investigations into colitis may include examining a faecal sample, sigmoidoscopy or colonoscopy, biopsy of inflamed areas or ulcers, and a barium enema (see barium X-ray examinations).

If the cause is an infection, antibiotics may be needed.

Crohn’s disease and ulcerative colitis are treated with corticosteroid and immunosuppressant drugs, and a special diet.... colitis

A malignant tumour of the colon. First symptoms of the disease include an inexplicable change in bowel movements (either constipation or diarrhoea), blood mixed in with the faeces, and pain in the lower abdomen. Sometimes, there are no symptoms until the tumour has grown big enough to cause an obstruction in the intestine (see intestine, obstruction of) or perforate it (see perforation).

A genetic basis has been found for some types of colon cancer.

However, in most cases, the precise cause is unknown.

Contributory factors include diet: eating a lot of meat and fatty foods and not enough fibre may increase the risk.

The disease often occurs in association with other diseases of the colon, such as ulcerative colitis and familial polyposis.

The chances of cure depend critically on early diagnosis.

Screening for this cancer includes an occult blood test; if the test is positive, sigmoidoscopy and colonoscopy may be carried out.

In most cases of colon cancer, a partial colectomy is performed.... colon, cancer of

A chronic inflammatory disease affecting the gastrointestinal tract. In young people, Crohn’s disease usually affects the ileum, causing spasms of abdominal pain, diarrhoea, loss of appetite, anaemia, weight loss, and malabsorption. In elderly people, the rectum is more often affected, causing rectal bleeding. In both groups, the disease may also affect the anus, the colon and, rarely, the mouth, oesophagus, stomach, and duodenum.

Complications include obstructions in the intestine; chronic abscesses; internal fistulas (abnormal passageways) between intestinal loops; and external fistulas from the intestine to the skin of the abdomin skin or around the anus. Complications in other parts of the body may include inflammation of the eye, severe arthritis in various joints, ankylosing spondylitis, and skin disorders (including eczema).

Investigatory procedures may include sigmoidoscopy and X-rays using barium (see barium X-ray examinations). Colonoscopy and biopsy may help distinguish the disease from ulcerative colitis.

Sulfasalazine and related drugs, and corticosteroid drugs may be prescribed.

A high-vitamin, low-fibre diet may be beneficial.

Acute attacks may require hospital treatment, and many patients need surgery.

The symptoms fluctuate over many years, eventually subsiding in some patients.

If the disease is localized, a person may remain in normal health.... crohn’s disease

The passage of blood from the rectum or anus. The blood may be red, dark brown, or black. It may be mixed with, or on the surface of, faeces or passed separately, and there may be pain. Haemorrhoids are the most common cause of rectal bleeding. Small amounts of bright red blood appear on the surface of faeces or on toilet paper. Anal fissure, anal fistula, proctitis, or rectal prolapse may also cause rectal bleeding.Cancer of the colon (see colon, cancer of) or the rectum (see rectum, cancer of), or polyps can also cause bleeding. Disorders of the colon such as diverticular disease may cause dark red faeces. Black faeces (melaena) may be due to bleeding high in the digestive tract. Bloody diarrhoea may be due to ulcerative colitis, amoebiasis, or shigellosis. Diagnosis may be made from a rectal examination, from proctoscopy, sigmoidoscopy, colonoscopy, or a double-contrast barium X-ray examination.

rectal examination Examination of the anus and rectum, performed as part of a general physical examination, to assess symptoms of pain or changes in bowel habits, and to check for the presence of tumours of the rectum or prostate gland. rectal prolapse Protrusion outsid.

nent in elderly people. If the prolapse is large, leakage of faeces may occur.

Treatment is with a fibre-rich diet.

Surgery may also be performed.... rectal bleeding

A cancerous tumour in the rectum. The cause is unknown, but dietary factors and genetic factors are thought to play a part. It is more common between ages 50 and 70.

Early symptoms are rectal bleeding during defecation and diarrhoea or constipation. Later, pain may occur. Left untreated, the cancer may eventually cause severe bleeding and pain and block the intestine. It may also spread to other organs.

The cancer may be detected by a rectal examination and confirmed with proctoscopy or sigmoidoscopy and biopsy.

Treatment is usually with surgery. For a tumour in the upper rectum, the affected area and the last part of the colon are removed and the 2 free ends of the intestine are sewn together. To promote healing, a temporary colostomy may be made. For a growth in the lower rectum, the entire rectum and anus are removed. Because there is no outlet for faeces, a permanent colostomy is created.

Radiotherapy and anticancer drugs may be used in addition to or instead of surgery.

Up to 40 per cent of people treated for rectal cancer live for 10 years or more.... rectum, cancer of