Thursday, May 23, 2024

Colon and Rectum Ailments

On 06 Apr 2024, Seniors Today hosted their weekly Health Live Webinar with Dr Jagdish M Kothari, a Senior GI and Hepatobiliary Specialist who spoke on and answered questions about Colon and Rectal Ailments and Cancers. 

Dr Jagdish M. Kothari, M.S., M.Ch. (Surgical Oncology), is a Senior Consultant – GI & Hepatobiliary Services at the HCG Cancer Centre, Ahmedabad & is Founder Member of Aastha Oncology Associates. After completing his MBBS and MS (General Surgery) from the BJ Medical College in 1988 he further continued his training in field of Surgical Oncology from Gujarat Cancer & Research Institute leading to M.Ch. Thereafter he went for advanced training in GI & Hepatobiliary Oncology at Memorial Sloan Kettering Cancer Centre (MSKCC), New York, USA in 1993. He is also a visiting fellow at Johns Hopkins Institute, Baltimore and MSKCC, New York, USA. He has been awarded the prestigious Internal Cancer Research Technology Transfer (ICRETT) fellowship by International Union Against Cancer (UICC) Geneva, Switzerland.

He specialises in GI & Hepatobiliary Surgeries like Sphincter Preservation Rectal Surgery, D2 Gastrectomy, Hepatectomy and Major Pancreatic Resection.

He has won many Best Presentation and Best Paper awards at various National & International Conferences. He has been invited as Faculty, Speaker and Panelist in national and international conferences. He is an active member of the Association of Fellows of UICC, Geneva, Switzerland, Indian Society of Oncology, Association of Colon and Rectal Surgeons of India, Association of Surgeons of India and the Indian Medical Council.

Colorectal cancer

The colon is the large intestine and the rectum is the terminal part of the large intestine.

Colorectal cancer is no more just a cancer affecting the western population, it has been increasingly diagnosed in the Indian population as well. 

It is the third most common cancer for both men and women. 

This cancer can be prevented, intervened and treated and thus has an excellent prognosis. 

Colorectal cancer can start as a small polyp in any part of the colon and rectum, and if diagnosed in the polyp stage- which is not cancerous, in the said stage- it can be managed and furthermore prevent the development of colorectal cancer. 

For breast cancer, a mammography is done- it does not identify precancerous conditions. However, in colorectal cancer, identification of the poly in its precancerous stage can help in preventing the development of the cancer. 

Risk factors for colorectal cancer:

  • Age more than 50 years. However early onset colorectal cancer cases are also being diagnosed 
  • Male > female 
  • Family history of colorectal cancer ie genetic predisposition 
  • History of inflammatory bowel disease such as Crohn’s disease, ulcerative colitis
  • Individuals consuming a low fibre and high fat diet 
  • Individuals consuming large amounts of processed and red meat 

Common signs and symptoms of colorectal cancer:

  • Change in bowel habits- increased or decreased frequency  
  • Diarrhoea 
  • Constipation 
  • Bright red / dark stools
  • Thin streak of stool
  • Discomfort in the abdomen which is unexplained 
  • Unexplained weight loss 
  • Anemia of unexplained etiology

Investigations done to make / confirm the diagnose colorectal cancer:

  • Digital per rectal examination 
  • Genetic risk assessment 
  • Sigmoidoscopy/ colonoscopy followed by biopsy for histopathology 
  • CT scan / PET scan for staging the tumour 

Treatment options for colorectal cancer include:

  • Surgery is the only and mainstay of treatment of choice as a permanent treatment for colorectal cancer 
  • Adjunct with chemotherapy, radiotherapy and targeted therapy- depending on the staging of the cancer 

Robotic surgery has been a very recent and important integration in the modern medical field and is being used for colorectal surgeries as well. 

Dr Noor Gill
Dr Noor Gill, MBBS, deciphers the space between heartbeats, figuratively and literally. Powered by frequent long naps and caffeine, she believes that “knowledge without giving back to society is meaningless” and works to make caring cool again.

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