Colorectal Surgery

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ShorePoint Health Port Charlotte and Punta Gorda's surgeons offer colon and rectal surgery, including minimally invasive techniques, to treat colorectal conditions. The surgeons work closely with gastroenterologists and other specialists to provide supportive care for colorectal conditions. This can include:

Colorectal Cancer

Colorectal cancer is a cancer that starts in the colon or the rectum, and can also be referred to as colon cancer or rectal cancer depending on the orientation of the tumor(s). Most colorectal cancers start as a growth on the inner lining of the colon or rectum, and are called polyps.

Polyps

Not all polyps become cancer, but some can change into cancer over time. There are two main types of polyps:

• Hyperplastic polyps and inflammatory polyps: These polyps are most common and generally are not pre-cancerous.
• Adenomatous polyps (adenomas): These polyps are referred to as a pre-cancerous condition since they sometimes change into cancer.

Other factors that may increase someone’s risk of developing colorectal cancer and a polyp more likely containing cancer:

• If a polyp measures larger than 1 cm.
• If more than 2 polyps are found.
• If there is an area in a polyp or in the lining of either the colon or rectum where the cells look abnormal, but don't necessarily resemble characteristics of cancer. This is referred to as dysplasia and is another pre-cancerous condition.

Colon motility problems, such as chronic constipation and bowel incontinence

Your colon is a major organ in the gastrointestinal tract that plays a critical role in regulating the frequency and consistency of stools. There are two primary symptoms:

• Altered bowel habits, such as constipation and diarrhea
• Irregular abdominal cramping

According to the National Center for Biotechnology Information, additional symptoms include straining, urgency, feeling of incomplete evacuation, passage of mucus and bloating.

Diverticular disease

Diverticular disease is a condition when diverticula (small bulges or sacs) form in the wall of the colon (large intestine), most commonly in the sigmoid colon (part of the large intestine closest to the rectum). According to The American Society of Colon and Rectal Surgeons (ASCRS), there are two main types of diverticular disease:

• Diverticulosis: The presence of diverticula without associated complications or problems. This condition can lead to more serious issues including diverticulitis, perforation (the formation of holes), stricture (a narrowing of the colon that does not easily let stool pass), fistulas, and bleeding.
• Diverticulitis: An inflammatory condition of the colon thought to be caused by perforation of one of the sacs. Several secondary complications can result from a diverticulitis attack. When this occurs, it is called complicated diverticulitis.

Hemorrhoids, fissure and fistula

• Hemorrhoids occur around the anus and lower rectum (the bottom section of your colon) and are enlarged, bulging blood vessels. Often they are referred to as varicose veins of the anus and rectum.
• Fissures are small rips or tears in the lining of the anal canal (the short tube surrounded by muscle at the end of your rectum).
• Fistulas are often the result of an anal abscess, or an infection in the internal glands of the anus. They are common in patients suffering from Crohn’s disease.

Inflammatory bowel disease, including Crohn's disease and ulcerative colitis

Inflammatory bowel disease (IBD) is often characterized by chronic inflammation of the gastrointestinal (GI) tract. There are two main types of IBD, Crohn’s disease and ulcerative colitis. Although the symptoms of both are quite similar, the areas affected in your GI tract are different. These differences include:

• Crohn’s disease: It may affect any part of your GI tract from the mouth to the anus, but most commonly affects the ileum (end of the small bowel) and the beginning of the colon (large intestine).
• Ulcerative colitis: Ulcerative colitis is limited to the colon.

Screening Tests

Colonoscopy

A colonoscopy is an internal examination of the colon (large intestine) and rectum, using a thin, flexible tube with a camera called a colonoscope. The doctor uses a video monitor to look for abnormalities such as ulcers, polyps, tumors or areas of inflammation or bleeding. If any irregularities are found, they can be biopsied or removed.

This outpatient exam is often used to screen for colon cancer or to evaluate symptoms such as abdominal pain, change in bowel habits or unexplained weight loss, among other symptoms. It can be completed in less than an hour and is performed under mild sedation to relieve any discomfort.

Colonoscopy can also be used to treat certain diseases, including removal of polyps, widening narrowed areas or blockages, or addressing bleeding from diverticula or lesions. Specialized procedures, such as laser surgery or cauterizing techniques, may also be performed during a colonoscopy.

Defecography

Through use of X-ray, defecography tests the motion of the pelvic floor (the muscles which control bowel movements and of the anus and rectum during evacuation). This test is used to evaluate for disorders of the lower bowel that are not evident by tests such as colonoscopy.

High-Resolution Anoscopy (HRA)

ShorePoint Health Port Charlotte now offers a screening procedure option for rectal cancer known as high-resolution anoscopy (HRA). HRA is a procedure used in the treatment and surveillance of anal dysplasia, a pre-cancerous condition, and the prevention of anal cancer by visualization under magnification. HRA is very different from a colonoscopy, since a colonoscopy cannot adequately examine the anal canal for the problems HRA can detect. The procedure is performed outpatient and generally lasts about 15 minutes. According to the World Journal of Gastrointestinal Endoscopy, without HRA only a small percentage of suspicious lesions are identified.

To learn more about treatment options for any of these colorectal conditions, please contact our gastrointestinal (GI) nurse navigator at (941) 766-4564.

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