Colorectal Conditions & Treatment
Anal cancer is usually diagnosed when patients experience pain, bleeding, or notice a nodule or mass near the anus. The colorectal surgeon will usually help with diagnosis and post-treatment follow-up. They also help coordinate care with the D’Amour Center for Cancer Care.
The first-line treatment is usually with chemotherapy and radiation. If the cancer cannot be cured this way, surgical removal of the anus is required and this is performed by a colorectal surgeon. Most patients will never require surgery for anal cancer if it is cured by the chemo-radiation treatment.
Includes: hemorrhoids, fistula, fissures, rectal prolapse
Many people think that hemorrhoids are the only problem that can affect the anal area. There are other disorders, and they can often be uncomfortable and painful. These disorders can include infections such as abscess, fistula, and condyloma (genital infections) as well as hemorrhoids, fissures, skin problems, and rectal prolapse.
The team at Baystate understands the sensitive and difficult nature of these ailments and assists patients in the treatment process. Many times, treatment for some of these disorders does not involve surgery. When surgery is required, it can often be done as an outpatient procedure and no hospitalization is needed.
Colon and Rectal Cancer
Colon and Rectal cancers affect up to one in twelve patients in their lifetimes. These cancers become more common with age and can be detected by colonoscopy. Most people should have their first colonoscopy at the age of 50. Some people require colonoscopy earlier if they have increased risk factors for colorectal cancer.
Colon and Rectal cancers are often treated with surgery alone or in combination with chemotherapy and/or radiation depending on the type, extent, and location of the tumor. Usually part of the colon or rectum is removed and reconnected. In some situations, a stoma/ostomy may be required.
Surgery can be done with open, laparoscopic or robotic techniques. Laparoscopic and robotic techniques minimize incision size and hospital stay, and improve recovery. Baystate Colorectal surgeons routinely use laparoscopic and robotic techniques to treat colon and rectal cancer when appropriate.
Diverticulitis is an inflammation of diverticula, which represent pouches in the colon wall. Sometimes the inflammation and infection can become recurrent.
Patients who have only one mild attack usually do not need surgery. Surgery is only performed when diverticulitis is severe or recurrent, and/or when infection is so severe that it spreads throughout the abdomen. Surgery is sometimes done as an emergency, but can often be done often on a minimally invasive elective basis.
Fecal incontinence is the inability to control your bowel movements, causing stool (feces) to leak unexpectedly from your rectum. Also called bowel incontinence, fecal incontinence ranges from an occasional leakage of stool while passing gas to a complete loss of bowel control. Common causes of fecal incontinence include constipation, diarrhea, and muscle or nerve damage. Fecal incontinence may be due to a weakened anal sphincter associated with aging or to damage to the nerves and muscles of the rectum and anus from giving birth.
Treatments, such as biofeedback, sphincter surgery and InterStim Therapy, are available that can improve fecal incontinence. For more information about InterStim, please click on the InterStim link above.
Infammatory Bowel Disease
Includes: Crohn’s Disease, Ulcerative Colitis
Crohn’s disease and ulcerative colitis are often first treated by a gastroenterologist with prescription medications. If these diseases become progressive and require surgery, the expertise of a colorectal surgeon can be very helpful in managing complicated surgical decisions and challenging operations. Patients may have a fear of what will happen with surgery, or have a fear of needing an ostomy bag. The colorectal surgery team understands these worries and guides patients through this difficult decision-making process
Surgery for ulcerative colitis is curative and is often performed when patients stop responding to medication, or develop precancerous changes in the colon. Patients undergo complete removal of the colon and rectum with sparing of the anal sphincter. A pouch is made out of small intestine and is attached to the anus to create a place for stool to gather before bowel movements. This complex reconstructive surgery is done routinely at Baystate using minimally invasive/laparoscopic and robotic techniques.
Crohn’s Disease can present challenges because it can affect patient’s digestive tracts anywhere from the mouth to the anus. Surgeons try to minimize operative procedures on Crohn’s patients, but the reality is that over half of Crohn’s patients may require surgery and repeat surgery through their lifetimes. Careful decision-making and surgical approach is a must. The colorectal surgeons at Baystate have extensive experience with complicated Crohn’s disease. At times, surgery can even be performed laparoscopically/robotically.
Ostomies, or stomas, are created for many reasons ranging from cancer to incontinence. People often fear life with a bag, but the truth is people can live very full lives with them. The decision to give a patient an ostomy bag is taken seriously and are only made when absolutely necessary. If a patient needs to have a bag, the team does its very best to prepare and educate the patient before the operation, during hospitalization, and in the follow-up period after the operation.
Pelvic floor disorders
Includes Incontinence, Constipation, Pelvic Pain
These disorders are very personal to patients, and can include, pain, incontinence, constipation, and other urologic or gynecologic issues. Physiology testing is performed on site in the colorectal practice to better assess these problems.
Patients may need surgery for some of these issues, but also receive support and treatment with therapies such a biofeedback. The team is committed to supporting patients with these very personal and difficult issues.
These are rare disorders that result in polyps in the colon at an early age. They can run in families or can be spontaneous. Patients often have hundreds or thousands of polyps and have a very high risk of developing colorectal cancer. These diseases include Familial Adenomatous Polyposis, Lynch Syndrome (HNPCC), Peutz Jeghers Syndrome, Juvenile Polyposis and other rare syndromes. You can discuss genetic counseling at Baystate Medical Center with your surgeon.
The treatment of these diseases usually centers around removal of all or part of the colorectum. These procedures can be performed laparoscopically and robotically and often involve reconstruction with a pouch. The colorectal team understand that this disease affects the whole family and the team works with families to guide them through the surgical process and the lifestyle adjustments that have to be made when polyposis syndromes occur in families.