Colon Conditions

Disorders in the colon can include colon cancer, benign growths (polyps), bowel obstruction, infection, and diverticulitis. Frequently, surgery is required to diagnose and treat these conditions. Dr. Castillo specializes in laparoscopic procedures and, when appropriate, will perform these surgeries using the most minimally invasive techniques.

Colon Cancer

When caught early, colon cancer is often curable. In the United States, it is the fourth most common cancer. It is recommended that everyone who is 50 or older should be screened for colorectal cancer. In the past, surgeons had to rely on "open" surgical techniques to reach the colon and remove any cancers. Now, with laparoscopic technology, they can perform these procedures with small incisions and a much shorter recovery time.

Symptoms

A patient may experience one or more of the following symptoms:

• Rectal bleeding-blood in the stool
• Changes in bowel movements
• Abdominal pain or discomfort such as frequent gas pains, cramps, bloating, or feeling of fullness
• Diarrhea, constipation, or the feeling that the bowel does not empty completely
• Weight loss with no known reason
• Constant tiredness
• Vomiting

Diagnosis

Cancer of the colon can be diagnosed with these tests:

• Sigmoidoscopy: A procedure to examine the rectum and lower colon (called the sigmoid colon) for polyps, abnormal areas, or cancer using a lighted instrument called a sigmoidoscope.
• Colonoscopy: A procedure to examine the rectum and entire colon for polyps, abnormal areas, or cancer using a lighted instrument called a colonoscope. In addition to a light and a lens for viewing, a colonoscope has a tool that removes polyps or tissue samples. These samples are checked under a microscope for signs of cancer.
• Virtual colonoscopy: A procedure that is done with an external scanning machine instead of a device inserted into the colon. It provides a series of detailed pictures of the colon that may show polyps and anything else that seems unusual on the inside surface of the colon.
• 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.

These tests are performed by a gastroenterologist in special facilities.

Treatment

Most people with colon cancer begin treatment with surgery to remove their cancer. Dr. Castillo has been performing both open (traditional) and laparoscopic colon surgery for many years. He will provide you with the most effective, least invasive treatment, while helping you maintain the best possible quality of life.

Resection and Primary Anastomosis: During a laparoscopic colon resection, Dr. Castillo makes a few small incisions through which he removes the cancer and a small amount of healthy tissue around it. He then staples together the ends of the healthy colon that are left. After recovering from surgery, most people who have had a colon resection find that bowel movements continue normally.

Resection and colostomy: If, after the resection is completed, not enough healthy colon remains for the two ends of the colon to be stapled back together safely, Dr. Castillo makes an opening in the abdomen for waste to pass through. This procedure is called a colostomy. A bag is placed around the opening to collect the waste. This procedure is almost always temporary but will require another operation for reversal.

Diverticulitis

Diverticulitis is a very common condition that nearly 50% of Americans have by age 60. The condition occurs when small pockets called diverticula that have formed on the inner lining of the intestine become infected or inflamed. These pouches are most often found in the colon.

Symptoms of diverticulitis may start suddenly and worsen quickly. They include:

• Pain in the abdomen
• Bloating or gas
• Chills and fever
• Vomiting and nausea
• Change in bowel habits

The following symptoms may indicate more serious complications and you should seek immediate medical treatment if you experience:

• Blood in your stool
• Fever above 100.4°F that does not go away
• Sudden, severe belly or back pain

Diagnosis

In addition to a physical exam, you may require blood and radiological tests. These tests may include:

• CT scan
• Abdominal ultrasound
• X-rays of the abdomen

Treatment

Surgery is recommended for patients with recurrent episodes of diverticulitis, or symptoms that do not respond to medication. Surgery may also be required for patients with severe or recurrent episodes of bleeding.

For patients who require surgery, Dr. Castillo performs minimally invasive techniques to remove the diseased part of the colon. In emergency surgeries, patients may require a temporary colostomy bag. Patients are encouraged to seek medical attention for abdominal symptoms early to help avoid complications.

Resection: In this operation, Dr. Castillo removes the diseased part of your colon and reconnects the healthy segments that are left. He uses laparoscopic surgery methods, which allow for a quicker recovery time.

Resection with colostomy: In cases where there is too much inflammation in the colon for the ends to be rejoined safely, Dr. Castillo makes an opening in your abdomen for waste to pass through into a colostomy bag. After the inflammation has had time to heal, Dr. Castillo may be able to operate again to reconnect the ends of the colon.