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Colorectal Surgery

Problems with your digestive system can be difficult to diagnose. If your primary care doctor is having trouble pinpointing the cause or your digestive discomfort, you may be referred you to an internist with experience diagnosing and treating these hard-to-define issues in adults. Your particular condition could be caused by anything ranging from a genetic disorder to a food allergy. In addition, there’s a vast array of symptoms that can stem from other, underlying health conditions.

If your condition is located in your lower intestines, your internist may recommend surgical treatment. In this case, you may be a candidate for colorectal surgery. This type of surgery is performed to repair and treat damage to your rectum, colon and anus. Colorectal surgery can also be an option to treat hernias.

Reasons for Colorectal Surgery

Blockages can form from scar tissue or masses that grow within your rectum, which can block the flow of feces. If you’ve sustained an injury to your lower digestive tract or have an obstruction, you may require surgery as well. Other causes of digestive system disorders that might require colorectal surgery include diseases such as:

  • Cancer
  • Inflammatory bowel disease (IBS)
  • Ulcerative colitis
  • Diverticulitis

If your general practitioner has diagnosed you with colorectal cancer or Crohn’s disease, you may need a major rebuilding of your digestive tract, which is only possible through colorectal surgery. There are other less serious conditions that may require colorectal surgery as well, such as hemorrhoids, rectal prolapse and skin tears in the lining of your anus. In addition to repairing these areas and removing blockages, colorectal surgery also tightens your sphincter muscle to help the digestive process work better going forward.

Types of Colorectal Surgery

Your colorectal surgeon may employ a wide range of procedures to treat intestinal conditions. Up until 1990, every colorectal surgery started with a large incision across your stomach, opening up that cavity and proceeding to remove the obstruction or make the necessary repair.

Today, colorectal surgeons perform surgery from an opening inside the body that goes to the outside, which is called an ostomy. The most common types of ostomy are colostomy and ileostomy. A colostomy brings part of the large intestine through the abdomen creating an opening that allows excrement to go out of the body to a bag or pouch. An ileostomy is the removal of the entire anus, rectum and colon.

Newer Procedures Available

Your internal medicine doctor or gastroenterologist may recommend a new surgical procedure called ileoanal anastomosis. This is a procedure that creates a reservoir in your rectum that acts like an artificial rectum.

Your doctor also may suggest laparoscopic surgery, which is commonly used to treat diseases in the digestive tract, including cancer. During this surgery, your local Manhattan colorectal surgeon uses an instrument with a small video camera attached. Called a laparoscope, it’s inserted through a small opening in your abdomen and the surgeon can see the obstructions or diseased tissue on a monitor, allowing him to remove it more effectively.

Diagnosis for Treatment

You may have a condition that only calls for surgery that’s minimally invasive. This is defined as a surgery performed through tiny incisions instead of large openings. The tiny incisions heal faster, which means a shorter recovery time for you.

After your internist diagnoses you, you can discuss your options and — based on your overall health and your input — determine the best treatment for you. Your doctor considers many factors to determine the best approach, including:

  • Your general health history
  • The type and level of pain you’re feeling
  • Your genetic history
  • Results of diagnostic tests

Diagnostic Tests for Colorectal Surgery

These tests may include a flexible sigmoidoscopy, colonoscopy, or a lower gastrointestinal (GI) series of tests to check the condition of your lower digestive tract. Each of these tests can identify the existence of masses or perforations on the walls of your bowels:

  • The flexible sigmoidoscopy test relies on a miniature camera attached to a flexible tube that the doctor inserts into your rectum. The test provides a visual of your rectum lining and sigmoid colon, which is the last section of your lower intestine. This instrument also has the ability to remove tissue or polyps for further testing.
  • The colonoscopy test is similar to the flexible sigmoidoscopy, except it allows your doctor to view your entire intestine. This sounds painful and it is, which is why you’re given a sedative for this test.
  • The series of lower GI tests includes an X-ray of your rectum and colon. This X-ray can show the existence of cysts, polyps, ulcers, cancer and pouches on the intestine walls. Before the X-ray, the technician provides you with a barium enema, which coats your intestinal tract, making it easier to see signs of disease on the X-ray.

Sometimes, magnetic resonance imaging (MRI) technology is used for diagnostic purposes. MRIs use a powerful magnet to take pictures inside your body. MRIs can also be used to help determine if you would benefit from an additional therapy like radiation or chemotherapy.

Before Your Surgery

Your internist discusses and explains the procedure, makes you aware of possible risks and side effects, as well as what to expect after the surgery. You have to sign a consent form for the surgery, as is the case with any surgery. The surgeon also takes urine and blood tests, possibly with an EKG or X-rays.

Your internal medicine specialist also instructs you to go on a restricted diet several days before surgery or a liquid-only diet the day before your procedure. This makes sure your bowel is empty and clean. You may also be required to have a series of enemas or oral anti-infection medicines to reduce bacteria in your intestines to prevent infection after the surgery.

After the Surgery

Recovery following colorectal surgery depends on the type of procedure you had. You may have to spend a few days in the hospital if you underwent an invasive procedure. Additional tests and follow-up treatments may be needed if you had surgery to remove cancer.

You’re provided with follow-up instructions for how to proceed. You may need additional visits to learn how to use colostomy equipment or physical therapy to strengthen your abdomen. Don’t hesitate to call your doctor if you experience severe symptoms following your particular procedure.