Colon Health and Colonoscopy in Houma & South Louisiana

Colorectal cancer is cancer that develops in the tissues of the colon or rectum. Your colon and rectum are part of your digestive system:

• Your colon is the first and longest part of your large intestine. It absorbs water and some nutrients from foods. It also changes the leftover waste products into stool (poop).
• Your rectum is the lower part of your large intestine. It's where your body stores stool.

Cancer that begins in the colon is called colon cancer, and cancer that begins in the rectum is called rectal cancer. Cancer that affects either of these parts may also be called colorectal cancer.

Colorectal cancer happens when there are changes in your genetic material (DNA). These changes are also called mutations or variants. Often, the genetic changes that lead to colorectal cancer happen during your lifetime and the exact cause is unknown. But certain genetic changes that raise your risk for colorectal cancer are inherited, meaning that you are born with them.

Besides genetics, other factors, including your lifestyle and the environment, can affect your risk of colorectal cancer.

Anyone can get colorectal cancer, but certain factors make you more likely to develop it:

• Being older; your risk of getting colorectal cancer increases as you age.
• Having a personal or family history of colorectal cancer.
• Having a history of adenomas. Adenomas are colorectal polyps (growths) that look abnormal under a microscope or are 1 centimeter or larger. Adenomas are not cancer, but they can sometimes turn into cancer over time.
• Having a genetic syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colorectal cancer).
• Having chronic ulcerative colitis or Crohn disease for 8 years or more.
• Having three or more alcoholic drinks per day.
• Smoking cigarettes.
• Being Black; Black people have an increased risk of colorectal cancer and death from colorectal cancer compared to other races.
• Having obesity.

Colorectal cancer may not always cause symptoms, especially at first. If you do have symptoms, they could include:

• A change in bowel habits that lasts more than a few days, such as:
  • Diarrhea
  • Constipation
  • Feeling that the bowel does not empty completely
  • Your stool is narrower or has a different shape than usual
• Blood (either bright red or very dark) in the stool
• Frequent gas pains, bloating, fullness, or cramps
• Weight loss for no known reason
• Fatigue

Because colorectal cancer may not cause symptoms at first, it's important to have screening tests for colorectal cancer. Screening tests look for signs of a disease before you have any symptoms. They can help find cancer early, when it may be easier to treat.

Most experts recommend that start screenings at 45 and continue until at least age 75. People over 75 and those who are at high risk should talk to their providers about how often you need screening and what type of test they should get.

The types of tests include different stool tests and procedures such as colonoscopies and flexible sigmoidoscopy. Talk with your provider about how often you need screening and what type of test you should get.

If you have symptoms that could be caused by colorectal cancer or if your screening test results are abnormal, you may need to have more tests to find out if you have cancer. Possible tests include:

• A physical exam.
• A digital rectal exam. For this exam, your provider inserts a lubricated, gloved finger into your rectum to feel for lumps or anything unusual.
• The tests that are also used for screening (colonoscopy, stool tests, etc.) and biopsy, if you have not already had them.
• Other blood and tissue tests.

Your treatment options usually depend on your age, your general health, how serious the cancer is, and which type of cancer you have.

For colon cancer, your treatment may include one or more of these options:

• Surgery.
• Radiofrequency ablation, a procedure that uses radio waves to heat and destroy abnormal cells. The radio waves travel through electrodes (small devices that carry electricity).
• Cryosurgery, a procedure in which an extremely cold liquid or an instrument called a cryoprobe is used to freeze and destroy abnormal tissue.
• Chemotherapy.
• Radiation therapy.
• Targeted therapy, which uses drugs or other substances that mainly attack specific cancer cells and cause less harm to normal cells.
• Immunotherapy.

For rectal cancer, your treatment may include one or more of these options:

• Surgery.
• Radiation therapy.
• Chemotherapy.
• Active surveillance, which means having regular tests to see if your rectal cancer has changed. If the tests show the cancer is starting to grow, then you will have treatment to try to cure the cancer.
• Targeted therapy, which uses drugs or other substances that mainly attack specific cancer cells and cause less harm to normal cells.
• Immunotherapy.

Avoiding the risk factors that you have control over may help prevent some cancers. That includes:

• Not smoking
• Limiting alcohol to under three drinks per day
• Managing your weight

There are also other steps you can take to try to prevent colorectal cancer. They include:

• Getting regular colorectal cancer screenings
• Having polyps removed before they can become cancerous
• Getting regular exercise

Colonoscopy and flexible sigmoidoscopy are procedures that let your doctor look inside your rectum and colon (large intestine). They use instruments called scopes. Scopes have a light and a tiny camera attached to a long, thin tube. These procedures let your doctor see problems such as inflamed tissue, ulcers, polyps, and cancer.

Colonoscopy checks your entire colon and rectum. Flexible sigmoidoscopy checks the rectum and the lower colon (sigmoid colon) only.

A virtual colonoscopy also looks inside your rectum and part of your colon. But it does not use a scope. Instead, it is an x-ray test. Another name for this test is CT colonography.

You may need a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy to find the cause of unexplained symptoms such as:

• Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
• Changes in your bowel activity, such as diarrhea
• Pain in your abdomen (belly)
• Unexplained weight loss

Doctors also use these procedures to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you are at higher risk, you may need to start getting screened for colorectal cancer earlier.

There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.

To prepare for a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy, you will need to:

• Talk with your doctor about any health problems you have and all of the medicines and supplements that you take. You may need to stop taking some of your medicines and/or supplements before the procedure.
• Follow the bowel prep instructions from your doctor. The bowel prep clears the stool out of your colon, so your doctor will be able to see the colon during the procedure:
  • You may need to follow a clear liquid diet, usually for about one day before the procedure. Avoid red or purple drinks or gelatin; the dye can look like blood in the colon. You probably need to stop eating and drinking the night before the exam.
  • You will need to take some laxatives. They may be pills, a powder that you dissolve in liquid, an enema, or a combination of these. The laxative will cause diarrhea, so you need to stay close to the bathroom.

For a virtual colonoscopy, you will also need to drink a contrast medium the night before. The contrast medium is a dye or other substance that is visible on x-rays. It can help your doctor tell the difference between stool and polyps.

For a colonoscopy:

• You will have the procedure at a hospital or outpatient center. It usually takes 30 to 60 minutes.
• You will get IV (intravenous) sedatives or anesthesia, usually along with pain medicine, so you won't be awake or feel pain during the procedure.
• You'll lie on a table while the doctor inserts a colonoscope through your anus and into your rectum and colon. The scope inflates your large intestine with air for a better view. The camera sends a video image to a monitor so your doctor can see your colon.
• Once the scope reaches the opening to your small intestine, the doctor will slowly remove the scope. While doing so, your doctor will examine your colon again.
• If you have polyps, your doctor may remove them and send them to a lab for testing. Most polyps aren't cancer, but removing them can prevent them from becoming cancer later on.
• If you have abnormal tissue, your doctor may do a biopsy.
• The sedative or anesthesia takes time to wear off completely. You'll stay at the hospital or outpatient center for 1 to 2 hours after the procedure. Then you will need someone to drive you home.

For a virtual colonoscopy:

• You will have the procedure at a hospital or outpatient center. It usually takes about 10 to 15 minutes.
• You do not need anesthesia.
• You'll lie on a table while a specially trained x-ray technician inserts a thin tube through your anus and into your rectum. The tube inflates your large intestine with air for a better view.
• The table slides into a tunnel-shaped device where the technician takes the x-ray images. You will turn over on your side or stomach to get more images taken.

For a flexible sigmoidoscopy:

• You will have the procedure at a hospital, medical office, or outpatient center. It usually takes about 20 minutes.
• You do not need anesthesia.
• You'll lie on a table while the doctor inserts a thin tube through your anus and into your rectum. The tube inflates your large intestine with air for a better view. The camera sends a video image to a monitor so your doctor can see your lower colon.
• Once the scope has reached the top of the lower colon, the doctor will slowly remove the scope. While doing so, your doctor will examine your lower colon again.
• If you have polyps, your doctor may remove them and send them to a lab for testing. Most polyps aren't cancer, but removing them can prevent them from becoming cancer later on.
• If you have abnormal tissue, your doctor may do a biopsy.

You may feel cramping in your abdomen or bloating during the first hour after the any of these procedures. If the doctor removed polyps or performed a biopsy, you may have light bleeding from your anus. This bleeding is normal.

For a virtual colonoscopy or a flexible sigmoidoscopy, you go back to your regular activities and diet right after the test. For a colonoscopy, you can expect a full recovery and return to your normal diet by the next day.

Your doctor will give you the results of your procedure. If you had a biopsy, it can take a few days to get those results.