Colitis is also known as inflammatory bowel disease or Idiopathic proctocolitis.

Colorectal cancer (CRC) is cancer of the colon and rectum in which abnormal cell growth occurs in the large intestine and a tumor is formed. A tumor may be benign or malignant. In a benign tumor, the cells grow and remain at their original site. In a malignant tumor, the abnormal cells grow and invade the adjacent intestine and spread to other sites.
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Crohn's disease, an IBD that affects nearly 500,000 Americans, differs from ulcerative colitis in three ways. First, while the ulcers in ulcerative colitis affect only the inner layer of the colon, the inflammation in Crohn's disease extends to the entire thickness of the ;tissue. Second, someone with Crohn's disease has sections of healthy bowel between affected areas, while the inflammation in ulcerative colitis follows an unbroken line. Also, Crohn's disease affects the entire GI tract - large and small intestines and sometimes even the stomach, esophagus and mouth - while ulcerative colitis is restricted to the colon as its name suggests.
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Gallstones are solid crystals made of either cholesterol or bilirubin, a pigment material. They can range in size from almost microscopic to over half an inch in diameter.
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Although as many as 60 million people in the United States alone experience heartburn every month, for some, it is an almost daily problem. If you feel a burning sensation that begins behind the sternum (breastbone) and moves up to the neck and throat and maybe even into the ears, you should speak to your doctor about the possibility of having GERD Gastroesophageal reflux disease.
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Inflammatory Bowel Disease (IBD) is a term that refers to both ulcerative colitis and Crohn s disease. Ulcerative colitis causes inflammation of the lining of the large intestine. Crohn s disease causes inflammation of the lining and wall of the large and/or small intestine.
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Irritable bowel syndrome (IBS) is a functional disorder of the colon (large intestine) that causes cramping abdominal pain, bloating, constipation and/or diarrhea. IBS is classified as a functional gastrointestinal disorder because no structural or biochemical cause can be found to explain the symptoms.
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Sigmoidoscopy is an internal examination of the distal large bowel (colon), using an instrument called a sigmoidoscope.The sigmoidoscope is a small camera attached to a flexible tube. It is inserted into the colon to examine the rectum, and the sigmoid and descending portions of the colon.
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Ulcerative colitis is a chronic (ongoing) disease of the colon, or large intestine. The disease is marked by inflammation and ulceration of the colon mucosa, or innermost lining. Tiny open sores, or ulcers, form on the surface of the lining, where they bleed and produce pus and mucus. Because the inflammation makes the colon empty frequently, symptoms typically include diarrhea (sometimes bloody) and often cramping abdominal pain.

The good news is that colorectal cancer is over 90% curable IF DETECTED EARLY. Because it has such a good prognosis with early detection, it is important to become educated about this disease to maximize your chance of finding it early.

Colorectal cancer starts because of polyps. The cells that line the wall of the large intestine frequently create grape-like growths called polyps. Most of the time, these growths are benign (harmless), but occasionally, they can turn into malignant tumors. This is a slow process taking between 5 and fifteen years, which gives you plenty of time to intervene.

Certain behaviors on your part can therefore decrease your risk of these polyps turning into tumors.First of all, exercise daily. It seems that even a small amount of daily exercise slows the growth of polyps. Watch your weight. Avoid smoking, and keep your alcohol intake moderate. Talk to your relatives to find out if anyone has a history of colorectal cancer or other cancers such as breast cancer. Discuss your risk factors with your doctor and ask him/her about taking folic acid.

If you are over 50, and have no history of colon cancer in your family, your annual physical should include a digital rectal examination, a flexible sigmoidoscopy and a three day fecal blood test (done by you in your home and sent to your doctor or a lab for analysis). A colonoscopy should be done every two to five years to allow your doctor to see the entire colon and look for any changes that may signal a predisposition to colorectal cancer such as polyps. During this procedure, biopsies can be taken to be further tested or polyps can be removed. This is painless.

If there is a history of colorectal cancer in your family, your first colonoscopy should be when you reach the age that your youngest relative with the disease was when he/she was diagnosed. After that, colonoscopies can be done every five years to check for changes. There are symptoms that you should bring to your doctor's attention which may require you to begin screening early for colorectal cancer:

• Fatigue
• Persistent diarrhea
• Persistent constipation
• Rectal bleeding
• Change in frequency or appearance of bowel movements
• Weight loss
• Anemia
• Abdominal pain
• Constipation

• Age: colorectal cancer is most common in people over the age of 50.
• Gender: colorectal cancer affects men and women; however women are more likely to develop colon cancer, while rectal cancer is more common in men.
• Inflammatory bowel disease: previous damage to the intestine, due to diseases such as chronic ulcerative colitis, increases the likelihood of the development of cancer.
• Family history: if family members have had colorectal cancer.
• Familial polyposis coli: inherited disorder where polyps (benign tumors) are present in the colon and rectum. Without preventative treatment, the development of CRC by age 40 is almost certain.
• Diet: a diet high in fat and animal protein, and low in dietary fiber.

The cause of Crohn's disease is not known, but there is some evidence to suggest that it is genetic. About 25% of those with the condition have a relative with the same condition or with ulcerative colitis. Researchers are currently attempting to find a gene; predisposing a person to Crohn's disease. All forms of IBD are not stress-induced.

The symptoms of Crohn's disease include diarrhea and abdominal pain, especially after eating. The discomfort usually centers on the right side or below the navel. Other symptoms include weight loss, fever, poor appetite, arthritis, skin problems, kidney stones, gallstones, abscesses, sores around the anal area and fistulas (openings where the bowel connects to the anus). It is also possible to suffer rectal bleeding that may be severe. Children with Crohn's disease may be delayed in their growth and development.

Crohn's disease is diagnosed by a series of different tests. Blood tests may show anemia, indicating internal bleeding, or an elevated white blood cell count, indicating inflammation. A barium enema x-ray is useful to show any ulcers in the intestine. In this test, the colon is filled by means of an enema with chalky white liquid called barium which allows doctors to see the colon in an x-ray. Also, a colonoscopy may be necessary.(link) This procedure will allow a doctor to view the extent of the inflammation and take a biopsy to rule out other intestinal diseases that have similar symptoms, such as ulcerative colitis.

Crohn's disease can cause a number of complications. First of all, the inflammation causes the intestine to narrow from swelling and the production of scar tissue. This can cause an obstruction. Also, the sores in the intestine can spread to surrounding tissue, especially around the anus. Once the sores spread or tunnel, they are called fistulas. Fistulas can usually be treated with medication, but sometimes need surgery to correct them.

Crohn's disease can usually be treated with medication. The drugs are similar those used to treat ulcerative colitis. The first step is with drugs containing mesalamine to control inflammation. If satisfactory results are not seen, the patient is treated with drugs called 5-ASA agents. This is a combination of sulfonamide, sulfapyridine and salicylate, and can be given orally or rectally. These medications also control inflammation and thereby greatly lessen the symptoms in mild to moderate cases. Possible side effects include nausea, heartburn, diarrhea and vomiting.

Should a patient fail to respond to treatment with 5-ASA agents, the next step is corticosteroids to reduce inflammations such as prednisone, hydrocortisone or budesonide. Side effects of corticosteroids include weight gain, high blood pressure, acne and/or facial hair. In severe cases, a person may be treated with anti-immune therapy drugs such as azathioprine to control the symptoms. Anti-immune drugs can increase a person's susceptibility to infection, however. On the other hand, treating a patient with a combination of anti-immune medications and corticosteroids is often very effective.

In some cases, it may be necessary to perform surgery when medication can no longer control the symptoms. A bowel resection may need to be performed, where the diseased section of the colon is removed and the two healthy ends are reconnected. In severe cases, the colon may need to be completely removed and one of the following options exercised:

• Brooke ileostomy. In this surgery, the doctor makes a small hole in the patient's side and attaches the ileum, or end of the small intestine, to it. An external pouch is worn to collect waste and emptied as needed.
• Continent ileostomy. In this surgery, rather than an external pouch, an internal pouch is created inside the abdomen and the patient empties it by inserting a tube through a leak proof opening in his/her side. This option carries with it the possibility of complications such as inflammation of the internal pouch or problems with the leak proof opening.
• Ileoanal anastomosis. Also known as a "pull-through operation," this procedure leaves part of the rectum in place and attaches the ileum to it. This option allows a person to have bowel movements as they did before, although they might be more frequent and looser. This surgery also carries the possible side effect of an inflamed pouch.

Gallstones form in the gallbladder, an organ located next to the liver whose purpose is to store bile, a digestive fluid produced by the liver to aid in the digestion of fat. Some components of fat, like cholesterol, do not respond well to bile and rather than dissolve as they should, they solidify and begin to form crystals. These crystals are gallstones. About 90% of all gallstones are formed this way.

There are also some gallstones made of bilirubin, and the reason that these form is not certain. However, those with certain blood diseases are at higher risk for this type of stone.

Approximately 20% of United States women and 10% of American men will develop gallstones by the age of 60. The risk of developing gallstones increases with age. Women who have had multiple pregnancies are at a higher risk, as are obese people or those who lose a great deal of weight quickly.

The largest symptom of gallstones is severe abdominal pain. However, four out of five people with gallstones experience no symptoms. These people are said to suffer from "silent gallstones." Symptomatic gallstones can cause complications such as inflammation of related organs like the liver or pancreas.

Gallstones can be treated either medically or surgically. There is a medication called ursodeoxycholic acid that is sometimes, but not always, able to dissolve gallstones. There is also a procedure called extracorporeal biliary lithotripsy where doctors use an ultrasound machine to locate the stones in the gallbladder.

Once they are located, they are broken into smaller pieces by high-energy shock waves. Then these smaller pieces are dissolved with medication. This procedure is relatively new and not available everywhere.

There are two surgical approaches to treated gallstones, both of which involve removing the gallbladder:

• One is to cut through the abdomen and simply remove the organ. This surgery, called cholecystectomy, is the way gallstones have traditionally been treated. It requires a hospital stay of five to seven days and a week or two at home to recover fully.
• The newer and easier method is done with a laparoscope, or small lighted tube. A tiny cut is made in the abdomen and the laparoscope is inserted. The instrument allows the surgeon to see the inside of the body on a monitor, and to remove the gallbladder by cutting it into small pieces which can be removed through the tiny opening.

GERD occurs when the fluid that resides in your stomach to digest food flows back into the esophagus. The fluid contains acid and digestive enzymes to break down food, and when these substances come into contact with the lining of the esophagus for a prolonged amount of time, it injures the esophagus and causes this burning feeling.

The "backflow" of GERD is caused by the muscle at the base of the esophagus, near the stomach. This muscle, called the lower esophageal sphincter, is supposed to keep acid in the stomach away from the esophagus. However, with GERD, it relaxes too much and too often, and allows the acids to flow backward.

GERD can sometimes be treated with changes in your behavior and diet as well as a few over-the-counter medications. However, if you change your diet and lifestyle and still must resort to OTC preparations a few times a week, you may need to visit your doctor to get more aggressive help.

There are also some gallstones made of bilirubin, and the reason that these form is not certain. However, those with certain blood diseases are at higher risk for this type of stone.

The risk of developing gallstones increases with age. Women who have had multiple pregnancies are at a higher risk, as are obese people or those who lose a great deal of weight quickly.

The largest symptom of gallstones is severe abdominal pain. However, four out of five people with gallstones experience no symptoms. These people are said to suffer from "silent gallstones." Symptomatic gallstones can cause complications such as inflammation of related organs like the liver or pancreas.

Gallstones can be treated either medically or surgically. There is a medication called ursodeoxycholic acid that is sometimes, but not always, able to dissolve gallstones. There is also a procedure called extracorporeal biliary lithotripsy where doctors use an ultrasound machine to locate the stones in the gallbladder.

Once they are located, they are broken into smaller pieces by high-energy shock waves. Then these smaller pieces are dissolved with medication. This procedure is relatively new and not available everywhere.

There are two surgical approaches to treated gallstones, both of which involve removing the gallbladder.

One is to cut through the abdomen and simply remove the organ. This surgery, called cholecystectomy, is the way gallstones have traditionally been treated. It requires a hospital stay of five to seven days and a week or two at home to recover fully.

The newer and easier method is done with a laparoscope, or small lighted tube. A tiny cut is made in the abdomen and the laparoscope is inserted. The instrument allows the surgeon to see the inside of the body on a monitor, and to remove the gallbladder by cutting it into small pieces which can be removed through the tiny opening.

Because the latter procedure is much less invasive, the recovery is much quicker.

Heartburn and GERD can be helped with the following changes to your behavior:

• Stop smoking
• Lose weight if you are more than 10 lbs. Overweight
• Avoid eating within two or three hours of going to bed
• Avoid sleeping on a waterbed
• Eat smaller, balanced meals throughout the day, rather than one or two big meals
• Avoid foods and beverages that contribute to heartburn such as tomato products, alcohol, chocolate, coffee and/or tea (with or without caffeine), peppermint, cinnamon, spicy foods, citrus fruits, greasy foods, peppers and onions
• Sleep with your head elevated either with an under-mattress wedge or build a platform to raise the upper half of the bed six inches. Extra pillows will not do the trick

• There are H2 blockers.
  H2 blockers are acid suppression agents that manage to lessen the amount of acid flowing back into the esophagus. This allows the lining of the esophagus to heal and therefore decreases the patient's discomfort. The FDA has approved some mild dosage H2 blockers for over-the-counter sale.
• Proton Pump Inhibitors.
  Proton pump inhibitors are more expensive, but often eliminate the symptoms entirely and can even cause a patient to go into remission for up to five years.
• Promotility Agents.
  Promotility agents give added pressure to the lower esophageal sphincter to help reduce to flow of acid into the esophagus. These are useful for mild cases of GERD.

It can sometimes be a frustrating experience when you are told that you may have inflammatory bowel disease (IBD) and that you need some tests in order to confirm the diagnosis. The diagnosis of IBD is based on a combination of exams: endoscopic (different types of scopes), radiologic (x-rays) and histologic (blood and tissue) tests. If you do have IBD, you may need additional tests from time to time to monitor the disease, or diagnose possible complications or the side effects of medications.

This condition is characterised by inflammation and ulcerations of the colon, also known as the bowel or large intestine. Not to be confused with irritable bowel syndrome. The mucous lining undergoes steady erosion with abscess formation.

The colon can become narrower and shorter. Ineffectual straining at stool movements can lead to nervous exhaustion. Ulcerative colitis usually affects the last part of the colon. The rectum is involved in majority of the cases, but sometimes it can cause inflammation throughout the entire colon.

If you have been diagnosed with inflammatory bowel disease (IBD), you'll want to learn as much as you can about all the treatment options available to you. The good news is that over the past decade, major advances in deciphering the mechanisms of this disease complex have greatly expanded those options.

At the present time, there are five basic categories of medications used in the treatment of IBD. They are:

• Aminosalicylates
• Corticosteroids
• Immunomodulators
• Antibiotics
• Biologic therapies
• Emotional Factors

Irritable Bowel Syndrome (IBS) is often described as alternating constipation and diarrhea accompanied with abdominal pain. Upon diagnostic testing, the colon shows no evidence of disease such as ulcers or inflammation. Therefore, IBS is diagnosed only after other possible digestive disorders and diseases have been ruled out.

Passing mucus with the stool or abdominal pain may accompany the bowel movements. It has also been known as spastic colon, spastic colitis, irritable colon, mucus colitis, and functional bowel disease.

The majority of these terms are incorrect because colitis implies inflammation of the large intestine (colon) and IBS does not cause inflammation.

"IBS is defined as at least 12 weeks, which need not be consecutive in the preceding 12 months, of abdominal discomfort or pain that has two of the three features:

• Pain relieved with passing a bowel movement.
• Onset of pain associated with a change in frequency of stool.
• Onset of pain associated with a change in form (consistency) of stool.

• Individuals who have diarrhea-predominant IBS.
• Patients have constipation predominant IBS.
• Some patients have pain/bloat type.

Flexible Sigmoidoscopy

Flexible sigmoidoscopy is an important screening procedure because of its ability to detect early changes in the distal colon. The 60-cm flexible sigmoidoscope provides excellent visualization with minimal discomfort to patients. Successful sigmoidoscopy requires adequate patient preparation, proper equipment and an experienced examiner who can recognize both normal and abnormal findings. Complications arising from sigmoidoscopy are rare, but patients may experience some cramping, gas or watery stools. Screening and primary preventive measures, including regular exercise and increased dietary fiber intake, can lower the morbidity and mortality associated with colorectal cancer.

Rigid Sigmoidoscopy

Rigid sigmoidoscopy has no longer the value it had in the past, before the advent of videocolonoscopy (flexible sigmoidoscopy). However, it may be still useful in ano-rectal diseases such as bleeding per rectum or inflammatory rectal disease, particularly in the general practice and pediatrics.

For performing the examination, the patient must lie on the left side, in the so called Sim's position. The bowels are previously emptied with a suppository and a digital rectal examination is first performed. The sigmoidoscope is lubricated and inserted with obturator in general direction of the navel. The direction is then changed and the obturaror is removed so that the physician can penetrated further with direct vision. A bellows is used to insufflate air to distend the rectum. Lateral movements of the sigmoidoscope's tip negotiate the Houston valve and the recto-sigmoid junction.

Colorectal Cancer Screening

Screening for colorectal cancer clearly reduces colorectal cancer mortality, yet many eligible adults remain unscreened. Several screening tests are available, and various professional organizations have differing recommendations on which screening test to use. Clinicians are challenged to ensure that eligible patients undergo colorectal cancer screening and to guide patients in choosing what tests to receive.

Detection of Proximal Adenomatous Polyps With Screening Sigmoidoscopy

The relative effectiveness of flexible sigmoidoscopy compared with colonoscopy to screen for colorectal cancer depends on the magnitude of the association between findings in the proximal and distal colon and the false-negative rate of screening sigmoidoscopy for proximal neoplasia. To address this, we performed a systematic review and meta-analysis of screening colonoscopy studies.

Laparoscopy

The Cleveland Clinic provides state-of-the-art laparoscopic surgery for a variety of colon and rectal conditions, including Crohn's disease, ulcerative colitis, diverticular disease, familial polyposis, chronic constipation, colon cancer and rectal prolapse.

A minimally invasive approach to surgery, laparoscopic procedures afford patients the benefit of smaller incisions, less pain, fewer heart, lung and wound complications and shortened hospital stay. "The best thing about laparoscopic colon surgery is that we can offer patients the results of a traditional, open surgery but with incisions that are only two inches long," remarks Cleveland Clinic Chairman of the Department of Colorectal Surgery Victor Fazio, M.D.

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