Colon Tumour and Colonic Polyps
Colonic Polyps per se do not cause abdominal pain. However, Colonic Polyps are potential precursors to the development of Colon Cancer.
Colon Tumours (Cancer) can cause abdominal pain in the later stages, particularly if there is obstruction of the colon or external invasion of the tumour into neighbouring organs. Other common symptoms of Colon Tumours include a change in the bowel frequency, change in the consistency of the stools, blood in the stools and loss of weight.
The treatment of Colonic Polyps is removal during a Colonoscopy. A Colon Tumour will require surgical removal that is usually through a keyhole/laparoscopic approach
Colonic Diverticuli are outpouchings of the colon that usually occur as one gets older. Colonic diverticuli can occur at any segment of the colon and can involve more than one segment. It is postulated that Colonic Diverticuli in patients with abnormally strong colonic contractions.
Colonic diverticuli do not usually cause pain. The majority of patients with Colonic Diverticuli usually go through life with no symptoms. In the event of pain, there are two different types of pain.
The most common type of pain is due to an infection of the outpouchings known as Diverticulitis. This usually manifests as a sharp pain over the abdomen that is overlying the affected segment of the colon. In severe cases of diverticulitis, colonic perforation can occur and this will result in widespread abdominal pain. Emergency surgery will be required in such circumstances.
The second type of pain is usually a dull ache or spasm-type pain over the segment of the colon that contains diverticuli. This is due to abnormal contractions of the segment of the colon rather than an infection and inflammation. This pain is likely to be recurring in nature.
Colitis refers to an inflammation of the lining of the colon. This is usually due to a viral or bacterial infection (Infective Colitis) and often self-limiting. In the rare occasion whereby the infection progresses, there is a risk of colonic perforation.
The commonest symptom of colitis is the presence of abdominal pain overlying the affected segment of the colon. In addition, there may be passage of blood mixed with mucus.
The elderly or individuals with known vessel disease/obstruction may develop Ischaemic Colitis. This is a form of colitis that develops due to obstruction of blood flow to the colon, akin to a heart attack. The colon then develops swelling and pain. The symptoms are similar to that of Infective Colitis. The diagnosis will require a high level of suspicion by the treating doctor.
Ulcerative Colitis and Crohn’s Disease
Ulcerative Colitis (UC) and Crohn’s Disease (CD) are collectively known as Inflammatory Bowel Disease. These are autoimmune conditions whereby the body attacks and damages itself. UC is limited to the colon and rectum whereas CD can involve the entire gastrointestinal tract from the oesophagus to the anus.
Both UC and CD can cause abdominal pain associated with the affected segment of the gastrointestinal tract. Symptoms such as blood in the stools, unexplained weight loss and anaemia are common to both conditions. In addition, CD can give rise to anal fistulas which manifest as a recurrent perianal abscess or anal discharge. Both UC and CD greatly increase the risk of gastrointestinal tract cancers, in particular, colon and rectal cancers.
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