Colon Issues By Dr. harold Gunatillake

Script
Let’s talk today on Large Bowel Issues, focussing more on dreaded colon cancer.
Your alimentary canal includes pharynx, oesophagus, stomach, small intestine, large
intestine, and anus.
Today, we are discussing on the debilitating medical
conditions in your large gut only.
This last part of your digestive system functions to absorb water from the remaining indigestible food matter, and to pass the waste material from the alimentary canal, through the anal canal.

It is the segment of the alimentary canal where the beneficial microbes dwell producing chemicals to protect the inner lining of the large gut through a process of fermentation of prebiotics like fibre.
The large intestine consists of the cecum, colon, rectum, and anal canal.
If you ever experience frequent bloating of the abdomen, colic’s, discomfort in your tummy, alteration in bowel movements, tiredness at the end of the day, losing weight. depressed with lethargy, you need to take the symptoms seriously, and see your doctor, soon.

Alteration or changes in bowel habits means that you are not regular as before, or may be passing scanty stools, or may be constipated or having loose motions.

Let’s discuss what issues can cause the problem

There are many diseases specific to large bowel and others occurring in combination with the other parts of the body.
The chronic diseases pertaining to the large bowel are
mainly inflammatory and are:
• Ulcerative colitis
• Crohn’s disease
• Spastic colon (Irritable bowel syndrome)- IBS
• Diverticular disease
• Colon Cancer
Both Ulcerative colitis and Crohn’s diseases, the inner
lining of the large gut can undergo a process called
‘dysplasia’ which is prone to cancer.
Even having Irritable Bowel Syndrome can increase your
risk of colon cancer.
Let’s now talk about UlLet’s now talk about Ulcerative colitis.

It is an inflammatory disease which affects the innermost lining of your large intestine.
It is a disease which debilitates you with life-threatening issues like turning into cancer.
The inner lining of the large gut is seen red or inflamed with ulcers scattered or localised to one region.

Exact cause of this condition is unknown, although it’s thought to be the result of a problem with the immune system, that is the defence system.
Genetics- Inherited genes are a factor in the development of ulcerative colitis.
And of course, there are environmental factors, too Radiological examination, that is through barium enema X rays- demonstrates haustral folds in the entire descending colon with small ulcerations.

There is no specific treatment for ulcerative colitis, only temporising measures to relieve symptoms.
Studies have shown probiotics may improve intestinal mucosa barrier function and immune system function
and promote secretion of anti-inflammatory factors,thereby inhibiting the growth of harmful bacteria in the intestine.

Crohn’s disease is also an inflammatory disease like ulcerative colitis, that can affect any part of the gastroesophageal tract from the mouth to the anus. Symptoms of both ulcerative colitis and Crohn’s disease are similar and there is no cure, but only temporizing
measures.
Diverticular disease
In this condition small bulges called diverticula- like little sacks pouch out from the wall of the large gut. They are most common in the sigmoid colon- part of the gut above the rectum.

The most common cause attributed to the condition idietary- a low in fibre and high in fat diet results in the formation of hard stools and consequently the pressure within the bowel rises and results in the pouches. These sacs remain dormant for a long time and gives no
problems.
The condition is diagnosed through barium meal enema x rays and through colonoscopy.
Common symptoms are abdominal distension and pain in association with diarrhoea or constipation.
They can get inflamed and abscesses may form around
the diverticula and antibiotics seem to settle temporarily. Perforation or with failure of medical therapy, segmental resection surgery may be indicated.
Cancer of the large bowel
Risk of Cancer of the large bowel is prevalent among Sri Lankan population.Colorectal cancer is the fourth leading cancer among men and sixth leading cancer
among women in Sri Lanka, according to authors Yasara Samarakoon, Nalika Gunawardena, Aloka Pathirana.
They further said that the high prevalence of being ‘at risk’ of colorectal cancer indicates the necessity of screening for colorectal cancer as a programme in Sri Lanka. Considering the logistic difficulties in offering follow-up diagnostic colonoscopy examinations for all,
the study recommends that those found as ‘high-risk’ be eferred for colonoscopy.

Furthermore, the high incidence occurs under the age of
50 years Why such a high incidence of colon cancer among Sri Lankans, when only a very small amount is linked to inherited genes. The most inherited syndromes that increase colon cancer risk is the high incidence of polyps in the large bowel. 

One reason why the incidence among Sri Lankans is the consumption of red meat from cattle seems to be high. Cattle red meat is much cheaper that goat meat, and
the average person can well afford to purchase cattle red meat. In most beef stalls in the main cities like Colombo and Kandy, the beef seems to sell fast, and you need to sometimes stand in a queue when the carcasses are brought with the health approved seal
from the health authorities, about 10 o’clock in the morning.
The incidence of consumption of pork is high among the population in the coastal regions of Sri Lanka.
Processed meats, like sausages, hot dogs, bacon are freely available in the supermarkets today, and they
seem to sell fast.
Processed foods that are high in sugar and low in fibre and nutrients have been linked to a higher cancer risk in the colon.
Researchers have found that a diet that causes blood sugar levels to spike is associated with an increased incidence and risk of large bowel cancer. Diets that include lots of vegetables, fruits and whole grain have been linked with a decreased risk of colon
cancer.
In Sri Lankan markets, leafy veggies are cheap, but not all veggies like beetroot, tomatoes, potatoes and many others are out of the reach of the average wage earner.
Obesity also seem to increase the risk of large bowel cancer. Excess body weight contributes to insulin resistance and eating more carbs and foods with added sugars seem to be the cause for obesity, in such situations.
There are certain superfoods that fight and prevents cancer such as most veggies containing cancer-fighting antioxidants and phytochemicals. For example, cruciferous vegetables, including broccoli, cauliflower and cabbage, contain sulforaphane, a substance that has been shown to reduce tumour size in mice by more than 50%
Vegetarians including vegans who consume plant-based foods have a reduced risk of developing or dying from colon cancer.
Ketogenic diet lowers blood sugar and insulin levels seem to reduce the risk of colon cancer.
Bottomline
All inflammatory diseases and cancer of the large bowel are incurable conditions. Cancer can be cured if detected early. It is reasonable to say that you should see your doctor
for an annual screening for cancer, if there is such risk and a family history.
Chronic inflammatory diseases must be diagnosed early for better palliative care and longevity.
Hope this talk was useful. Please be aware of these
tummy issues and get investigated early for better
health and wellbeing
With blessings, thank you
Dr Harold Gunatillake