Colon Surgery

Patient Education > Colon/Rectal > Colon Surgery

The colon is the "large bowel" or also called the "large intestine." It is the tube-like part of your digestive tract that stores stool and pushes it out from your body. A healthy colon has a smooth protective wall. Colon tissue, however, can undergo changes. Growths can occur on the colon wall. All growths need to be removed promptly. Some of these can develop into cancer.

Possible symptoms of colon abnormalities can include abdominal pain or rectal pain, rectal bleeding, changes in bowel habits, or fatigue. If you notice any of these changes, notify your family doctor immediately. Frequent, regular check ups by your family doctor are one of the surest ways of detecting colon growths. Early detection is the key to a more successful outcome.

Sometimes the tissue in the colon changes, possibly as a result of genetics, a high fat, low fiber diet, or exposure to cancer causing substances. As the tissue changes, polyps or cancers may form on the colon lining. A "benign" polyp is a noncancerous growth. It can be as small as a pea or as large as a golf ball. Some polyps are considered precancerous. The larger the polyp is, the greater chance of it turning into cancer. Early removal of polyps may prevent them from changing into cancers.

A cancer is made up of abnormal cells that are growing out of control. Cancers can be the size of a mushroom, or they can be much larger. They can grow into or through the lining of the colon and spread to other parts of the body. The sooner cancers are removed, the greater the chance of preventing spread. If the cancer cells break off, they may travel through the colon lining into the lymph and blood vessels. These vessels may carry the cancer cells to the lymph glands, liver, lungs, or other organs, starting new cancers. This cancer spread is called metastasis.

The first step in diagnosing a colon problem is to have a thorough history and physical exam by your family physician. The physician may order additional diagnostic tests that can help pinpoint additional problems. This might include a digital rectal exam. This involves inserting a gloved finger into the rectum to evaluate for signs of tissue change. A stool sample can be checked for the presence of blood. A sigmoidoscopy and barium enema can also be performed. A sigmiodoscopy is a lighted tube used to view the lower left colon and can be used to remove tissue samples. This requires no sedation and causes little discomfort. A barium enema gives a picture of the entire colon on x-ray. The colon is filled with liquid barium. Air may be pumped inside the colon to allow an improved view of any small abnormalities. A colonoscopy is an advanced technique used for viewing the whole colon. It may be used for removing small polyps and collecting tissue samples. You will be sedated during the procedure. After the evaluation, your physician will explain the findings and discuss possible surgery and other treatments.

Treatment of polyps involves removal of the growth, often through a colonoscope. Larger or flat polyps that can't be removed with a colonoscope may require abdominal surgery to remove them. If you have colon cancer, your doctor may test to see if it has spread. These tests may include a chest x-ray to check the lungs, CT scans of the abdomen and pelvis, and blood tests for anemia or tumor markers. After these tests are done, you doctor surgically removes the cancerous portions of your colon and reconnects the healthy parts. You may also require more treatment, such as radiation or chemotherapy, before or after surgery. If surgery is performed early, it may be all the treatment you need to correct you colon problem.

Preparing for colon surgery will require a special bowel preparation to make sure the colon is thoroughly clean. This would include a laxative solution to completely clean your colon of stool. You may also be given antibiotics to help reduce the chance of infection. The surgery should remove the cancer and the surrounding tissue and lymph glands to reduce the chance of recurrence. The resection is designed to keep the colon's tube-like shape. In other words, the colon is reconnected or put back together in most surgeries. In a few selected cases or special circumstances a colostomy is required. This is when the patient wears a bag on the abdominal wall to collect stool.

Risks and complications of colon surgery include, but are not limited to, bleeding, possible blood transfusion, infection, injury to nearby organs, pneumonia, breakdown of anastomosis (where the colon is stapled together), possible need for a colostomy, bowel obstruction, blood clots, risks of anesthesia, altered bladder, bowel or sexual function, or reaction to medications.

The average hospital stay after the colon surgery is between four and six days. During that time you will be watched closely to make sure that you're healing well and that your colon has started working again. Full recovery usually takes four to six weeks. You still may tire easily for several months. Additional treatments may be recommended if the cancer has spread beyond the colon. These may include chemotherapy and/or radiation therapy.

By detecting and treating your colon problem early, the chances are good that you can return to a full and active life after your recovery, even if you have colon cancer. A high fiber, low fat diet and regular visits to your doctor are the keys to maintaining your colon's health.