Coloproctology is the branch of medicine concerned with diseases of the colon, and includes four major groups of diseases of the colon - a disease of the final part of the large intestine (rectum) and anus that are usually benign, functional disorders, burned-ska diseases and malignant diseases.
Fortunate that the benign pathology of the terminal part of the colon and anus, which include hemorrhoids, fissures (cracks), peri anal fistula and genital warts (warts), and the most frequent among the patients. In recent years, increasing both the inflammatory diseases such as Crohn's disease (inflammation which mainly affects the small intestine) and ulcerative colitis, and in that sense we are all closer to the West - primarily the U.S., UK and Israel. However, najozbilnjije disease with which koloproktolozi and is principally engaged in colon cancer.
"Cancers arise as a consequence of disturbances in cell mitosis, based on gene mutations. Question is what causes cancer, because we know what causes it, but we came to the production of an adequate remedy. It is assumed to be potential carcinogens found in the stool, and that because of the long retention (constipation), long-term contact and chairs lining the colon leads to changes in the cells of the colon, causing their rapid division and leads to tumor formation. But basically, most cancers arise as a consequence of free radicals that cause oxidative stress. On one side we have the free radicals, and other scavenging weakened host defense. So, in that the interaction between the origin and the fight against oxidative stress, increases the concentration of free radicals that destroy the cell and thus lead to disease cells, organ disease, and ultimately, to a disease organism or until the occurrence of tumors. As for inflammatory diseases, and also that the etiology is unclear, but believes that it is threefold, and that the causes should be sought among bacteria and viruses in the transformation of pathological proteins. One thing is clear - the cause leading to the destruction cell elements, thus releasing the enzymes and factors that lead to disease and inflammation of the attacked organ, "explains Professor. Dr. sci. honey.Krivokapić, Head of Department III of the First Surgical Clinic and president of CCS Surgical Section of Serbia.
For more effective prevention, diagnosis, monitoring and treatment of diseases of colon cancer requires a multidisciplinary approach. Although the scientific koloproktologija area mainly for surgeons in recent years into it they are actively involved and other specialized doctors - gastroenterologists, anesthesiologists, pathologists and rentgenolozi.
Among the many diseases of the colon can be determined by that history. conversation. Diseases of the final part of the colon, particularly benign disease can be diagnosed by simple inspection of the anal examination. Every patient is required to review your finger (rectal beating) and a small instrument called anoskop.
Other diagnostic tools, which include summaries contrast agents (Barium enema), review rektoskopom or colonoscopy, are reserved for diseases of the colon located further from the anus. At the same time, histopathological confirmation is carried out and a biopsy of the lesion, whether it is malignant or benign.
In addition, in some cases are used and highly-sophisticated methods, such as endorectal ultrasound, abdominal ultrasound, magnetic resonance imaging and computed tomography. A wide range of diagnostic procedures implemented in the event of serious illness or, in colorectal cancer (colon cancer).In inflammatory diseases apply the same method except that rarely use the scanner and magnetic resonance imaging, and is mostly used by colonoscopy, Barium enema and biopsy.
Colonoscopy - endoscopic examination of the colon with a thin flexible instrument, is only one way in which it is called. targeted screening and detection of tumors in people who are still healthy and have no symptoms of disease, which is crucial for the healing of colon cancer. In fact, for colon cancer is considered curable in most cases if caught at an early stage of the disease.
Colorectal cancer is a surgical disease. Depending on the histopathological diagnosis obtained after the treatment applied to other modalities of therapy - especially polihemio therapy, and in some patients and postoperative radiation. For advanced carcinoma of the final part of the colon is introduced preoperative radiation to reach the state in which surgical treatment is purposeful.
The great importance of prevention
However, the principle of 'better to prevent than cure', and the surgeons themselves point to the importance of prevention, which in the case of colon cancer has two levels. Primary prevention refers to the struggle that the disease does not appear - through proper diet that will provide the appropriate chair, and physical activity to prevent obesity. Research suggests that a diet aimed at preventing colon cancer should be based on large amounts of ma-fresh fruits and vegetables rich in fiber neleguminoznog (cabbage, broccoli, citrus fruits, apples, pears, plums), and a mean discharge of red meat from the menu.
Because colon cancer is not the only disease of this organ, in the diet should not be neglected cereals or leguminous vegetables (soybeans, peas, beans), and it is advisable to drink and more water. More fruits and vegetables in any case, the more vitamins that are excellent antioxidants, and will thus prevent the formation of cell mutations and diseases arising from them.
"Secondary prevention is another thing. On the one hand it involves the removal of small lesions that can lead to cancer, and on the other side of the screening is mainly related to malignant disease. Screening here is to reveal lesions in the colon in the early stages, while still there are no symptoms when the polyps from which cancer occurs most often, small. skrininzi In our work only in certain cases. We as a country not yet at that level of awareness and development to implement a broad screening. It works in some countries Europe, but there is no form of the global campaign, something that is done routinely. currently being implemented in America, Czech Republic, Slovenia, and occasionally in the UK and Japan. But we are now on their way to make a program of screening colon cancer "says prof. Dr. sci. honey. Krivokapić.
According to recent data, the U.S. colorectal cancer of the anus is more common than lung cancer, probably because the multi-year campaign against smoking in this country bear fruit, that is, reducing the number of smokers. In other Western countries, lung cancer is still the first, a cancer of the colon in the second list of malignant diseases.
Stoma appliances for patients with diseases of the digestive tract
"We just do not have accurate information because they do not report any disease. Institute Dr Milan Jovanović-Batut have certain information, but they are not perfectly accurate - not because they are doing wrong, but because the disease is not reported properly. Simply There is no law that forced doctors to report any illness or even punish them.
We are the 2002nd conducted an analysis of registered cases in all 55 centers in Serbia, primarily surgical centers, where patients can occur due to colon cancer. We came to the information that was reported around 3853, and that is operated approximately 3253 cases. When we compare with the population, it follows that it is approximately 51.3 patients per 100,000 thousand population. This is a very high incidence, "concludes Professor Krivokapić.
According to statistics for Serbia in 2000. The men were mostly suffering and dying from lung cancer and colorectal cancer, while women are most afflicted by cancer of breast and cervical and colorectal cancer.
Threatened by all the younger population
The rule that the malignant tumor afflicts people between 65 and 70 years, applies less so and more and more very young people with cancer of the colon. Risk group on which the doctors in particular should take into account are those aged over 50 years. It was then that should begin with screening.
Although the youngest patient team with the third department of the First Surgical Clinic, CCS was only 17 years in our country there is a large group of patients treated for colorectal cancer in the third decade of life. That is why doctors suggest the need for great caution even in younger populations, if you experience symptoms such as bleeding in the stool, bleeding after discharge, changes in bowel patterns and types of diarrhea or constipation when there is a burden on family history
"Last year we tried to come to grips with this difficult disease. The Serbian Ministry of Health formed a group for the early detection, prevention and treatment of colon cancer, which I chair. Last December we had a consensus - a conference on early detection, prevention and treatment of colon cancer. Then he published a book of consensus, and perhaps a precursor to the creation of a good practice guide for the treatment of colorectal cancer. There we stood, and should take action now proceed through the purchase of so-called. hemokul-tests health centers, which will serve for the examination chair to acute, mild bleeding that can not be seen, and largely a consequence of a change in the colon that can be benign or malignant. This should be implemented for all who are at risk, this includes people older than 50 years, then, patients with ulcerative colitis, patients with polyps, and patients who have a positive family history. We want the action to involve health centers, general practitioners and to work on the information. media could help us to warn residents of what to expect, to activate the general practitioners in health to think of it, and educate physicians and surgeons in the diagnosis and treatment of colon cancer, "says Professor SciTech. Dr. sci. honey. Krivokapić.