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Doctors' Answers to "Frequently Asked Questions" - Colon

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Colon Tumors [posted 11/3/98]
Question: I recently had 4 TA's 1 1/2 cm in size remove via a colonoscopy I have been informed that cancer growth was found in the heads of 2 of the polyps but the cancer had not spred any further. I was under the impression that TA's were only non-cancerous polyps. No further treatment at this time has been mentioned except for future colonoscopy. Is it possible that this information I received is correct and if so, should I be overly concerned..I'm really worried and having a hard time sleeping and working because of my fear.

Answer: I'm not sure what your TA abbreviation means. Tubular Adenoma? If so, these can procede to colon cancer. The usual time from start to cancer in the bowel is 6-8 years, so regular colonoscopy will prevent the problem almost completely. I understand your anxiety, but, this is one of the least of your problems. Focus on exercise and other things to increase your longevity, since the colon will not be a problem.

Colitis - Is Budesonide a Good Alternative to Prednisone [posted 10/28/98]
Question: I have seen mention on colitis newsgroup of new drug budesonide as a substitute for prednisone for treatment of colitis --without the long term side effects. Appreciate your comments.

Answer: About the same as prednisone, just costs more.

Colon Ulcer - Alternatives to Pentasa
Question: Looking for a less expensive substitute for Pentasa, which has been prescribed for my son who has been diagnosed as having ulcerative colitis. Thank you.

Answer: Try Asacol, varies with region concerning cost.

Spastic Colon
Question: What is the best medicine for a spastic colon?

Answer: Unfortunately, there is no "best" medicine. Generally, we focus on anti-cholinergics to slow the colon since spasm tends to be the symptom that bothers patients the most. Drugs like Bentyl. Some patients, however, have more constipation, and these drugs merely increase this symptom. Generally, patients need to slow down the colon with Bentyl or equivalent drugs when the colon is spasming and speed it up with fiber, etc. when it is slow. Attention to your own colon and its rhythm is the best advice.

Colon - Diverticulitis
Question: Is diverticulitis caused and controlled more by diet or stress? What are the best methods of prevention?

Answer: Diverticuli are small blind pouches that develop off the gastrointestinal tract. In common parlance, these refer to the sacks off the colon since these are by far the most common. These are actually herniations of the colon and are usually fed by a small artery. They are most common in the sigmoid colon and increase in frequency with age. There is no clear cause of diverticuli although they are more common in developed countries than in underdeveloped countries. This has led to the thought that increased pressure causes these pouches or sacs. The pressure is thought to be due to lack of fiber in the diet and increasing colonic pressure while defecating. For most people, a diet high in fiber will minimize the symptoms-probably Tom decreasing the pressure on the sacs. Whether a high fiber diet will prevent this from increasing is not clear; but, is the current medical recommendation.

General Information
Question:Please give me all the possible information about a bleeding colon ulcer associated with diarrhea which at this moment is at an initial stage. Is there a cure? How do you cure it? Who cures it? Who, or which hospital is the expert?

Answer:Bleeding ulcers of the colon are probably inflammatory bowel disease. These diseases have an unknown cause and range in severity from one episode to continued bowel inflammation progressing to multiple surgeries. Crohn's Disease and Ulcerative Colitis are the major two entities. Crohn's Disease preferentially affects the terminal ileum which is the last part of the small intestine;however, some patients also have envolvement of the colon. Crohn's is treated with different anti-inflammatories and occasionally has involvement of other organ systems(especially arthritis)leading many to think that this is a disorder of the immune system. Ulcerative colitis usually affects only the colon with occasional minor involvement of the terminal ileum. It also is thought to be secondary to a disorder of the immune system. Unlike Crohn's, UC has an increased risk of cancer of the colon with the risk being proportional to the time of inflammation of the colon. Depending on the severity and frequency of the problem, a GI specialist usually manages this disease.
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