Washington Colorectal Surgery - Colorectal Surgery, Arlington, VA

Patient Info

Frequently Asked Questions:

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Conditions:

Washington Colorectal Surgery is dedicated to the sensitive, sophisticated treatment of patients with diseases and disorders affecting the colon, rectum and anus. Conditions treated include, but are not limited to, the following:

anal cancer
anal fissures
anal warts
anorectal abscess
bowel/fecal incontinence
colorectal cancer
constipation
crohn's disease
diverticulitis
hemorrhoids
irritable bowel syndrome (ibs)
laparoscopic surgical procedures
pilonidal disease
polyps
pruritis ani
rectal prolapse
rectocele
tem - transanal endoscopic microsurgery
ulcerative colitis

What is anal cancer?

Anal cancer arises from the cells around the anal opening (verge) or within the anal canal up to its junction with the rectum. Most anal cancers arise from skin cells and are called squamous cell carcinomas. Some arise from the special mucosal cells lining the upper anal canal and are called cloacogenic carcinomas. There are several other types of cancers that may occur in this area, however, these are the two most common. They behave similarly and are treated in generally the same way. Cells that are becoming malignant but have not invaded below the surface are called pre-cancerous. This condition is called Bowen's disease.

What is an anal fissure?

An anal fissure is a small tear or cut in the skin lining the anus which can cause pain and/or bleeding.

What are anal warts?

Anal warts are a common and bothersome condition that affects the area around the anus. Also called Condyloma Acuminata, they may also affect the skin of the genital area. They first appear as small blemishes, maybe as small as a pinhead and can grow larger than the size of a pea. Usually, they do not cause pain or discomfort to an individual which is why patients may be unaware that the warts are present. Anal warts are thought to be caused by HPV or Human Papilloma Virus which is relatively contagious and is transmitted from person to person by direct contact.

What is anorectal abscess?

Abscesses in the anorectal region occur in all age groups and are a common distressing problem. Adequate drainage is the treatment of choice. Drainage results in healing in more than half of the cases, and persistent or recurrence is due to inadequate drainage or the presence of predisposing factors such as systemic disorders or the development of fistula in ano. There are different types of abscesses which are defined by location: Perianal, Ischiorectal, Intersphincteric, Supralevator, Postanal, and Submucous.

What is bowel (or fecal) incontinence?

Bowel (or fecal) Incontinence is the decreased ability to control stool or gas. Its severity ranges from mild difficulty with gas control to severe loss of control over liquid and formed stools. Incontinence of stool is a common problem but, because of embarrassment, often not discussed. Both bowel and bladder incontinence are problems that tend to increase with age.

What is colorectal cancer?

Colorectal Cancer is the second leading cause of cancer-related death and one of the most preventable. One in twenty people will develop colorectal cancer in their lifetime. It is estimated that 14% of all cancers diagnosed each year occur in the colon or rectum. This translates into almost 138,000 cancers and nearly 60,000 people die of colorectal cancer every year.

Most colon and rectal cancers develop from a single cell in the lining of the bowel. These cells multiply and then grow into a benign growth called a polyp. As the polyp increases in size, it may become cancerous with the potential to invade the bowel wall and/or spread to other parts of the body. The change of a polyp from benign to cancer appears to be associated with changes or mutations in the genes that control each cell. These changes may be inherited but can and do occur spontaneously.

What is constipation?

Constipation refers to infrequent bowel movements, but also may refer to a decrease in the volume of stool or the weight of stool, the need to strain in order have a bowel movement, the sense of incomplete evacuation, or the need to use enemas, suppositories or laxatives in order to maintain regularity.

What is crohn's disease?

Crohn's disease is a chronic inflammatory process primarily involving the intestinal tract. Although it may involve any part of the digestive tract from the mouth to the anus, it most commonly affects the last part of the small intestine (ileum) and/or the large intestine (colon and rectum).

What is diverticulitis?

Diverticulitis is a common condition that afflicts 50% of Americans by age 60 and almost everyone by age 80. Most people never have symptoms and even fewer require surgery. Diverticula are pockets that develop in the sigmoid or left colon wall because of weakness. Diverticulitis describes the perforation and/or inflammation of the diverticulum. The symptoms of diverticulitis are: abdominal pain (usually lower left abdomen), diarrhea, cramps, change in bowel habit, and occasionally rectal bleeding.

What are hemorrhoids?

There are two types of hemorrhoids: external and internal. They are often described as varicose veins of the anus and rectum. Hemorrhoids are enlarged, bulging blood vessels in and around the anus and lower rectum.

External hemorrhoids: develop near the opening to the anus. If a blood clot develops in one of them, a very painful swelling may occur. The external hemorrhoid feels like a hard, sensitive lump and only bleeds if it ruptures.

Internal hemorrhoids: develop within the upper anal canal where it meets the rectum. They are usually painless. Painless bleeding may occur as well as prolapse during a bowel movement. An internal hemorrhoid can cause severe pain if completely prolapsed–which is rare.

What is IBS or irritable bowel syndrome?

IBS is a common disorder that may affect up to 30% of all Americans at some point during their lives. The disorder has many names including nervous colon, spastic colon, spastic bowel, mucous colitis, and spastic colitis. It is a pattern of symptoms such as pain and bloating that tend to occur together. It is not a disease–meaning it cannot be caught or transmitted from person to person. And it is not life threatening. IBS may produce the following symptoms: cramps, urgency or a gassy, bloated feeling in the abdomen, and mucous in the bowel movements.

Laparoscopic surgical procedures

Laparoscopic or minimally invasive surgery is a specialized technique for performing surgery. This technique has been commonly used for gynecological surgery and gallbladder but over the past few years the use of this technique has expanded to include colorectal surgeries as well. In the traditional open procedures, the surgeon uses a single incision to enter the abdomen. Laparoscopic surgery uses several small incisions. At each incision, a tubular instrument called a trochar is inserted. Specialized instruments and a special camera known as a laparoscope are passed through the trochars during the procedure, and the abdomen is also inflated with gas so that the surgeon has working and viewing space. Because here is a camera, and the images are transmitted to high resolution video monitor. This is what allows the surgeon to perform the same operation as traditional surgery but with smaller incisions.

The advantages of laparoscopic surgery is that compared to traditional open surgery, patients often experience less pain, shorter recovery time, and less scarring.

Most open intestinal procedures can be performed using the laparoscopic techniques. These include: surgery for Crohn's disease, ulcerative colitis, diverticulitis, rectal prolapse, severe constipation and cancer.

What is Pilonidal Disease?

Pilonidal disease is a chronic infection of the skin in the buttocks crease. The condition results from a reaction to hairs imbedded in the skin that occur in the cleft between the buttocks. Pilonidal disease is much more common in men than women as well as obese people and those with stiff, thick body hair. Also, it frequently occurs between puberty and the age of 40.

What are polyps?

Polyps are abnormal growths rising from the lining of the colon or rectum and protruding into the intestinal canal. Polyps can be flat or have a stalk. They are one of the most common conditions that affect the colon and rectum. They occur in almost 20% of the adult population. Most polyps are benign.

What is pruritis ani?

Anal area itching is called Pruritis Ani and is a common condition. An irresistible urge to scratch is the result of this condition and usually occurs at night or after a bowel movement.

What is rectal prolapse?

Rectal Prolapse is a condition where the rectum (lower end of the colon) turns itself inside out. In the early phases of this condition, the rectum does not stick out of the body but if the condition is allowed to worsen, it may protrude from the body. Weakness of the anal sphincter muscle is associated with rectal prolapse and can result in leakage of stool or mucous. This condition is most often associated with women but can occur in men also.

What is a rectocele?

A rectocele is a bulge of the front wall of the rectum into the vagina. The rectal wall may become thinned and weak, and it may balloon out into the vagina when you push to have a bowel movement. Most rectoceles occur in women where the front wall of the rectum is up against the back wall of the vagina. This area is called the rectovaginal septum and may be a weak area in the female anatomy. Other parts of the anatomy may also push into the vagina. The bladder bulging into the vagina is called a cystocele, and the small intestine pushing down on the vagina from above may form an enterocele.

TEM - transanal endoscopic microsurgery

Only about 50 centers throughout the U.S. offer TEM, and until now, there have been none in Virginia. As of October, Virginia Hospital Center is the only hospital in the state to offer this procedure. (New York's Columbia University Medical Center, an internationally known academic institution, only just added TEM in 2007 as well.). TEM allows accessibility to areas of the rectum and anus that are very difficult to reach with any other technology. The surgeon can remove large and inaccessible tumors without having to open the abdomen, in a procedure that is pretty much painless and offers much quicker recovery than open surgery. Previously, surgeons could only use minimally invasive surgery to remove small growths near the opening of the anus, but TEM allows access to the entire rectum, up about 15 centimeters for men and 11-12 centimeters for women. Surgeons use a custom-designed stereotactic scope that offers magnified three-dimensional viewing as well as cutting and suturing. TEM is recommended for patients with benign polyps, very early cancers, or noncurable cancers. The procedure can also be used to repair high rectal-vaginal fistulas, which are often otherwise difficult to access.

What is ulcerative colitis?

The cause of Ulcerative Colitis is not known. Ulcerative Colitis is an inflammation of the lining of the colon. The symptoms can include: rectal bleeding, abdominal cramps, weight loss, diarrhea, and fever. In addition, patients who have had ulcerative colitis for many years are at an increased risk to develop large bowel cancer.

Information above provided courtesy of The American Society of Colon & Rectal Surgeons