What are the main pathologies affecting the colon?

Functional disorders of the colon:

The colon can sometimes present functional disorders that are essentially distinguished into:

• Constipation occurs when the physiological function of defecation is difficult, painful, inadequate, or not as frequent as desirable. Among the most frequent causes of chronic constipation are a diet too low in fiber, dehydration, overweight and sedentary lifestyle, malformations, or inflammatory bowel diseases;
• Irritable bowel syndrome: This is not a real disease but a dysfunction that can occur in very sensitive or stressed individuals with symptoms such as constipation alternating with diarrhea, abdominal spasms, bloating, and difficult digestion. At the origin of this very frequent disorder, there is an abnormal contraction of the colon muscles;

Structural disorders of the rectum

In addition to functional disorders of the colon, there are structural disorders that can manifest in the rectum and are often consequences of disorders present in the colon. These include:

• Internal or external hemorrhoids: These are varicose veins that can become irritated and bleed, causing pain and problems during defecation;
• Anal fissures: Painful fissures that form around the anal orifice;
• Perianal abscess: This forms when the small glands surrounding the anus become hypertrophied and infected and fill with pus;
• Anal fistula: This is generally the evolution of an anal abscess, with the formation of a kind of "canal" between the inflamed gland and the skin covering the perianal area, in which pus accumulates;

Diseases of the colon and rectum

The disorders mentioned below can lead to diseases affecting the colon and rectum:

• Diverticulitis: In some individuals, diverticula only constitute a problem when they are irritated, generally by an accumulation in their cavities of food fragments or fecal matter;
• Colonic polyps: These are benign neoformations but defined as precancerous, because in some cases they can degenerate and become malignant tumors;
• Colitis: This is inflammation of the colon which can be of different types depending on the causes. Among the most common are ulcerative colitis, Crohn's disease, infectious colitis, and ischemic colitis;

Colorectal Cancer

What is colorectal cancer?

Colorectal cancer is a proliferation of neoplastic cells from the mucosa that lines the inside of the colon or rectum, with a clear prevalence of colon tumors over rectal tumors.

The tumor that develops in this organ is most often malignant, developing from a pre-existing polyp. Indeed, intestinal polyps are considered precancerous lesions, although not all are likely to transform into cancer. The type at highest risk is represented by adenomatous polyps, and the possibility that they transform into malignant tumors increases with the size of the polyp. Adenomatous polyps exceeding 2.5 cm in diameter are neoformations that must be removed before they degenerate into adenocarcinomas. Although colorectal cancer is one of the most widespread malignant conditions, it generally tends to manifest after the age of 60, with maximum incidence between 60 and 64 years. However, it is increasingly common for symptoms to appear as early as the age of 30.

What are the risk factors for colorectal cancer?

The main risk factors for colorectal cancer are:

• Family history;
• Smoking;
• Diet (high in saturated fats and animal proteins, low in fiber);
• History of chronic inflammatory bowel disease, including Crohn's disease and ulcerative colitis;
• Prolonged stress;

What are the symptoms of colorectal cancer?

Symptoms of colorectal cancer are unfortunately late and easily confused with other benign intestinal disorders, including: alternating constipation and diarrhea, lack of appetite and weight loss. Other symptoms, such as blood in the stool (often occult) and simultaneous anemia, are alarming signals of cancerous proliferation.

Who should have a health check-up and when?

Men and women should undergo a first check-up from age 50, even without symptoms. Colonoscopy is the recommended test. This should be brought forward to age 45 with increased risk due to family history. An alternative under 50 is testing for occult blood in the stool, followed by colonoscopy if positive.

How to prevent colon diseases and cancer

Many lifestyle interventions can reduce the risk of developing colorectal cancer or colon disease.

• Diet: A diet low in fat, processed meats, and red meat, and rich in fruits, vegetables, and legumes can reduce the risk, particularly due to its high fiber content;
• Physical activity: Reduces the risk by one-fifth; one hour of intense or two hours of moderate activity is sufficient;
• Body weight: Reducing weight also helps decrease risk;
• Smoking and alcohol: These are risk factors. Quitting smoking and limiting alcohol intake reduces risk;