Rectum disease

Theory and Equipment. Many diseases of the human body can be identified by visual appearance. Tumors in the upper gastrointestinal (GI) tract, for example, possess a characteristic salmon pink color (3). The presence of such a color can be an indication of disease. Endoscopy is the medical imaging tool used to detect such colors in the inside of hoUow internal organs such as the rectum, urethra, urinary bladder, stomach, colon, etc. An endoscope is the instmment used to perform endoscopy. Endoscopic imaging involves the production of a tme color picture of the inside of the human body using lenses and either hoUow pipes, a fiber optic bundle, or a smaU CCD camera. AU three use a large field-of-view, sometimes referred to as a fish eye, lens to aUow a 180° field of view. 

Rectum. Local treatment of conditions and diseases of the rectum, including hemorrhoids and local inflammation, usually involves dmg-containing suppositories or enemas. 

Flexible sigmoidoscopy can be performed to identify obstruction in the rectum and lower colon, whereas colonoscopy can evaluate the entire colon for organic disease. 

Campylobacter spp. are gram-negative bacilli that have a curved or spiral shape. Campylobacter are sensitive to stomach acidity as a result, diseases or medications that buffer gastric acidity may increase the risk of infection. Data suggest that the infectious dose for C. jejuni is similar to that for Salmonella spp. After an incubation period, infection is established in the jejunum, ileum, colon, and rectum. 

Recent advances in the treatment of cancer of the colon and rectum now offer the potential to improve patient survival, but for many patients, improved disease- and progression-free survival represent equally important therapeutic outcomes. In the absence of the ability of a specific treatment to demonstrate improved survival, important outcome measures should include the effects of the treatment on patient symptoms, daily activities, performance status, and other quality-of-life indicators. Individualized patient care to balance the risks associated with treatment with the benefits of a specific treatment regimen is necessary to optimize patient outcomes. 

Colon cancer A disease in which cells in the lining of the colon become malignant and proliferate without control. Often referred to as colorectal cancer to include cells of the rectum. 

Proctitis Inflammation confined to the rectum in patients with inflammatory bowel disease. 

Ambrose NS, Allan RN, Keighley MR, Burdon DW, Youngs D, Lennard-Jones JE Antibiotic therapy for treatment in relapse of intestinal Crohn s disease. A prospective randomized study. Dis Colon Rectum 1985 28 81-85. 

Chia JG, Wilde CC, Ngoi SS, Goh PM, Ong CL Trends of diverticular disease of the large bowel in a newly developed country. Dis Colon Rectum 1991 34 498-501. 

There are two forms of idiopathic inflammatory bowel disease (IBD) ulcerative colitis, a mucosal inflammatory condition confined to the rectum and colon, and Crohn s disease, a transmural inflammation of GI mucosa that may occur in any part of the GI tract. The etiologies of both conditions are unknown, but they may have a common pathogenetic mechanism. 

There are a wide range of ulcerative colitis presentations. Symptoms may range from mild abdominal cramping with frequent small-volume bowel movements to profuse diarrhea (Table 26-3). Many patients have disease confined to the rectum (proctitis). 

Ulcerative colitis chronic inflammatory disease affecting the large intestine and the rectum Urticaria a skin condition characterised by pruritus Uterine fibroids fibrous tissue growth in the uterus Verrucas viral skin infection, wart... 

Crohn s disease is granulomatous and in most cases it is a simultaneous disease of the ileum and colon. The primarily inflamed region is the distal ileum, and all intestinal layers are thickened. The mucosal surface is reddened, nodular, and cobblestone-Uke, with mnltiple linear ulcerations. The mucosal layer is thickened by inflammatory infiltrate, the submucosa and serosa by fibrosis, and the serosa by hypertrophy. Chronic nlcerative colitis is a systemic disease that starts at the rectum or the sigmoid colon and progresses proximally to involve the entire left side of the colon. The colonic crypts are the first sites of cell damage and death, and the disease primarily involves the mucosal layer of the intestine. 

Inflammatory Bowel Disease (IBD) comprises several diseases, including ulcerative colitis and Crohn s disease. Ulcerative cohtis is a disease of the colon, originating in the rectum and extending proximally to a variable extent. It frequently affects the entire colon but never... 

VIII.b.1.1. Proctitis. Disease limited to the rectum in the active phase can be treated with corticosteroids or aminosalicylates as suppositories or ene-mata (Table 3). Treatment has to be continued for one to two months until symptoms resolve. 

Crohn s disease is a non-specific inflammatory disease differing from ulcerative colitis in causing full thickness disease, often involving the small bowel, and/or sparing the rectum, often segmental, which is associated with full thickness Assuring and with granuloma formation. 

The effectiveness of 5-ASA therapy depends in part on achieving high drug concentration at the site of active disease. Thus, 5-ASA suppositories or enemas are useful in patients with ulcerative colitis or Crohn s disease confined to the rectum (proctitis) or distal colon (proctosigmoiditis). In patients with ulcerative colitis or Crohn s colitis that extends to the proximal colon, both the azo compounds and mesalamine formulations are useful. For the treatment of Crohn s disease involving the small bowel, mesalamine compounds, which release 5-ASA in the small intestine, have a theoretic advantage over the azo compounds. 

Hydrocortisone enemas, foam, or suppositories are used to maximize colonic tissue effects and minimize systemic absorption via topical treatment of active inflammatory bowel disease in the rectum and sigmoid colon. Absorption of hydrocortisone is reduced with rectal administration, although 15-30% of the administered dosage is still... 

For the treatment of inflammatory bowel disease involving the rectum or sigmoid colon, rectally administered glucocorticoids are preferred because of their lower systemic absorption. 

Rogy, M.A., Beinhauer, E.G., Reinisch, W., Huang, L. and Pokieser, P. (2000) Transfer of interleukin-4 and inleukin-10 in patients with severe inflammatory bowel disease of the rectum. Hum. Gene Then, 11, 1731-1741. 

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