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ANORECTAL
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COLONOSCOPY
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GASTROSCOPY
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ANUSITIS AND PRURITIS ANI
Irritation of the skin around the anal opening (anusitis or pruritus ani) causes pain, burning, itching and blood on the toilet paper. Anusitis is very occasionally related to hemorrhoids, but most commonly is due to irritation of the anal canal. This results in a discharge to the outside that is extremely irritating to the anal skin.
Itching & Discharge
Therefore, in order to stop the itching and the discharge we must control the anusitis. Suppositories and some skin creams may help but take longer to work. In the meantime, we should try to keep the anal skin clean and dry. These methods treat the symptoms but long-term improvements will only occur if you eliminate the causes.
The Cause
Diet is the main cause of anusitis. Keeping a food diary and recording what causes the problem will help. The ideal way to identify the causes of the problem is to go on a strict diet for 3 weeks and then reintroduce the foods you eliminated every 2 to 3 days, one food at a time. You should notice returning symptoms within 24 to 48 hours.
Stress & Smoking
Stress and smoking may be a cause of anusitits.
Bowel Habits
One to three large, soft, regular bowel movements each day is ideal. You may need a higher fiber diet and more water (6-8 glasses/day) to achieve this goal. Prune juice will help you to achieve a daily soft bowel movement.
Anal Hygiene
Do not use colored toilet paper after a bowel movement, try using large balls of cotton batting, first to wipe, then to wash and finally to pat dry.
Miscellaneous
1. Never scratch!
2. Prevent moisture in the anal area by applying cornstarch two to six times daily. Lay a cotton ball with cornstarch powder over the anal opening. Use it before and after perspiring i.e. jogging, golfing, etc. Do not use Vaseline or oily ointments.
3. It is imperative that the whole cycle of rectal irritation, discharge and anal moisture followed by scratching be broken. The pruritus will disappear if no other pathology is present. If not, further investigation and treatment is necessary.
4. Keep on the diet and medication until long after you feel better or the problem may recur.
ANAL FISSURE
Anal fissure, as opposed to the fissuring of anusitis, is usually a single split in the skin and has the typical symptoms of a tearing or cutting pain during a bowel movement, and an itching irritation typically one half hour later. It is commonly related to constipation.
It is an acute fissure if present for less than 3 consecutive months, and after that it becomes a chronic. Early treatment with Diltiazem cream and stool softeners such as, prune juice can help cure the problems.
ANAL FISTULA AND LESIONS
Fistula Fistula is a false passage or tunnel usually from the lower end of the anal canal to the skin right next to it. It will not go away by itself and can be treated, in most cases, under local anesthetic in the clinic by de-roofing the tunnel and allowing it to heal from the inside out, which takes a few weeks. It is only painful if the post-operative wound is not kept clean and dry.
Anal Lesions Anal lesions such as skin tags and hematomas (blood clots) are also removed under local in the clinic, but only if they bother the patient. This procedure takes about 3 minutes, but it requires the same care to keep the healing wound clean and dry.
CONSTIPATION
Constipation is characterized by a stool that is hard, dry or small, and it is often associated with a drop in your normal number of bowel movements.
How Many Bowel Movements are Normal?
This depends on you. For some people, 3 bowel movements a day is normal; for others, three times per week is normal.
The Cause Constipation can be caused by a variety of things. Occasional constipation is generally caused by a lack of dietary fibre, not drinking enough fluids, not getting enough exercise, or excessive stress of common illness. All of these inhibit bowel activity and can cause irregularity.
The risk of constipation may be increased by age or pregnancy. Also, certain prescription drugs may have a constipating effect. Do not discontinue any medications without consulting your physician.
Is Constipation Serious?
Generally, the answer is no. However, any change in bowel habits can be an indication of more serious bowel problems. If constipation symptoms last for longer than 7 days, or if you notice blood, mucous or discoloring of the stool, consult your physician.
The Treatment First, evaluate your diet. Ensuring a high level of fibre is important to maintain regularity. You should also try to eliminate some foods and beverages that can constipate you, like fatty foods or chocolate. Second, ensure you are drinking 8 glasses of water or other fluids each day. Third, you should exercise for 15-30 minutes, 3 times per week. Additionally, try to develop good bowel habits, get into a routine, and ensure you have plenty of quiet time to spend in the bathroom. If diet and lifestyle changes aren't enough, try a natural source bulk laxative, like Metamucil, or a stool softener.
How Will a Diet Change Help?
By increasing the fibre in your diet you will help to provide bulk to your stools. This occurs because the fibre will absorb water and will not break down in the stomach. This will make the stool bulkier, softer and easier to pass. When increasing your fibre, it may take a couple of days for you to see an effect…
Because fibre increases the bulk of your stools, some people may experience a short-term feeling of bloating. However, this will pass as your body becomes accustomed to increased fibre intake.
Are You Alone?
No, you are not alone. Over our lifetimes most of us will be constipated at one time or another.
IRRITABLE BOWEL SYNDROME
Irritable Bowel Syndrome (IBS) is a disturbance of the intestinal tract. Its symptoms include abdominal pain, bloating and abnormal bowel movements. Diarrhea may often alternate with constipation, while pain and bloating may be relieved by a bowel movement. Nerve endings in the bowel are unusually sensitive, so that normal bowel events, such as passing fluid or gas, cause abnormal muscle reactions.
Cause & Impact
IBS is known as a functional disorder. There is no direct cause of the syndrome. Symptoms appear to be caused by spasm of your bowel muscles. This results from increased sensitivity within the bowel to almost anything: eating, stress, emotional arousal or gaseous distention. People who have had IBS often say they felt like their life revolved around the bathroom because of their alternating constipation and diarrhea. However, with some simple lifestyle changes, those same people say that their lives are back to normal.
The Treatment Evaluate your eating habits and levels of stress. Try to increase dietary fibre and avoid foods that trigger your symptoms. Also, remember to drink at least 8 glasses of fluid per day. Avoid or develop coping mechanisms for stress. Stress may be triggered by overwork, poor sleep habits or personal difficulties. Proper rest and exercise can help reduce stress levels and help with IBS.
Change Your Diet
Changing diets will help many people with IBS, but it varies from person to person. Avoid caffeine, nicotine and/or alcohol and foods such as dietary fats as these are common triggers of your symptoms. However, any food can trigger your IBS symptoms.
Learning what is right, and wrong, for you is the best way to minimize the effects of IBS and maximize the benefit of your diet. Generally, adding bran or another natural source fibre, like the psyllium in Metamucil, can help to relieve the constipation associated with IBS.
Are You Alone?
No, in fact the symptoms of IBS occur in 10-20% of adults. Its symptoms are the second most common cause of workplace absenteeism, after the common cold.
Is IBS Forever?
Not necessarily. It has been established that 10% of IBS sufferers get better each year. Of course, this will be affected by your lifestyle and stress levels, but you have the ability to control these factors and the symptoms of IBS. In severe cases we have doctors who have had good success in managing patients with IBS.
DIVERTICULAR DISEASE
Diverticulosis is a common condition diagnosed when small pouches "diverticula" are found in the wall of the colon. Diverticula are caused when pressure, such as that caused by constipation, builds up inside the intestine and makes the intestinal wall bulge out in spots where the wall may be weak.
Usually there are no symptoms. However, occasionally mild pain or cramping may occur, commonly on the left side of the abdomen. These symptoms, or any significant changes in bowel habits, should be reported to your physician.
Is Diverticulosis Serious?
Not usually. Most patients that have Diverticula do not have any symptoms. The Diverticula that form in the wall of the colon do not usually cause any problems and can only be detected by a medical examination.
Diverticulitis Diverticulitis occurs when one or more of the Diverticula become inflamed or infected. Symptoms can include pain and tenderness, severe at times, most commonly on the lower left side of the abdomen, a change in bowel function (constipation or diarrhea), fever or blood in the stool. If left untreated, this can have serious implications.
Is Diverticulitis serious?
Generally, diverticulitis can be treated with antibiotics and a high fibre diet. In more serious cases, surgery may be required. If any of these symptoms, or any other significant change in your bowel habits occur, you should be seen by a physician directly.
The Treatment The key to managing diverticular disease is avoiding constipation. First, evaluate your diet. Ensuring a high level of fibre is important to maintain regularity. You should also try to eliminate some foods and beverages that can constipate you, like fatty foods.
Second, ensure you are drinking 8 glasses of water or other fluids each day. Third, you should exercise for 15-30 minutes 3 times per week. Additionally, try to develop good bowel habits, get into a routine and ensure you have plenty of quiet time to spend in the bathroom. If symptoms flare up, consult your doctor.
Are You Alone?
About half of all North Americans aged 60 to 80, and almost everyone over the age of 80, have diverticular disease.
Irritation of the skin around the anal opening (anusitis or pruritus ani) causes pain, burning, itching and blood on the toilet paper. Anusitis is very occasionally related to hemorrhoids, but most commonly is due to irritation of the anal canal. This results in a discharge to the outside that is extremely irritating to the anal skin.
Itching & Discharge
Therefore, in order to stop the itching and the discharge we must control the anusitis. Suppositories and some skin creams may help but take longer to work. In the meantime, we should try to keep the anal skin clean and dry. These methods treat the symptoms but long-term improvements will only occur if you eliminate the causes.
The Cause
Diet is the main cause of anusitis. Keeping a food diary and recording what causes the problem will help. The ideal way to identify the causes of the problem is to go on a strict diet for 3 weeks and then reintroduce the foods you eliminated every 2 to 3 days, one food at a time. You should notice returning symptoms within 24 to 48 hours.
Stress & Smoking
Stress and smoking may be a cause of anusitits.
Bowel Habits
One to three large, soft, regular bowel movements each day is ideal. You may need a higher fiber diet and more water (6-8 glasses/day) to achieve this goal. Prune juice will help you to achieve a daily soft bowel movement.
Anal Hygiene
Do not use colored toilet paper after a bowel movement, try using large balls of cotton batting, first to wipe, then to wash and finally to pat dry.
Miscellaneous
1. Never scratch!
2. Prevent moisture in the anal area by applying cornstarch two to six times daily. Lay a cotton ball with cornstarch powder over the anal opening. Use it before and after perspiring i.e. jogging, golfing, etc. Do not use Vaseline or oily ointments.
3. It is imperative that the whole cycle of rectal irritation, discharge and anal moisture followed by scratching be broken. The pruritus will disappear if no other pathology is present. If not, further investigation and treatment is necessary.
4. Keep on the diet and medication until long after you feel better or the problem may recur.
ANAL FISSURE
Anal fissure, as opposed to the fissuring of anusitis, is usually a single split in the skin and has the typical symptoms of a tearing or cutting pain during a bowel movement, and an itching irritation typically one half hour later. It is commonly related to constipation.
It is an acute fissure if present for less than 3 consecutive months, and after that it becomes a chronic. Early treatment with Diltiazem cream and stool softeners such as, prune juice can help cure the problems.
ANAL FISTULA AND LESIONS
Fistula Fistula is a false passage or tunnel usually from the lower end of the anal canal to the skin right next to it. It will not go away by itself and can be treated, in most cases, under local anesthetic in the clinic by de-roofing the tunnel and allowing it to heal from the inside out, which takes a few weeks. It is only painful if the post-operative wound is not kept clean and dry.
Anal Lesions Anal lesions such as skin tags and hematomas (blood clots) are also removed under local in the clinic, but only if they bother the patient. This procedure takes about 3 minutes, but it requires the same care to keep the healing wound clean and dry.
CONSTIPATION
Constipation is characterized by a stool that is hard, dry or small, and it is often associated with a drop in your normal number of bowel movements.
How Many Bowel Movements are Normal?
This depends on you. For some people, 3 bowel movements a day is normal; for others, three times per week is normal.
The Cause Constipation can be caused by a variety of things. Occasional constipation is generally caused by a lack of dietary fibre, not drinking enough fluids, not getting enough exercise, or excessive stress of common illness. All of these inhibit bowel activity and can cause irregularity.
The risk of constipation may be increased by age or pregnancy. Also, certain prescription drugs may have a constipating effect. Do not discontinue any medications without consulting your physician.
Is Constipation Serious?
Generally, the answer is no. However, any change in bowel habits can be an indication of more serious bowel problems. If constipation symptoms last for longer than 7 days, or if you notice blood, mucous or discoloring of the stool, consult your physician.
The Treatment First, evaluate your diet. Ensuring a high level of fibre is important to maintain regularity. You should also try to eliminate some foods and beverages that can constipate you, like fatty foods or chocolate. Second, ensure you are drinking 8 glasses of water or other fluids each day. Third, you should exercise for 15-30 minutes, 3 times per week. Additionally, try to develop good bowel habits, get into a routine, and ensure you have plenty of quiet time to spend in the bathroom. If diet and lifestyle changes aren't enough, try a natural source bulk laxative, like Metamucil, or a stool softener.
How Will a Diet Change Help?
By increasing the fibre in your diet you will help to provide bulk to your stools. This occurs because the fibre will absorb water and will not break down in the stomach. This will make the stool bulkier, softer and easier to pass. When increasing your fibre, it may take a couple of days for you to see an effect…
Because fibre increases the bulk of your stools, some people may experience a short-term feeling of bloating. However, this will pass as your body becomes accustomed to increased fibre intake.
Are You Alone?
No, you are not alone. Over our lifetimes most of us will be constipated at one time or another.
IRRITABLE BOWEL SYNDROME
Irritable Bowel Syndrome (IBS) is a disturbance of the intestinal tract. Its symptoms include abdominal pain, bloating and abnormal bowel movements. Diarrhea may often alternate with constipation, while pain and bloating may be relieved by a bowel movement. Nerve endings in the bowel are unusually sensitive, so that normal bowel events, such as passing fluid or gas, cause abnormal muscle reactions.
Cause & Impact
IBS is known as a functional disorder. There is no direct cause of the syndrome. Symptoms appear to be caused by spasm of your bowel muscles. This results from increased sensitivity within the bowel to almost anything: eating, stress, emotional arousal or gaseous distention. People who have had IBS often say they felt like their life revolved around the bathroom because of their alternating constipation and diarrhea. However, with some simple lifestyle changes, those same people say that their lives are back to normal.
The Treatment Evaluate your eating habits and levels of stress. Try to increase dietary fibre and avoid foods that trigger your symptoms. Also, remember to drink at least 8 glasses of fluid per day. Avoid or develop coping mechanisms for stress. Stress may be triggered by overwork, poor sleep habits or personal difficulties. Proper rest and exercise can help reduce stress levels and help with IBS.
Change Your Diet
Changing diets will help many people with IBS, but it varies from person to person. Avoid caffeine, nicotine and/or alcohol and foods such as dietary fats as these are common triggers of your symptoms. However, any food can trigger your IBS symptoms.
Learning what is right, and wrong, for you is the best way to minimize the effects of IBS and maximize the benefit of your diet. Generally, adding bran or another natural source fibre, like the psyllium in Metamucil, can help to relieve the constipation associated with IBS.
Are You Alone?
No, in fact the symptoms of IBS occur in 10-20% of adults. Its symptoms are the second most common cause of workplace absenteeism, after the common cold.
Is IBS Forever?
Not necessarily. It has been established that 10% of IBS sufferers get better each year. Of course, this will be affected by your lifestyle and stress levels, but you have the ability to control these factors and the symptoms of IBS. In severe cases we have doctors who have had good success in managing patients with IBS.
DIVERTICULAR DISEASE
Diverticulosis is a common condition diagnosed when small pouches "diverticula" are found in the wall of the colon. Diverticula are caused when pressure, such as that caused by constipation, builds up inside the intestine and makes the intestinal wall bulge out in spots where the wall may be weak.
Usually there are no symptoms. However, occasionally mild pain or cramping may occur, commonly on the left side of the abdomen. These symptoms, or any significant changes in bowel habits, should be reported to your physician.
Is Diverticulosis Serious?
Not usually. Most patients that have Diverticula do not have any symptoms. The Diverticula that form in the wall of the colon do not usually cause any problems and can only be detected by a medical examination.
Diverticulitis Diverticulitis occurs when one or more of the Diverticula become inflamed or infected. Symptoms can include pain and tenderness, severe at times, most commonly on the lower left side of the abdomen, a change in bowel function (constipation or diarrhea), fever or blood in the stool. If left untreated, this can have serious implications.
Is Diverticulitis serious?
Generally, diverticulitis can be treated with antibiotics and a high fibre diet. In more serious cases, surgery may be required. If any of these symptoms, or any other significant change in your bowel habits occur, you should be seen by a physician directly.
The Treatment The key to managing diverticular disease is avoiding constipation. First, evaluate your diet. Ensuring a high level of fibre is important to maintain regularity. You should also try to eliminate some foods and beverages that can constipate you, like fatty foods.
Second, ensure you are drinking 8 glasses of water or other fluids each day. Third, you should exercise for 15-30 minutes 3 times per week. Additionally, try to develop good bowel habits, get into a routine and ensure you have plenty of quiet time to spend in the bathroom. If symptoms flare up, consult your doctor.
Are You Alone?
About half of all North Americans aged 60 to 80, and almost everyone over the age of 80, have diverticular disease.
The Rudd Clinic is a leader in specialization in colonoscopy examinations and cancer screening programs. There is a big difference between early detection and prevention of colon cancer. This is because there is a:
· 15% 5-year cure rate when a colon cancer is found on colonscopy in a patient with complaints
· 85% 5-year cure rate when a colon cancer is found on colonscopy in a patient without complaints
· 100% 5-year cure rate removing a benign polyp
The Procedure
At The Rudd Clinic, we use the latest high tech video colonoscopy equipment for prevention of colon cancer. We take full advantage of the fact that all colon cancer comes from polyps (small wart-like growths on the lining of the inside of the colon), and we remove them on the spot during the colonoscopy examination, which is completed in our clinic under light or full sedation.
We feel colonoscopy is one of the most worthwhile services we provide at the Rudd Clinic, since we now rarely see colon cancer except in new patients, or those who do not adhere to our prevention follow-up program.
Colonoscopy is true cancer prevention.
The value of prevention in colon cancer over other internal cancers, such as breast, prostate, lung, etc. is that in colon cancer there is a precursor (i.e. a polyp) which can be removed to prevent the colon cancer from starting. In the other forms of cancer, the malignancy is already established when a growth or tumor is discovered.
· 15% 5-year cure rate when a colon cancer is found on colonscopy in a patient with complaints
· 85% 5-year cure rate when a colon cancer is found on colonscopy in a patient without complaints
· 100% 5-year cure rate removing a benign polyp
The Procedure
At The Rudd Clinic, we use the latest high tech video colonoscopy equipment for prevention of colon cancer. We take full advantage of the fact that all colon cancer comes from polyps (small wart-like growths on the lining of the inside of the colon), and we remove them on the spot during the colonoscopy examination, which is completed in our clinic under light or full sedation.
We feel colonoscopy is one of the most worthwhile services we provide at the Rudd Clinic, since we now rarely see colon cancer except in new patients, or those who do not adhere to our prevention follow-up program.
Colonoscopy is true cancer prevention.
The value of prevention in colon cancer over other internal cancers, such as breast, prostate, lung, etc. is that in colon cancer there is a precursor (i.e. a polyp) which can be removed to prevent the colon cancer from starting. In the other forms of cancer, the malignancy is already established when a growth or tumor is discovered.
Gastroscopy (Esophagogastroduodenoscopy, or EGD) is a procedure where a doctor examines the upper part of your gastrointestinal tract (gut). The upper gut consists of the oesophagus (gullet), stomach and duodenum. The doctor uses an endoscope for this procedure, so it is sometimes called an endoscopy.
The Purpose
Gastroscopy (EGD), is a commonly performed routine test. This test may be advised if you have symptoms such as recurring indigestion, recurring heartburn, pains in the upper abdomen, repeated vomiting, difficulty swallowing, or other symptoms thought to be coming from the upper gut. The sort of conditions which can be confirmed (or ruled out) include:
· Oesophagitis (inflammation of the oesophagus). The doctor will see areas of redness on the lining of the oesophagus.
· Duodenal or stomach ulcer. An ulcer looks like a small, red crater on the inside lining of the duodenum or stomach.
· Duodenitis (inflammation of the duodenum).
· Gastritis (inflammation of the stomach).
· Cancer of the stomach or oesophagus.
· Various other rare conditions.
The Procedure
During gastroscopy, the doctor may numb the back of your throat by spraying on some local anaesthetic, You may be given a sedative to help you to relax. This is usually given by an injection into a vein in the back of your hand.
You lie on your side on an examining table. You are asked to put a plastic mouth guard between your teeth. This protects your teeth and stops you biting the endoscope. The doctor will then ask you to swallow the first section of the endoscope. Modern endoscopes are quite thin and easy to swallow. The doctor then gently pushes it further down your oesophagus and into your stomach and duodenum.
The video camera at the tip of the endoscope sends pictures to a screen. The doctor watches the screen for abnormalities of the oesophagus, stomach and duodenum. Air is passed down a channel in the endoscope into the stomach to make the stomach lining easier to see. This may cause you to feel "full" and want to belch.
The doctor may take one or more biopsies of parts of the inside lining of the gut — depending on why the test is done and what they see. This is painless. The biopsy samples are sent to the lab for testing, and to look at under the microscope. The endoscope is then gently pulled out.
How Long Does It Take?
A gastroscopy usually takes about 10 minutes. However, you should allow at least 2 hours for the whole appointment to prepare, give time for the sedative to work (if you have one), for the gastroscopy itself, and to recover. A gastroscopy does not usually hurt, but it can be a little uncomfortable, particularly when you first swallow the endoscope.
The Purpose
Gastroscopy (EGD), is a commonly performed routine test. This test may be advised if you have symptoms such as recurring indigestion, recurring heartburn, pains in the upper abdomen, repeated vomiting, difficulty swallowing, or other symptoms thought to be coming from the upper gut. The sort of conditions which can be confirmed (or ruled out) include:
· Oesophagitis (inflammation of the oesophagus). The doctor will see areas of redness on the lining of the oesophagus.
· Duodenal or stomach ulcer. An ulcer looks like a small, red crater on the inside lining of the duodenum or stomach.
· Duodenitis (inflammation of the duodenum).
· Gastritis (inflammation of the stomach).
· Cancer of the stomach or oesophagus.
· Various other rare conditions.
The Procedure
During gastroscopy, the doctor may numb the back of your throat by spraying on some local anaesthetic, You may be given a sedative to help you to relax. This is usually given by an injection into a vein in the back of your hand.
You lie on your side on an examining table. You are asked to put a plastic mouth guard between your teeth. This protects your teeth and stops you biting the endoscope. The doctor will then ask you to swallow the first section of the endoscope. Modern endoscopes are quite thin and easy to swallow. The doctor then gently pushes it further down your oesophagus and into your stomach and duodenum.
The video camera at the tip of the endoscope sends pictures to a screen. The doctor watches the screen for abnormalities of the oesophagus, stomach and duodenum. Air is passed down a channel in the endoscope into the stomach to make the stomach lining easier to see. This may cause you to feel "full" and want to belch.
The doctor may take one or more biopsies of parts of the inside lining of the gut — depending on why the test is done and what they see. This is painless. The biopsy samples are sent to the lab for testing, and to look at under the microscope. The endoscope is then gently pulled out.
How Long Does It Take?
A gastroscopy usually takes about 10 minutes. However, you should allow at least 2 hours for the whole appointment to prepare, give time for the sedative to work (if you have one), for the gastroscopy itself, and to recover. A gastroscopy does not usually hurt, but it can be a little uncomfortable, particularly when you first swallow the endoscope.
