Colorectal diseases and ailments are those that affect the colon (also called the large intestine), and the rectum—the last 4-5 inches of the colon. Colorectal conditions can range from mildly irritating to life-threatening.
Whether mild or severe, symptoms should never be ignored, as colorectal conditions can quickly progress. The symptoms of colon and rectal disease can also resemble other conditions—this is why it’s important to see an expert like Dr. Bilchik, a renowned colorectal surgeon, and scientist who has pioneered techniques to improve staging in colon cancer and other conditions of the GI tract.
The following conditions often require colorectal surgery, which may include minor or major reconstruction of the intestinal tract:
- Colorectal cancer: Affecting more than 100,000 people in the U.S. every year, colorectal cancers include those of the colon (large intestine) and the rectum (last 4-5 inches of the colon).
- Crohn’s disease: This is a chronic inflammatory condition that primarily affects young adults between the ages of 16 and 40 living in northern, industrialized regions of the world (including the U.S. and Europe). Surgery is often required to remove tissue damaged by chronic inflammation.
- Ulcerative colitis: An inflammatory disease of the large intestine, ulcerative colitis affects around 500,000 people in the U.S.; it can increase a person’s risk of developing colon cancer.
- Diverticular disease: Affecting nearly 50% of Americans by age 60, and nearly everyone by age 80, diverticulosis is a condition where pouches form on the wall of the colon; when these pouches become inflamed or infected, the result is diverticulitis (“itis” refers to inflammation). Surgery may be necessary to remove part of the colon in patients who experience recurring episodes, with complications of the condition, or with severe attacks that don’t respond to medication.
Other conditions that may require surgery include hemorrhoids, rectal prolapse (when part of the rectum slips out of place, often protruding from the anus), anal fissures (tears in the lining of the anus), and bowel incontinence.
Types of Colorectal Surgery
Many types of surgery are used to treat colorectal disorders. Today, procedures are often performed laparoscopically or robotically—minimally-invasive techniques that result in less pain, faster healing times, and smaller incisions.
Most surgeries to treat colorectal cancer, ulcerative colitis, Crohn’s disease, and diverticular disease involve the resection (cutting out) of the diseased portion of the intestine and the reattachment (anastomosis) of the cut ends of the intestine back together. Types of surgeries include:
- Laparoscopy –use of thin lighted instruments to remove cancerous tissue and lymph nodes
- Robotic surgery – high definition minimally invasive surgery performed with an XI DaVinci robot
- Abdominoperineal resection – treatment of anal and distal rectal cancers that are too low to preserve anal function; the rectum and part of the sigmoid colon are removed, and the end of the colon is brought through an opening in the abdominal wall (colostomy). However, every effort is made to preserve the anal sphincter rather than do an APR.
- Small bowel resection – removal of diseased portions of the small intestine affected by Crohn’s disease, rectal or colon cancer, polyps, ulcers, and benign tumors; the colorectal surgeon will either reattach the cut ends of the small intestine back together or create an opening to the outside of the body (an ostomy).
This is not an exhaustive list of colorectal surgery types—Dr. Bilchik will cover additional surgery types with you and will work closely with you to determine the best treatment approach for your particular situation.
Complications and Risks
As with any surgery, there are risks and potential complications with colorectal surgery, including infection, blood clots and pneumonia. Every effort is made to avoid these complications by walking and eating soon after surgery.
Dr. Bilchik will discuss all of the risks with you and provide you with medical counseling and guidance before and after surgery. He will closely monitor you to ensure you are adapting well to life after surgery.
What to Expect After Surgery
Most patients spend 1-5 days in the hospital. Open procedures typically require a 3-5 day hospital stay, while laparoscopic or robotic procedures have shorter hospital stays of 1-3 days. You can typically return home after the hospital staff has seen evidence of bowel function (flatulence or bowel movements), when you no longer require IV fluids, and when your pain is reasonably controlled.
Following a minor surgery, you may be able to return to work (depending on your profession) after just 2-4 days. Laparoscopic surgery has a 2-4 week recovery time, and open procedures have a 4-6 week recovery time. You should avoid heavy lifting and overexertion, after surgery, and follow a general rule: If it hurts, don’t do it.
Dr. Bilchik embraces a personalized approach to care and believes that every patient should be treated with dignity and compassion and should have access to the most current treatments available. Contact Dr. Bilchik’s office today, at (310) 449-5206, for a consultation.