Punjab News/Don’t ignore blood in stool-Experts

Mohali, November 29, 2013: Max Super Speciality Hospital (MSSH), Mohali organised a health workshop on Piles and Gallbladder diseases at Rotary Club here today.

While addressing the members of Rotary Club, Dr NM Gupta, Principal Consultant, General Surgery, MSSH said that though the most rectal bleeding was caused by the non-serious causes the bleeding could also be caused by cancerous or pre-cancerous conditions. Pre-cancerous polyps near the end of the colon could mimic bleeding from piles. These were generally present in the colon for years before they became cancerous. If it was detected early, the same could be removed very safely from the colon thus preventing progression to cancer, said Dr Gupta.  
Also present on occasion were, Dr KS Dhillon, Sr Consultant and Dr MS Bedi, Senior Consultant from Department of Advanced Laparoscopic and General Surgery at MSSH.
While cautioning about rectal bleeding, Dr Gupta said that bleeding of the rectum was a common problem in daily life which was usually ignored as piles. Initially it was intermittent, hence the patient usually forgot about it unless it became a regular feature or was associated with pain while passing motion. The common causes of bleeding per rectum could be benign which could be piles, inflammatory bowel disease, local perianal conditions, Benign mass lesions, Solitary rectal ulcer, polyps, Colitis or Dysentery. Bleeding could be because of Anal,  Rectal or Colon  cancers. Cancer of rectum caused painless bleeding and must never be ignored, pointed out Dr Gupta.
Colon cancer could be diagnosed in patients who have ignored bleeding for years because they assumed it was from piles. Polyps, the growths that occurred on the inner lining of the large intestine and colon cancer became more common with aging, and thus investigation of bleeding was most important, and was usually most intensive in patients over 40-50 years of age, pointed out Dr. Gupta.
Talking about when to seek immediate medical attention, Dr Dhillon said that if rectal bleeding was continuous or heavy, accompanied by severe abdominal pain or cramping or anal pain then there was a family history of any gastrointestinal cancers especially colon cancer. One must seek medical help immediately. Every case of blood in stools was not a case of piles and other causes should be ruled out by careful examination. Above the age of 50, cancer remained a serious cause for the same, warned Dr Dhillon.
“Digital rectal examination could ascertain the cause of bleeding with reasonable certainty in majority of patients with modalities such as Proctoscopy, Sigmoidoscopy, Colonoscopy, CECT abdomen, Angiography and Radionuclear scan. However in patients with family history of any malignant disease they should be subjected to regular colonoscopy after age of 35- 40 years. In case of family history of colonic polyps, one should undergo colonoscopy from the age of 15- 20 years as they are at very high risk of cancer.”
Colon and rectal cancer were two dangerous causes of bleeding that are often confused with piles. Surgery for colorectal cancers has also made significant advances that majority of cases could be done by laparoscopy thus promoting early recovery with minimum pain, asserted Dr Dhillon.
Informing about other topics like inflammatory bowel diseases the ulcerative colitis or Crohn disease, Dr Bedi said that majority of these cases could be managed medically but few cases would require surgery that could also be done by laparoscopy which ensured early recovery. With advances in technology, now almost all colorectal cases could be done by minimal access techniques which were the best technique in the management of malignant condition of colorectum.  Max Hospital, Mohali was well equipped with technology and expertise to manage these conditions by minimally invasive technique thus providing full benefit of modern technology and expertise to these patients, maintained Dr Bedi.