Other Diseases Of The Colon (large intestine) & Small Intestine

Dr. Vivek Mangla


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Other Diseases Of The Colon (large intestine) And Small Intestine

Crohns disease

Crohn's disease is a type of inflammatory bowel disease (IBD). It causes inflammation of your digestive tract, which can lead to abdominal pain, severe diarrhoea, fatigue, weight loss and malnutrition.While there's no known cure for Crohn's disease, therapies can greatly reduce its signs and symptoms and even bring about long-term remission and healing of inflammation. Surgery for Crohn’s disease is recommended in carefully selected cases because the disease can recur in any remaining portion of the gastrointestinal tract.

Ulcerative colitis

Ulcerative colitis is a type of inflammatory bowel disease (IBD). The main symptom is bloody diarrhea. Ulcerative colitis treatment usually involves either drug therapy or surgery. Depending on severity of your disease, anti-inflammatory drugs or drugs which suppress immunity are prescribed. Surgery is the definitive therapy for UC. Restorative proctocolectomy is often curative, alleviates symptoms & removes the risk of colon cancer. We do a J pouch (ileoanal anastomosis) so that patient does not need to wear a stool bag and can expel stool normally. This is associated with very good results.


Diverticulosis is a condition that occurs when small pouches, or sacs, form and push outward through weak spots in the wall of your colon. These pouches are most common in the lower part of your colon, called the sigmoid colon. High fibre diet and probiotics are most often recommended for uncomplicated diverticulosis. Diverticulosis may also cause problems such as diverticular bleeding and diverticulitis. Colonoscopy is often successful in controlling bleeding. However intractable bleeding or bowel perforation/fistulae will need surgery.The most common type of surgery for all forms of diverticular disease is called sigmoid resection (sigmoidectomy). In most cases, this is a minimally invasive procedure that is done by inserting instruments through small cuts in the abdominal wall (laparoscopy). Sometimes, pus collection resulting from leak from one of the diverticulae can occur. This may be managed initially with drainage but would need a more definite surgery later on. Some times this disease can result into an abnormal communication between the colon and the vagina in females and urinary bladder in males. We routinely manage patients with diverticular disease and its complications laparoscopically with very good results.

Acute mesenteric ischemia

Acute mesenteric ischemia (AMI) is a group of diseases characterized by an interruption of the blood supply to varying portions of the small intestine, leading to ischemia and secondary inflammatory changes. It is a rather uncommon cause of abdominal pain. If untreated, this process will eventuate in life threatening intestinal necrosis. Early diligent diagnosis and timely surgical intervention are the cornerstones of modern treatment.

Lower GI bleeding

Lower GI bleeding occurs from the colon, rectum, or anus, and presents as either hematochezia (bright red blood, clots or burgundy stools) or melena. Most cases of acute colonic bleeding will stop spontaneously, thereby allowing non-urgent evaluation. However, patients with recurrent bleeding, hemodynamic changes, and significant comorbid conditions should be hospitalized and evaluated urgently. After initial resuscitation, identifying the source of bleeding is a clinical priority. Common options for diagnosing the source of bleeding include colonoscopy/sigmoidoscopy and/or CT angiography and. Causes can include diverticular disease, inflammatory bowel disease (ulcerative colitis, and Crohn's disease), colon cancers or polyps, haemorrhoids, ischemic colitis, radiation proctitis, vascular ectasia.Laparotomy for acute LGIB is undertaken when endoscopic or radiological interventional measures have failed. Emergency subtotal colectomy is an effective and definitive method of treating unlocalised massive LGIB.

Colonic obstruction/perforation

Many patients suffer from this blockage in small or large intestine that stops food form passing through. Patients often have abdominal pain, vomiting & constipation. Without treatment, blocked parts can die leading to serious problems. An experienced understanding of CT scan barium study can help decide which patients need surgery or who will recover well without surgical intervention.

Most common cause is intestinal adhesions because of previous surgery. It is imperative to rule out colon cancer. Sometimes large hernia can also cause obstruction. Inflammatory bowel disease such as crohn’s may also lead to thickened wall causing partial or complete intestinal obstruction. Twisting of the colon (volvulus) is an emergency condition. Prompt diagnosis and early intervention result in better outcomes. Telescoping of bowel (intussception) is more common in children but we have seen this in adult patients as well.