Ischemic colitis, colon polyps, colorectal cancer, hemorrhoid, and anal fissure: Diagnose, treat, and manage gastrointestinal disorders, ensuring optimal internal medicine care.

1. Gastrointestinal
Disorders
Ischemic Colitis, Colon Polyps, Colorectal Cancer, Hemorrhoids, Anal Fissures,
Anorectal Abscess, Proctitis
SHUBHANGI CHATURVEDI

2. INTRODUCTION
Gastrointestinal disorders
affecting the colon and rectum
encompass a spectrum of
conditions, each presenting
distinct clinical features and
requiring specific diagnostic and
therapeutic approaches. This
brief overview will touch upon
ischemic colitis, colon polyps,
colorectal cancer, hemorrhoids,
anal fissures, and anorectal
abscesses.

3. Ischemic Colitis
Ischemic colitis is inflammation in your large intestine, or colon. It results from a lack of blood flow to the area, usually because an artery is
blocked or narrowed.
Etiology:
 Reduced blood flow to the colon
Clinical Findings:
 Abdominal pain
 Bloody diarrhea
 Fever
 Nausea and vomiting
Diagnosis:
 Colonoscopy
 CT angiography
 CBC
 Lactate levels

4. Differential Diagnosis:
 Inflammatory bowel disease (IBD)
 Infectious colitis
 Diverticulitis
Treatment:
 Supportive care
 NPO
 Antibiotics
 Surgery in severe cases

5. Colonic Polyps
Colon polyps are growths on the inside
lining of your colon (large intestine).
They’re a type of tumor, a cluster or
mass of abnormal cells. Polyps are
tumors that grow out of the mucous
lining inside your hollow organs, like
your gastrointestinal tract, your nose
or female reproductive organs.
Aetiology:
 Genetic factors, lifestyle, age
Types:
 adenomatous polyps, hyperplastic
polyps, and serrated polyps.

6. Signs and Symptoms:
Often asymptomatic
Rectal bleeding
Changes in bowel habits
Abdominal pain if symptomatic
Diagnosis:
Colonoscopy
Biopsy
Treatment:
Polypectomy during colonoscopy

8. Who is more likely to develop colorectal cancer?
Being older; your risk of getting colorectal cancer increases as you age.
Having a personal or family history of colorectal cancer.
Having a history of adenomas. Adenomas are colorectal polyps (growths) that
look abnormal under a microscope or are 1 centimeter or larger. Adenomas
are not cancer, but they can sometimes turn into cancer over time.
Having a genetic syndrome such as familial adenomatous polyposis (FAP) or
Lynch syndrome (hereditary non-polyposis colorectal cancer).
Having chronic ulcerative colitis or Crohn disease for 8 years or more.
Having three or more alcoholic drinks per day.
Smoking cigarettes.
Being Black; Black people have an increased risk of colorectal cancer and
death from colorectal cancer compared to other races.
Having obesity.

9. Clinical Findings:
 Change in bowel habits, rectal
bleeding, abdominal pain,
unintentional weight loss.
 Diagnosis:
 Colonoscopy, biopsy, imaging
studies (CT, MRI).
Treatment:
 Surgery, chemotherapy, radiation
therapy.
Prognosis:
 Varies based on stage; early
detection improves outcomes.
Etiology:
 Genetic predisposition, age,
lifestyle factors.

10. Hemorrhoids:
› Hemorrhoids, (also called piles, are swollen veins in the anus and lower rectum. Hemorrhoids are
similar to varicose veins. Hemorrhoids can develop inside the rectum, called internal
hemorrhoids. They also can develop under the skin around the anus, called external
hemorrhoids.

12. Aetiology:
Increased pressure on the veins in the rectal and anal
area.
Signs and Symptoms:
Rectal bleeding, pain, itching, prolapse.
Diagnosis:
Clinical examination, anoscopy.
Treatment:
Dietary changes, topical medications, procedures
(sclerotherapy, rubber band ligation).

15.  An anal fissure is a crack or tear in the lining of your anal canal. It’s a common cause of anal
pain and rectal bleeding, especially during bowel movements (pooping).Anal trauma usually
causes a fissure, especially from straining to pass hard stools. Anal fissures can occur suddenly
or gradually. They can also heal quickly or slowly.
Etiology:
 Tears or cuts in the lining of the anus.
Causes:
 Chronic constipation and straining to poop.
 Chronic diarrhea.
 Childbirth.
Other contributing conditions include:
 Sexually transmitted infections (STIs).
 Inflammatory bowel disease (IBD).
 Anal cancer.
 Tuberculosis (TB).
 Diaper rash.
Diagnosis:
 Clinical examination.
Treatment:
 Topical medications, dietary changes, warm baths.

18. Anorectal Abscess:
An anorectal abscess is a collection of pus in the
area of the anus and rectum.
Etiology: Bacterial infection in the anal or rectal
area.
Signs and Symptoms: Swelling, pain, redness, fever.
Diagnosis:Clinical examination, imaging
(ultrasound).
Treatment:Incision and drainage, antibiotics.

19. Conclusion
Gastrointestinal disorders, including colonic polyps, ischemic
colitis, and anorectal conditions, present a diverse range of
clinical findings and require tailored diagnostic and treatment
approaches.
Early detection through screenings such as colonoscopies is
crucial for improving outcomes in colorectal conditions, while
prompt intervention and comprehensive care contribute to
better patient prognosis.

20. References
› American College of Gastroenterology. (2022). Clinical Guidelines: Colorectal Cancer Screening. Retrieved from
https://gi.org/clinical-guidelines/colorectal-cancer-screening/
› https://my.clevelandclinic.org/health/diseases/13177-anal-fissures#overview
› Lichtenstein, D. R., et al. (2020). Management of Colonic Diverticulitis. American College of Gastroenterology Practice
Guidelines. Retrieved from https://gi.org/guideline/management-of-colonic-diverticulitis/
› https://medlineplus.gov/colorectalcancer.html
› National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2021). Hemorrhoids. Retrieved from
https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids
› https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268
› Rex, D. K., et al. (2017). Colonic Polyps: Diagnosis and Management. American College of Gastroenterology Practice
Guidelines. Retrieved from https://gi.org/guideline/colonic-polypectomy/
› https://my.clevelandclinic.org/health/diseases/15370-colon-polyps