Age is only one factor that can increase your risk for colorectal cancer. Regular screenings are often advised at an earlier age for patients whose lifestyles or family history put them at risk for developing cancer of the colon. People who have a personal history of adenomatous polyps, colon cancer or inflammatory bowel disease such as ulcerative colitis or Crohn’s disease are at a higher risk of developing colon cancer.

Having an immediate family member who has been diagnosed with colorectal cancer often places you at a higher likelihood for developing the condition yourself. Let your doctor know if a sibling, child or parent has colorectal cancer. If the family history includes Lynch syndrome, familial adenomatous polyposis or hereditary nonpolyposis colorectal cancer, the possibility exists that the conditions could be passed down through the generations.

Race can also play a part in the risk of colon cancer. African-Americans are at a greater risk than the rest of the population.

Other risk factors include diets low in fiber and high in fat, diabetes, obesity, smoking, heavy alcohol use and not getting enough exercise. These are lifestyles choices that can be easily changed to lower the risk of colorectal cancer.

Other types of cancers that have been treated by pelvic radiation, such as prostate cancer and various female cancers, can sometimes cause colorectal cancer.

Being in a high risk group does not mean that you will develop colorectal cancer, but simply that the chances of developing the disease are greater. Regular screening should be done when a patient is considered to be high risk, to detect and treat the cancer as soon as possible.

Easing Bowel Movements

Straining is a major cause of hemorrhoids, as this causes blood to rush to the anus and engorge the capillaries. One way to reduce the need for straining is to eat a diet rich in fiber, which is the same recommendation for preventing many chronic diseases. Sitting for too long on the toilet and straining with bowel movements are both signs of constipation which might lead to the development of hemorrhoids. Besides getting more fiber in the diet, exercise can help reduce constipation.

Another helpful preventative technique is to change posture. Sitting on a toilet puts the pressure of gravity on the anus, and may cause an enlargement of the hemorrhoids. Squatting instead of sitting is another way to reduce the risk of hemorrhoids.

Pregnancy

Hemorrhoids are a common complaint during pregnancy, and the cause is related to slowing digestion, pressure from the growing baby, and the extra blood flow to the pelvis. Taking supplements improperly may also cause stool to be bulkier than normal. Exercise can help here too, both by enhancing digestion and maintaining a strong circulatory system. Remaining on your left side will make it easier for blood to return to the heart because the baby’s head will no longer be pressing on the inferior vena cava, the main vein to the heart. This will allow for easier emptying of the hemorrhoidal veins.

Other causes

Since they may be caused by other medical problems, including liver disease and infections of the anus, hemorrhoids in Los Angeles that worsen or do not go away on their own should be investigated by a doctor. The use of exercise, increasing the amount of dietary fiber, and drinking more water will prevent many cases of hemorrhoids.

Anal itching is nothing to be ashamed of, and most people will experience at least one episode of anal itching during their adult years. Do not avoid seeking care for your anal itching. With proper treatment, you should experience relief from your symptoms.

Here are a few common causes of anal itching that you may wish to speak with your physician about:

• Dry Skin: As a result of the normal aging process, the skin around the anus becomes dry. Excessive dryness can lead to intense itchiness.
• Moisture: Moisture that develops around the anus is another cause of anal itching. The excessive moisture usually results from intense sweating or loose stools.
• Diarrhea: Diarrhea from dietary causes, illness, medications, overuse of laxatives or fecal incontinence may irritate the sensitive skin around the anus, leading to itching and discomfort.
• Hygiene: Washing the anus with abrasive cloths, harsh soaps or hygiene products or wiping with rough toilet paper can irritate the anus. Leftover soap, chemicals from scented hygiene products or toilet paper or perfumes in detergent can also irritate the anus and cause itching.
• Foods: Certain foods, including spices, hot sauce, acidic fruits, chocolate and caffeine may cause irritation and itching after you pass a bowel movement.
• Skin Disorders: Skin problems including psoriasis, seborrhea, eczema and yeast infections lead to itching around the anus.
• Infections and Injuries: Infections such as pinworms and other parasites, as well as sexually transmitted diseases cause anal itching in some individuals.
• Hemorrhoids: In Los Angeles, hemorrhoids are a common cause of anal itching. Hemorrhoids develop due to pressure on the anus, such as straining during a bowel movement.

Change the Diet: Increasing fiber will make stools softer and easier to pass, easing the discomfort of hemorrhoids and making them less likely to cause symptoms.

Increase Fluids: Stool tends to become dry and difficult to pass when there is inadequate fluid intake. Drinking more water may help relieve discomfort.

Cut the Salt: Excess sodium in the diet can make blood vessels swell, aggravating hemorrhoids. Cutting down on salt intake may reduce fluid retention, as well.

Try Witch Hazel: Applying chilled witch hazel oil to hemorrhoids can make them shrink and feel better.

Reduce Weight: Overweight people may be more prone to hemorrhoids because of increased anal pressure. Pregnant women can relieve pain by lying on their left side for 20 minutes every few hours.

Avoid Straining: Straining to pass stool may be one of the main causes of hemorrhoids. Increasing fiber and fluids can eliminate this issue.

Heed the Urge: Passing stool when you feel the urge, rather than waiting may prevent inflammation later on.

Use Wet Wipes: Toilet paper can be too abrasive on hemorrhoids. Wet wipes sooth and cut pain.

Sit in a Warm Bath: A few minutes in a warm, shallow bath with the knees up might increase blood flow to the anal area and reduce the size of the hemorrhoids.

Ask the Doctor: This is the most important form of hemorrhoid treatment. If hemorrhoids do not respond to natural remedies within a couple of weeks, then your proctologist or colon and rectal surgeon should be consulted to possibly avoid more serious problems later on.

An inflamed diverticulum can rupture and infect the patient’s abdominal cavity. The infection can spread throughout the body and threaten the patient’s life. An inflamed diverticulum can also block the colon. A non-inflamed diverticulum can bleed so much that it compromises the patient’s health. In these cases, a partial colectomy is required to remove the diseased part of the colon.

Traditionally, the partial colectomy was a very invasive surgery that required a large incision. Now, surgeons are turning more and more to laparoscopic surgery. Laparoscopic surgery operates with much smaller incisions than the usual colectomy, and the surgeon is guided by a video monitor attached to a tiny camera that enters the abdominal cavity. With laparoscopic surgery, the patient may have a shorter recovery time.

During the colectomy, the surgeon finds the diseased area of the colon and removes it. The surgeon then reconnects the two ends of the healthy colon back together. On occasion, there may be a need for a temporary colostomy which diverts the fecal flow to a bag placed surgically on the outside of the abdomen. This temporary situation allows the colon to heal and the colostomy may be closed within 1 to 4 months.

Of course, each patient’s condition is different and you should consult your proctologist or colon and rectal surgeon.

Although the cause for this increase is not clear, the increase itself is important to take it into consideration. Because colon cancer is mainly thought of as being a condition that affects the elderly, this cancer is often not discovered in younger individuals, such as those in their 30s or 40s, until the later stages when it is more serious and harder to treat. If you have a family history of colon cancer, then it is especially important to speak with your doctor about early testing for the condition.

People who have symptoms such as abdominal pain, bleeding and a change bowel habits may want to speak with their doctors about the possibility of colon cancer as the cause of these symptoms. It is important to take preventative actions with diseases like colon cancer. Colonoscopy is just such a preventative test and can find a polyp of the colon before the polyp becomes malignant. When diagnosed early, colon cancer is often much easier for your physician to treat.

Many people think that common actions such as eating spicy foods, sitting on cold benches or sidewalks while waiting for buses, or having anal sex cause hemorrhoids. The development of hemorrhoids is not so simple however. Hemorrhoids, which are an enlarged collections of veins, arteries and connective tissues around the anus, are associated with a number of potential causes, including not eating properly, not exercising, sitting for long periods during the day, weight gain, old age, pregnancy, or stools that are too hard. Hemorrhoids affect individuals of all ages.

It is important to understand that there are degrees of severity of hemorrhoids in Los Angeles. Small hemorrhoids may cause large problems, and large hemorrhoids may be asymptomatic. While hemorrhoids are often very painful, they are generally not severe, and in certain cases, may even regress over time. Many people require treatment for their hemorrhoids as a result of the pain, and your colon and rectal specialist will often be able to treat hemorrhoids without invasive surgical procedures. Eating foods that are rich in fiber, such as fruits and vegetables, whole grains and legumes, can help to prevent hemorrhoids, as can getting plenty of exercise. Try to exercise at least five days each week at a moderately difficult level for at least half an hour. Exercise can increase your blood circulation and help slow the development of hemorrhoids. Consuming sufficient amounts of fiber can keep your stools soft so that you don’t have to strain when you are passing your stools.

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Common. Embarrassing. Treatable.

Fecal incontinence refers to the involuntary loss of solid or liquid stool, or flatus. Affecting more than 18 million Americans, fecal incontinence can undermine self-confidence, create anxiety, and lead to social isolation. Women are almost twice as likely as men to report incontinence to solid stool as are men. Out of embarrassment, many patients are hesitant to discuss this problem with a healthcare provider. However, fecal incontinence is treatable. Treatment can lessen symptoms in most cases and may possibly provide a cure. Several recent breakthroughs hold significant promise.

CAUSES

Continence requires the normal functioning of both the lower digestive tract and the nervous system. In most cases, incontinence results from a combination of causes. The internal and external anal sphincters surround the distal rectum and anal canal. The sphincters and the surrounding pelvic musculature effectively hold the anorectum closed and prevent the involuntary escape of feces. Any damage to, or loss of control over these muscles can lead to incontinence. The damage most commonly occurs during vaginal childbirth or anal surgery.

Neurologic disorders such as diabetes, multiple sclerosis, or spinal cord injury can decrease anorectal sensation and control over the lower digestive tract. Nerve damage to the pudendal or inferior rectal nerves during vaginal childbirth can also decrease anal sphincter function.

Decreased distensibility of the rectum, as in inflammatory bowel disease such as Crohn’s disease or ulcerative colitis may impair the rectum’s ability to expand or to store fecal matter. Radiation-induced inflammation of the rectum may lead to radiation proctitis and urgency. The radiation may have been used to treat prostatic cancer, rectal cancer or various gynecologic malignancies.

In a fecal impaction, large masses of hardened or even soft feces accumulate in the rectum and cause rectal over-distention. The anal sphincters reflexively relax and allow liquid stool to escape around the blockage. Fecal impaction is a common cause of transient incontinence in older adults. Factors that make impaction more likely include certain mental health conditions, Parkinson’s disease, Alzheimer’s disease, the use of narcotics and immobility.

Diarrhea caused by irritable bowel syndrome, active inflammatory bowel disease, or acute gastroenteritis, can lead to the involuntary, uncontrollable and embarrassing loss of liquid stool.

Often, the cause of fecal incontinence cannot be identified. This idiopathic incontinence most commonly occurs in middle-aged and older women.

HOW TO INVESTIGATE INCONTINENCE

The underlying cause of fecal incontinence often can be established with a combination of medical history, physical examination, and diagnostic testing. A physical exam may reveal decreased sphincter tone, a patulous sphincter, a sphincter defect or an atrophied perineal body.

Direct examination is the first step in the testing process. Anoscopy, sigmoidoscopy or colonoscopy may be recommended. These can help identify inflammation, tumors, or other disorders that can cause incontinence.

Diagnostic tests are particularly useful in pinpointing the cause and ensuring correct treatment. Stool cultures may be obtained to determine if there is an underlying reason for diarrhea, especially if an infectious cause is suspected. A history of any recent foreign travel should be obtained.

Anorectal manometry measures internal anorectal pressures under different conditions. Manometry can identify several of the different causes of incontinence and may be particularly useful in revealing poor anal sphincter tone. Manometry can also be used to determine if rectal sensation and rectal reflexes are impaired.

An anal or rectal ultrasound examination can reveal abnormalities of the anal sphincters, the rectal wall, and the pelvic muscles that help maintain continence. These structures may have been previously damaged during childbirth or elective operations on the anorectum. Ultrasound is the safest and most reliable test for identifying structural abnormalities of both anal sphincters.

HOW CAN THE PHYSICIAN HELP?

Three classes of treatment are commonly used to ameliorate or cure fecal incontinence. Depending on the underlying cause of the incontinence, treatment may include medical therapy, biofeedback or operative intervention.

NONSURGICAL THERAPY

Medical therapy includes medications that can firm the stool, and reduce or eliminate episodes of fecal leakage. Often, basic measures will improve minor incontinence, but more aggressive measures may be needed to control frequent or severe episodes of leakage.

Bulking agents promote larger stools and may help control diarrhea and leakage by thickening the stools. Methylcellulose is a form of fiber that is commonly used. Increasing natural dietary fiber may also help to bulk stools.

Medications that reduce stool frequency are usually prescribed for diarrhea, and may help to control incontinence. Loperamide (Imodium®) and diphenoxylate (Lomotil®) are two such medications. Loperamide can also increase anal sphincter tone, thus helping to control the egress of anal contents.

When taken before meals, anticholinergic medications such as hyoscyamine can decrease the incontinence that occurs after meals in some people. Anticholenergic medications reduce colonic contractions in part by reversibly blocking the binding of the neurotransmitter acetylcholine to receptor sites in cells of the parasympathetic nervous system.

Patients who have become impacted with large amounts of soft or hard stool may require an initial manual disimpaction. A fecal impaction allows the uncontrollable leakage of liquid around the impaction. After disimpaction, one or more medications are prescribed to keep the intestinal contents moving on a regular basis. This will prevent the continued leakage.

When incontinence is related to a disability or a mental health condition, a clinician will often recommend a scheduled toileting program. Incontinence is less likely to occur in those on a toilet regimen. Enemas may be necessary to promote evacuation, but should be used only as a last resort.

Kegel exercises may be prescribed to strengthen the perineal muscles but these exercises are of unproven benefit.

PROCEDURES: WHEN A SPECIALIST CAN HELP

Biofeedback is a safe and noninvasive way of retraining anorectal muscles. During biofeedback training, sensors are used to help patients identify anal sensations and contract the anal sphincter muscles, which, in turn help maintain continence. However, biofeedback is of limited usefulness as results are not consistently successful.

Anal electrical stimulation uses a mild electrical current applied next to the anal sphincter to strengthen the anal muscles. The electrical current is applied using a small probe, which is inserted inside the rectum for a few minutes every day for 8 to 12 weeks. Although often prescribed, anal electrical stimulation is of limited usefulness as results are not consistently successful.

Solesta® injections into the submucosa of the anal canal may physically narrow and tighten the anal canal. Solesta® is a gel composed of the natural substances dextranomer and sodium hyaluronate. Solesta® injections are performed in the office and do not require anesthesia. With few drawbacks, these injections are a promising intermediate step before surgical options are considered. The injections should be given by a specialist in order to minimize the risk of complications.

The SECCA procedure is an outpatient procedure that delivers carefully placed radio-frequency energy into the anal sphincter mechanism. It is performed under regional or general anesthesia. Over time, scar tissue develops which then tightens the anal sphincter. The procedure has shown excellent results in lifestyle improvement for the majority of patients. However, it is not commonly performed.

Recently FDA approved, InterStim® sacral nerve stimulation has demonstrated excellent results in reducing or eliminating fecal incontinence. It achieves the ideal balance of a high success rate with limited side-effects, and is relatively non-invasive. The electrical stimulation can eliminate leakage in 40 to 75 percent of people whose anal sphincters are intact. Even those without normally functioning sphincters are finding symptomatic improvement. Under fluoroscopic control, electrodes, which are connected to a temporary test generator are placed into the third sacral foramina and when actuated, influence the behavior of the pelvic floor muscles and bowel. If the symptoms improve, a permanent subcutaneous battery-generator is placed two weeks later. Results to date have been excellent.

Surgical sphincter reconstruction can reduce or resolve incontinence, specifically in women who develop a tear in the external anal sphincter during childbirth, or in patients with a surgical injury to the sphincter. An overlapping sphincteroplasty cures fecal incontinence in 80 percent of women with childbirth-related sphincter tears. However, continence may diminish over time.

In those who have irreparable sphincter damage, muscles can be transferred from other areas of the body and positioned as a new anal sphincter. Muscles from the thigh, buttock or perineum are wrapped around the anal canal. These muscles mimic the action of the damaged sphincters. Muscle transfer procedures can restore continence in up to 73 percent of patients. However, these procedures are performed only by specialists, and postoperative complications are not uncommon. Artificial sphincters, while available in a few institutions, are fraught with problems and are used only in a small, carefully selected group of patients.

Colostomy creation is a surgical procedure in which the colon is surgically brought to the abdominal wall. Stool is collected in a deodorized bag which fits snugly against the skin. This eliminates leakage of stool from the rectum. A colostomy is used as a last resort after other treatments have failed. It may also be considered for people with intolerable symptoms who are not candidates for any other therapy. Although extreme, in those who are candidates for a colostomy to control incontinence, the quality of life is improved.

Great strides have been made in the treatment of fecal incontinence. Embarrassment and social isolation need not be the natural results of this awkward problem. A specialist will be able to tailor the correct treatment for each patient and offer hope to those afflicted with incontinence.

1. Age

Age seems to be a factor because a lot of people have an early onset of IBD. There are many patients with IBD that are around 50 or 60 years old, but a lot of young adults and even children are diagnosed with IBD as well. Most of the time the symptoms of IBD will start to manifest when people become young adults. There is not necessarily an environmental cause for IBD, but this does lead researchers to believe that genetics and family history are a factor.

2. Medication

It is known that certain medications can exacerbate the symptoms of IBD in some cases, but there is no medication that is known to cause the illness itself. It has been noted that drugs like accutane, ibuprofen, and certain oral contraceptives can increase the likelihood of IBD or worsen the symptoms in some cases.

3. Diet

Diet is not necessarily a determining factor, but it seems that people with high fat diets or diets that include a lot of animal proteins may be at a higher risk for developing IBD.

4. Location

Location seems to play a role in IBD because it has been shown that people in Western countries like the UK and US have higher rates of the illness whereas it is not nearly as common in Asian countries like China, Japan, and Korea. The location seems to contribute a complex number of risk factors involving the diet, pollution and smoke, but there is not one reason why it could cause IBD.

5. Family History

Family history plays a significant role in IBD because there are roughly 30 genes associated with the illness. The mere presence of the genes does not necessarily mean that a person will have IBD because environmental factors also play a large role in triggering the onset of IBD.

6. Ethnicity

Researchers have noticed that people of European descent seem to have a higher rate of IBD than other ethnicities. It also seems that certain symptoms can be more prevalent in certain racial groups than others.

7. Appendectomy

It has been noticed that people who have had an appendectomy seem to be at a lower risk for Crohn’s disease and ulcerative colitis due to changes in immune function after the operation. They have only noticed benefits in people that had the surgery before they began to manifest IBD symptoms, so it will not help to get the surgery once you have been diagnosed.

8. Bacteria

The presence of certain bacteria in the colon could help contribute to IBD. Bacteria are a natural part of the colon and most of the bacteria promote a healthy digestive system, but the harmful bacteria can cause problems.

9. Smoking

It is already known that smoking can cause a number of health problems, but it can actually aggravate these types of digestive problems too. People with Crohn’s disease are encouraged to stop smoking immediately because smoking can intensify the symptoms and prolong the illness.

Bathroom Habits

Certain bathroom habits and behaviors cause blood to pool in your rectal veins, leading to hemorrhoids. Hurrying yourself during a bowel movement causes excessive straining and pressure on the veins in your rectum.

Bowel Problems

Frequent or persistent constipation or diarrhea increases pressure and stress on the veins in your anus, contributing to the development of hemorrhoids. Straining and pushing while constipated also increases pressure on rectal veins.

Obesity

Being overweight causes an excess of pressure on your anal veins, often causing hemorrhoids to develop. Hemorrhoid development is more likely if you carry your excess weight in your abdominal or middle region.

Pregnancy

Hormonal fluctuations during pregnancy often cause women to develop hemorrhoids. This occurs as a result of increases in blood flow to the pelvic area. As the fetus grows in size, the pressure on the pregnant woman’s rectal veins increases.

Childbirth

Straining during labor and delivery increases the pressure on the veins in the anal canal, leading to hemorrhoids that develop during childbirth.

Chronic Diseases

If you have a chronic health problem such as heart or liver disease, pooled blood in your abdomen and pelvis can enlarge the anal veins and cause hemorrhoids.

If you suffer from hemorrhoids in Los Angeles, we can help you relieve your discomfort and get you back to your usual activities with minimal pain or hassle. There are many options for hemorrhoid treatments, which are safe and effective at relieving your pain.