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Colon and Rectum

The Center for Digestive Health at Beth Israel provides a detailed and focused approach to colorectal diseases. We offer internationally-recognized expertise in the surgical, gastroenterological, endoscopic and medical management of these disorders, and work closely with our highly skilled radiologic and oncologic colleagues when necessary in order to provide the most appropriate therapeutic program with a patient-centered approach to these problems.

Conditions we treat:

Diagnostic Tools
Treatment Options


Cancer and Pre-cancer (polyps)
The Center for Digestive Health has expertise in screening for and treating colon polyps and cancer. Gastroenterologists, oncologists and surgeons provide the full spectrum of care, from detection and removal of polyps of all sizes during colonoscopy to diagnosis, staging and treatment of colorectal cancer.


Diverticulosis and Diverticulitis
Diverticula are pockets in the colonís wall in which hard pieces of stool may get trapped. While diverticulitis is often benign, it always requires subsequent colonoscopy to exclude a co-existing cancer and it may require emergency or elective surgery.


Hemorrhoids and Anal Fissures, Abscesses and Fistulas, and Anal Warts
Comprehensive approach includes a complete diagnostic evaluation, treatment and further management for any precancerous or ongoing conditions.


Irritable Bowel Syndrome (IBS)
IBS is a common disorder of gastrointestinal movement (motility) which requires accurate diagnosis and evaluation. Abdominal pain, constipation and diarrhea are all typical symptoms of irritable bowel syndrome.


Inflammatory Bowel Disease (IBD)
Inflammatory bowel disease causes inflammation in the digestive track. The main forms of IBD are Crohn's disease and Ulcerative colitis.


Diagnostic Tools for Colorectal Conditions

Colonoscopy
Patients suffering from gastrointestinal problems may need to undergo a colonoscopy. A colonoscopy is a test that allows a physician to examine the large intestine (rectum and colon). During the procedure, a flexible video endoscope is passed through the anus and guided through the rectum and colon to provide a diagnostic view of the lining of the colon and access for treatment. At the time of the procedure, tissue samples can be collected (this is called a biopsy) and abnormal growths (like polyps) can be taken out. Colonoscopy is frequently used as a screening test to check for cancer or precancerous growths in the colon or rectum (polyps).


Water-assisted Colonoscopy (WAC)
The use of water instead of air to inflate the colon during colonoscopy. The Center has the expertise to provide this through its research program.


Endoscopic Ultrasound (EUS)
This test uses a flexible endoscope with an ultrasound probe attached to its tip for evaluating suspected tumors in the rectum or diseases around the rectum.


Other Endoscopic Procedures
Other endoscopic procedures such as, anoscopy, proctoscopy and sigmoidoscopy are used to examine the lining of the anus, rectum and lower part of the large intestine (colon). These tests are used to look for abnormal growths (such as tumors or polyps), inflammation, bleeding, hemorrhoids and other conditions.


Biopsy
Pathologists analyze tissue removed at the time of endoscopy or surgery to make a diagnosis. The Center has a database of cancer pathologies and treatments dating back more than 15 years. Through this database, physicians are able to offer statistics-based insight to patients on staging and the Center-specific outcomes of techniques.


Imaging
Scans such as ultrasound, CT (computed tomography), PET (positron emission tomography) or MRI (magnetic resonance imaging). and high-resolution MRI defacoraphy, in which the mechanics of a patientís defecation are visualized in real-time.


Test and Exams

  • Blood and stool tests
  • A digital rectal exam



Treatment Options
Treatment strategies for colorectal conditions vary depending on the type of condition and its progressions.

Lifestyle and Medication

  • Over-the-counter and/or prescription medicines
  • Changes in diet and other lifestyle modifications
  • Nutritional guidance and other support


Surgery

  • Surgery (both minimally invasive and traditional open procedures) to remove all or parts of the colon, treat hemorrhoids and other anal disorders, and drain abscesses. Many of the surgical techniques are combined with endoscopic diagnostic and therapeutic techniques to provide a rapid and safe therapy
  • Surgical resectionólaparoscopic and laparoscopic-assisted techniques, as well as complex open resections, are done with the best balance of cure rates and avoidance of complications and damage to pelvic nerves that control bladder and sexual function


Non-surgical Treatments

  • Colonoscopic evaluation and treatment of benign disease and early cancers to help avoid surgery. The Center has experts in colonoscopy, endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for large polyps
  • Sclerotherapy injections, rubber band ligation, radiofrequency and staple hemorrhoidectomy are all used to treat hemorrhoids
  • Simple and complex fistula repairs, fistulotomy, plug therapy and advanced flap procedures are available
  • Radiation or chemotherapy


Other

  • Psychosocial services

To learn more about the many services provided by the Center for Digestive Health at Mount Sinai Beth Israel or to make an appointment for a consultation, please call
(212) 604-6822.

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