There are many different types of colorectal problems. As the name suggests it is a problem with any part of the colon (large bowel) or rectum (lowest part of the bowel which stores faeces before they are passed). Colorectal problems can largely be divided into functional (such as irritable bowel syndrome – by far the commonest group of problems we see in colorectal clinics – or problems with leakage of stool), inflammatory (such as bowel infections, colitis or diverticulitis), anatomical (for example prolapse of the bowel or skin tags by the back passage) or related to a growth (including benign polyps and, sometimes, bowel cancer).
Why have I been referred to a colorectal clinic?
Your GP has referred you because there is concern about the health of your large bowel. The commonest reasons for being referred to this clinic are a change in the normal bowel pattern (diarrhoea, constipation or a variable combination of the two), abdominal pain related to bowel function and bleeding from the bowel. The referral has been made to investigate the reason why your bowel is work- ing differently to previously.
What will happen in clinic?
I will talk to you about the problems related to your bowel as well as check on your general health for related problems. I will then examine you, which will often include an internal examination of the back passage, in the presence of a chaperone. After this I will discuss my suspicions for the cause of your symptoms and discuss the options for investigation and treatment.
What investigations could I be offered?
There are many different ways of investigating the abdomen in general and the large bowel specifically. The tests offered depend on you specific situation, and the suspected cause of your symptoms. Tests may include endoscopy (colonoscopy or flexible sigmoidosco- py), CT scan (plain scan or virtual colonoscopy), blood tests or stool tests. Some of these tests involve the use of preparatory medica- tion to clean all (colonoscopy or virtual colonoscopy) or part (flexible sigmoidoscopy) of the large bowel. I will discuss the options with you and the alternatives available in the clinic. Once the tests are completed I will make recommendations either for treatments or lifestyle/dietary changes to try and correct the symptoms (most likely outcome), further tests or, rarely, surgery.
IRRITABLE BOWEL SYNDROME (IBS)
IBS is a term which refers to a combination of abdominal and bowel symptoms. It is a “functional” problem with the bowel whereby the bowels look normal but do not work in a normal way. The cause is not known but it may relate to an imbalance in the transmitters between