Colorectal Surgery And What You Need To Know
Colorectal Surgery is a field of medicine that deals with disorders of the rectum, anus and colon. Doctors specialising in this field of medicine are called colorectal surgeons. They are fully trained in general surgery before completing advanced training in this area of the body.
About the Colon, Rectum and Anus
The colon is part of the large intestine and the final part of your digestive system. Its primary job is to form the food you ingest mixed with the digestive juices in your stomach into firm stools for excretion.
The rectum is the part of your digestive system that comes after the colon. Here, the colon empties into the rectum as waste collects as bowel movements.
The rectum then empties into the next part of your digestive system, the anus. The anus is where bowel movements leave your body.
Colorectal Surgical Disorders
At ParkCity Medical Centre, our Colorectal Clinic offers the best surgical and non-surgical treatment for a wide range of conditions including:
Colorectal cancer – cancer of the colon and rectum
Haemorrhoids (piles) – varicosities or swelling, and inflammation of veins in the rectum and anus
Anal fissures – unnatural cracks or tears in the anus
Perianal abscess and anal fistula – abnormal connections or passageways between the rectum or other anorectal area to the skin surface
Diverticular disease – the presence of small pouches in the large intestinal wall
Severe constipation conditions
Rectal prolapse – protrusion of the walls of the rectum through the anus
Other general surgical conditions including any injuries to the anus, removal of objects inserted into the anus etc.
Colorectal Centre at Parkcity Medical Center
As a one-stop colorectal centre, ParkCity Medical Centre’s services include:
Cancer screening and prevention
Diagnostic endoscopy including sigmoidoscopy and colonoscopy under day-care settings
Advanced therapeutic endoscopy including polyp removal
Virtual (CT) colonography
Faecal occult blood test
Our colorectal surgeons share their expertise and work together to provide patients with up-to-date, evidence-based treatment including minimally invasive techniques.
PMC believes in a multidisciplinary team approach to treat cancer with the best physicians, oncologists, rehab specialists and other support services working together to optimise patient care. Our surgeons combine the latest surgical techniques with advanced equipment to achieve the best possible outcomes.
We also provide a full subspecialty service in pelvic floor disorders and functional disorders of the bowel such as constipation and incontinence. Our clinic is one of the few private centres in Malaysia equipped with biofeedback and anal manometry facilities. Other state-of-the-art facilities include 3D endoanal ultrasound, MRI defecography, Anorectal biofeedback and colonic transit studies.
3D Endoanal Ultrasound (3D-ERUS)
An established technique for imaging the rectum and the anal canal. It provides an accurate visualisation of the five-layer structure of the rectal wall and of all the pelvic organs surrounding the rectum.
A non-invasive test that uses magnetic resonance imaging to obtain images at the different stages of defecation to assess how good the pelvic muscles are working and give insight into rectal function.
A treatment programme that uses neuromuscular conditioning techniques to treat patients with faecal incontinence or chronic constipation that is associated with dyssynergia constipation.
Colonic Transit Study
A test that depicts how rapidly food passes through the digestive system. It is also known as a pellet study. A patient will be given some pellets to swallow consecutively for a few days. They will then have to come into the hospital for an x-ray.
What Should You Expect At A Colorectal Appointment?
You should expect your first appointment with your colorectal surgeon to take around 30 to 45 minutes. During your appointment with our PMC colorectal specialists, expect to be asked questions regarding your general and colon health followed by an abdominal exam, a digital rectal exam or both.
In an abdominal exam, you will be requested to lie down so that our doctor can examine your stomach for any abnormalities. A digital rectal exam, however, involves your colorectal surgeon examining your back passage with a small device called an anoscope to view the insides of your bowel. This procedure isn’t distressing, and your colorectal surgeon may request that you come in again for further investigation if necessary.
After your appointment, your colorectal surgeon will meet with you to give you your results and discuss anything that they may have been discovered during the examination.
Preparing Your Bowel For Your Visit With The Colorectal Surgeon
Before a colonoscopy or sigmoidoscopy visit, you will need to do some preparation. Your colon and bowel needs to be empty and clean for the colorectal surgeon to conduct a good examination. So, you may be asked to get ready for the procedure by cleaning out your colon and bowel.
You will be given instructions ahead of your appointment. Go through them thoroughly and should you have any questions, contact your colorectal surgeon.
Clear your calendar for the evening before and the day of your appointment and make plans for a family member or friend to accompany you for your appointment.
Tweaking your diet a few days ahead of your procedure can help the cleansing process and opt to eat light three or four days before. You are recommended to have a low fibre diet as it's easy to digest and will leave your system quickly. You may have foods such as white bread, pasta, rice, cooked vegetables, fruits without skin or seeds, lean meat, chicken, fish or eggs. Stay away from fatty foods, tough meat, whole grains, raw vegetables, seeds, nuts, popcorn and fruit with seeds or peel. During this time, your doctor may instruct you to stop taking supplements or medication that you use regularly.
The day before your appointment you would have been instructed not to eat anything solid, you would only be able to consume clear liquids. It's important to stay hydrated by drinking clear liquids such as apple juice, clear soup, sports drinks and water. Avoid any drinks that may have red, blue or purple colouring as they can discolour the colon lining and make it harder for your colorectal surgeon to see. Also, stay away from alcoholic drinks and anything you can’t see through such as milk or orange juice.
The night before your procedure, you would have been given strong laxatives by your doctor to clear your digestive tract. Once the laxatives start working, you will experience frequent diarrhoea and may have some cramps and bloating. The purging process may still be happening as you make your way to your appointment. If you are worried about having an accident, you may consider wearing adult diapers and packing an extra set of clothes.
If you have completed the process and the laxative working effectively, your excrement should look like clear liquid. While the process isn’t easy, it is a small step to protecting your health.
However, if you are experiencing severe pain or bleeding in your rectum, tell your Colorectal Surgeon because you may not need to do a bowel preparation. Also inform your colorectal doctor if you are taking medication to thin your blood.
At PMC, you can rest assured that you will be in good hands with our award-winning doctors and professionally-trained staff.
Dr Law Chee Wei
Consultant General & Colorectal Surgeon