Understanding the Colon and When Surgery May be Necessary

About the Colon?

The colon is a long, tubular organ made up of four distinct sections through which digested material passes. Its primary function is to absorb water, electrolytes and any remaining nutrients from food waste after it has been processed in the small intestine.

The colon is the longest organ in the digestive tract, and it is vital for digestion. Modern medicine has also developed effective ways to support or replace its function when the colon must be removed for medical reasons, ensuring that patients can still maintain healthy digestion.

Signs and Symptoms That a Patient Might Need a Partial or Whole Colon Removal?

There are various signs that something may be going wrong within your digestive system. In most cases, gastrointestinal issues create damage over time, and this damage can become irreparable if it persists for long enough.

This is why it is so important to maintain a healthy diet, exercise consistently and consult with your doctor if you are experiencing issues. If patients are experiencing the following symptoms, it is particularly important that they contact a physician.

• Rapid, unexplained weight loss
• Bloody or black stool
• Persistent abdominal pain
• Sudden fatigue
• Changes in bowl function
  • Shape of stool
  • Frequency
  • Frequent Diarrhea or constipation

A physician would typically need to do thorough testing to be able to diagnose the issue, and the decision to remove all or parts of a patient’s colon is not taken lightly. The following are often the reasons for colon surgery:

• Cancer- removing tumors and/or adjacent structures such as lymph nodes
• Bowl obstruction- Surgical clearing of blockages that prevent normal movement of intestinal contents.
  • If left untreated, this can be life-threatening
• Inflammatory Bowel Disease- Surgeons sometimes need to remove areas of the colon that have been greatly affected by the inflammation that accompanies Crohn’s disease, ulcerative colitis or other gastrointestinal issues
• Uncontrolled bleeding-If physicians are unable to control intestinal bleeding, which can be caused by a variety of factors, they may need to remove the portion where the bleeding is present
• Diverticulitis- If a person has too many diverticula, inflamed pouches, in their colon, surgeons might opt to remove the affected portion of the colon

What Surgery Looks Like:

This procedure varies greatly, and the type of surgical technique used depends on the specific circumstances of the patient’s case.

In some cases, surgeons are able to remove just a small portion of the colon or perform a hemicolectomy, removing only the right or left side of the colon. In the most severe cases, the surgical team will perform a total colectomy, removing all of the colon, or a proctocolectomy, removing both the colon and the rectum.

If the surgical team removes only parts of the colon, they then conduct an anastomosis, which is a surgical connection of the two healthy portions or they perform a colostomy, which is a procedure in which the end of the intestine is able to be accessed through an opening in the stomach.

• Minimally invasive surgery- The surgeon makes several small incisions and inserts narrow, hollow tubes along with a laparoscope—a small camera that provides a live view of the surgical area. Surgical instruments are then guided through these tubes, allowing the surgeon to remove the appropriate portion of the colon using either hand-controlled tools or robotic assistance.

In some cases, surgeons might need to do open surgery.

• Open surgery- The doctor creates a large incision across the abdomen through which to remove all or part of the colon and any necessary adjacent tissues.

Colectomy Risks:

As with any surgery, patients are at risk of the following:

• Excessive bleeding
• Injury to other nearby organs
• Infection near the surgical site

Colon surgery does, however, have its own set of unique risks. Patients who undergo a colectomy also need to be aware of another set of distinct risks:

• Nutritional Deficiencies
  • The colon handles absorption of key minerals; therefore, those who have part or all of their colon removed may need to supplement these key components.
• Anastomotic leaks
  • If a person has two healthy portions of their colon fused together, the area can become slightly disconnected, which can cause the contents of the colon to leak, causing infection.
    • This issue must be addressed quickly.
  • Bowel obstruction
    • Adhesions, or scar tissue, from surgery can sometimes create a bowel obstruction.
      • Patients need to vigilantly watch for symptoms of a bowel blockage following colon surgery, ensuring they contact their doctor if they suspect a potential blockage.
    • Ileus (paralysis of the bowel)
      • Ileus is pretty common and typically temporary following a colectomy. It can be treated with supportive care while waiting for the bowel to “wake up” again.

Adapting to Life After Surgery

A colectomy is a pretty serious surgery, and recovery takes time. For some people, the recovery process can be anxiety-inducing, but it is important to remember that when given time, most people’s bodies will adjust on their own.

If patients are left with a temporary or permanent ostomy bag following surgery, nurses will teach them how to remove, empty and replace the bag.

Most people who undergo this procedure continue to live vibrant lives, often with less pain than they previously endured.

Support and Surgical Care at South Central General Surgery

South Central General Surgery’s experienced team of surgeons offer a wide variety of surgical services. If you suspect you might need colon surgery, ask your gastroenterologist or primary physician for a referral.

If you have any questions, please call South Central General Surgery at 601-649-7802.