Gastrointestinal disorders can be structural or functional. Structural intestinal disorders are physical abnormalities, inflammation, or blockages. They are often considered more complex or dangerous because they tend to cause uncomfortable symptoms that last longer than usual and usually won’t improve with lifestyle changes alone.
The most common types of structural bowel disorders include inflammatory bowel disease, colon polyps, and hemorrhoids. Causes of bowel structural issues are more widespread. Everyone must have experienced a functional GI disorder at some point in their life. These can be signs of digestive system abnormalities and include constipation, diarrhea, and gas.
What is Intestinal Trauma?
Intestinal trauma can occur due to both blunt and penetrating injuries to the abdomen. Falls, car accidents, bike wrecks, and any activity causing a hard blow to the abdomen can lead to blunt trauma to the intestine. On the other hand, penetrating intestinal injury results from gunshot wounds, stabbings, or injuries caused by sharp objects.
What are the complications of abdominal trauma? Major complications include bowel perforation due to trauma, evisceration (protrusion of internal organs through a wound in the abdominal wall), and bruising. Severe abdominal pain, tenderness, rigidity, bleeding, fever, nausea, and vomiting are symptoms of intestinal trauma.
Diagnosis of intestinal injury is done through physical examination and imaging tests such as CT scans and X-rays. During the physical examination, your doctor will assess the signs of trauma, including tenderness on touch, distension, and guarding.
Both surgical and non-surgical options are available to treat bowel injuries. However, surgical intervention, such as Laparotomy, is considered the best treatment for intestinal rupture, as it can repair the damaged intestine, control bleeding, and address infections.
Ampullary Tumors: Causes, Symptoms, and Treatment
Ampullary cancer is a rare condition that starts as a growth of cells in the ampulla of Vater. The condition is more common in adults older than 70. The ampulla of Vater is located where the pancreatic duct and bile duct join the small intestine. Ampullary tumors can also form near many other parts of the digestive system, including the intestine, liver, and pancreas.
Most ampullary adenomas (benign tumors) have the potential to progress to cancer.
Signs and symptoms of ampullary tumors may include;
- Jaundice
- Diarrhea
- Blood in the stool
- Fever
- Clay-colored stools
- Weight loss
- Nausea
- Vomiting
The causes of ampullary cancer are not clear. However, studies suggest that ampullary tumors develop when cells in the ampulla of Vater undergo changes in their DNA. Diagnosis of ampullary tumors can be done through endoscopic ultrasound, biopsy, X-ray, CT scans, and MRI. Jaundice is the initial symptom that prompts diagnosis.
There is no way to prevent ampullary cancer. Also, the survival rate of ampullary carcinoma is very low. Therefore, recognizing early signs of ampullary carcinoma, such as jaundice, is important to get the necessary treatment. Treatment options for ampullary cancer include surgery to remove the cancer, radiation therapy, and chemotherapy.
Familial Polyposis Coli and Colon Cancer Risk
Familial adenomatous polyposis (FAP) is a hereditary syndrome. If you have FAP, you’ll develop hundreds of precancerous colon polyps starting from a young age (usually during your teenage years) which increases your lifetime risk of at least one becoming cancerous. This means the colon cancer risk in familial polyposis is significantly high.
To manage the risk, healthcare professionals usually suggest the complete removal of the colon (total colectomy) early in life. However, even after colectomy, you’ll need to continue having regular screenings. Without surgical intervention, most people with this genetic disorder will develop colon cancer by middle age.
At what age does FAP develop?
Colon polyps in FAP often appear during the teenage years, with an average onset age of 16. But until they grow large enough to be dangerous, they may not cause symptoms. Common symptoms of FAP include rectal bleeding, diarrhea, chronic abdominal pain, lumps under the skin, and benign bone tumors, often visible on the jawbone.
If your parents and family doctor are aware that you are at risk, they may begin screening after you turn 10. Familial adenomatous polyposis is caused by a mutation in the tumor suppressor gene called adenomatous polyposis coli (APC). How is familial adenomatous polyposis inherited? This mutation occurs during conception, which is how it runs in families.
If you want to know whether you have inherited the APC gene mutation, you can undergo genetic testing. At the lab, they’ll collect a DNA sample (blood or saliva) and look for specific gene mutations. If these tests confirm APC mutation, screening for familial polyposis coli, such as colonoscopy, will be the next step to check for adenomas.
FAP Management and Treatment
Treatment of polyposis coli involves lifelong surveillance, and eventually, surgery. If you have fewer polyps, they can be removed one by one during colonoscopy screening. Other regular screenings may include upper endoscopy, ultrasound, CT scan, or MRI. Those with classic FAP and too many polyps will need a total colectomy in their late teens or early thirties.
Can familial adenomatous polyposis be prevented? Although genetic counseling can help you understand the risks, you cannot prevent the gene mutation from happening at conception. Preventing colon cancer in FAP patients is possible only through colon removal surgery. Without timely treatment, the average life expectancy with FAP is 42 years.
Complications of familial adenomatous polyposis.
The most important complication of FAP is colorectal cancer. While colon removal surgery can lower your risk, living without a colon will complicate your life. Since the gene mutation that causes FAP is present in every cell of your body, you may develop tumors throughout your body, including stomach polyps, duodenal polyps, and rectal polyps. Other complications may include papillary thyroid cancer, cancerous brain tumors, and liver cancer.
It is certainly upsetting to learn that you have a digestive disorder, whether structural or functional, that affects your daily life. When it is a genetic disorder like familial adenomatous polyposis, it can be particularly frustrating, as it will require lifelong care.
But do not worry! If you have symptoms of structural bowel disorders or a family history of colon cancer, consult our experts at Dr. Patta’s Gastro Center today! Once you understand the root cause, you can take the necessary steps to manage further complications.
