CRC is quite common pathology in the world. In the structure of cancer incidence , colorectal cancer is the fourth place, and in the structure of cancer-related deaths – second among women ( after breast cancer ) and third place among men (after prostate cancer and lung cancer ) . In Ukraine, annually doctors identify more than 15 000 cases of colorectal cancer .
Degree of risk of developing colorectal cancer varies from state to state and even region of the country . It also differs between specific individuals , depending on the characteristics of diet, lifestyle and hereditary factors.
Risk factors and disease manifestation
Among the risk factors for colorectal cancer are the following : poor nutrition (high fat in the diet of meat , low – vegetables ) , genetic factors (familial polyposis) , occupational exposures ( asbestos production , sawmills ) , immunodeficiency states. Factors contributing to the occurrence of colorectal cancer , the authors include many long stay feces in the rectum. This is due to the negative effect of carcinogens ( indole, skatole ) contained therein , which are formed in the colon in the process of putrefaction of proteins.
Colon polyps are precancerous disease and increases the risk of colorectal cancer . Also polyps to precancerous colon states include ulcerative colitis , Crohn’s disease , diverticulosis , chronic proctitis , proctosigmoiditis , anorectal fissures , fistulas .
Unfortunately, the early stages of the disease may be asymptomatic . Nevertheless , there are also some indications , for which particular attention should be paid . CRC has the characteristic symptoms and non-specific manifestations . The clinical picture of the disease depends on the stage of the pathological process of tumor growth and the nature of its location in the gut. CRC can manifest weakness, fatigue , weight loss, unmotivated , nausea, abdominal pain in the anus , tenesmus (painful false urge to defecate ) , feeling of incomplete evacuation , frequent loose stools , which is replaced by constipation , discharge of blood, mucus , pus from the rectum , as well as progressive iron deficiency anemia. All these manifestations should make an appointment to go to a specialist.
Diagnosis of colorectal cancer
Early detection of colorectal cancer – the key to successful treatment. That is why it is important timely access to a doctor in case of warning signs .
In the diagnosis of colorectal cancer using different research methods – laboratory , endoscopic , radiological – they complement each other and help to choose the most optimal treatment .
If you suspect a CRC conduct laboratory studies that include clinical and biochemical blood tests for the detection of blood in the stool , as well as specific test – definition of tumor marker CEA ( cancer embryonic antigen) . There are other markers of tumor growth in colorectal cancer : CA 19-9 , CA 242.
Endoscopic methods of diagnosis of CRC are sigmoidoscopy and colonoscopy . Before their execution obligatory in digital rectal examination . During sigmoidoscopy examined the rectum and distal (lower part) by examination of the sigmoid colon mucosa to the level of 20-35 cm from the anus . If sigmoidoscopy can detect pathological changes of the mucous membrane of the intestine of this site as well as to make removal of polyps , take the material for biopsy.
Unlike rectoscopy , colonoscopy is investigated whole colon . Colonoscopy allows for inspection of the colonic mucosa through the anus introduced flexible probe with a miniature camera . To confirm the diagnosis of CRC must perform a colonoscopy with biopsy .
Barium enema is a radiological diagnostic method and consists of filling the colon radiopaque substance and subsequent product images. If you suspect a tumor irrigoscopy conducted at dosed filling bowel air ( double contrast ) .
All these diagnostic procedures are performed at full purgation . To detail the physician could view the mucosa of the colon, it should not be the lumen contents. So on the eve of these studies need to clean the intestines with special laxatives. Currently, there are effective medications for rapid emptying of the colon. One such tool is the modern osmotic laxative MOVIPREP ®.
MOVIPREP ® advantage is the ease and convenience of its use . During the course of treatment the patient consumes 2 liters of a solution of the drug , instead of the usual 4 liters , which should be taken with some other drugs for bowel cleansing . In this cooking MOVIPREP ® is available. To prepare the first liter of solution must be content A of one sachet and a sachet dissolved in a small amount of water and then brought to 1 liter with water . The resulting solution was required to drink for 1-2 hours (about 1 cup every 15-20 minutes ) . Procedure for preparing and receiving a second liter of solution is similar.
The first liter of diluted drug drink in the evening , the second liter – the morning of the study. MOVIPREP ® also can use a different scheme : drink 2 liters of diluted preparation the night before the colonoscopy . When applying MOVIPREP ® recommended supplementation clear liquid in a volume of 1 liter, to prevent violations of water-electrolyte balance , reducing the risk of dehydration. Should drink boiled water , tea, carbonated drinks, fruit juices without pulp .
In preparation MOVIPREP ® contains AKo ( ascorbate complex) , polyethylene glycol 3350, sodium sulfate, sodium chloride and potassium chloride . It AKo (composed of ascorbic acid and sodium ascorbate ) to reduce the volume of drug solution to 2 L and thus to increase stool bulk . Polyethylene glycol 3350 ( macrogol ) increases the amount of feces and stimulates peristalsis, sodium sulfate – is a strong osmotic effect . Sodium chloride and potassium chloride, are part of MOVIPREP ®, make up for the loss of electrolytes , which came out with a chair.
Colorectal cancer is not a rare disease. Therefore, to reduce the risk of colorectal cancer , it is necessary to normalize the diet, to include in the diet of fresh vegetables and fruit ( vegetable fibers ) , reduce the consumption of meat. It is also important to give up smoking and maintain physical activity. Conducting screening tests is an important preventive measure to prevent the development of colorectal cancer . Screening is mandatory for those over 45 years , as well as the presence of colorectal cancer in a close relative ( should begin regular check-ups for 10 years before the age at which CRC originated from a relative ) .