Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- FHx
Other diagnostic factors
- rectal bleeding
- mucus discharge
- tenesmus
- change in bowel habit
- signs of anaemia
- fatigue
Risk factors
- increasing age
- FHx
- previous history of polyps
- male gender
- acromegaly
Diagnostic investigations
1st investigations to order
- colonoscopy
- flexible sigmoidoscopy
- double-contrast barium enema (DCBE)
- virtual colonoscopy/CT colonography
- chromoendoscopy
- narrow band imaging (NBI)
Investigations to consider
- histology
- i-Scan endoscopic image enhancement technology
Emerging tests
- autofluorescence
- cap-assisted colonoscopy
Treatment algorithm
obstruction through intussusception
detected during colonoscopic examination or screening
familial adenomatous polyposis
Peutz-Jeghers syndrome
Contributors
Authors
George Malietzis, MBBS, MRCS
Clinical Lecturer
Department of Surgery and Cancer
Imperial College
London
UK
Disclosures
GM declares that he has no competing interests.
John T. Jenkins, MD
Consultant Colorectal Surgeon
Department of Coloproctology
St. Mark's Hospital
London
UK
Disclosures
JTJ declares that he has no competing interests.
Acknowledgements
Dr George Malietzis and Dr John T. Jenkins would like to gratefully acknowledge Dr Phil Tozer, a previous contributor to this monograph. PT declares that he has no competing interests.
Peer reviewers
John Anderson, FRCS
Consultant Colorectal Surgeon
Glasgow Royal Infirmary
Glasgow
UK
Disclosures
JA declares that he has no competing interests.
Sharon Stein, MD
Assistant Professor of Surgery
Division of Colon and Rectal Surgery
University Hospital Case Medical Center
Cleveland
OH
Disclosures
SS received a fee for educational courses on laparoscopic surgery, paid for in part by Covidien, Olympus, and Applied Medical.
Differentials
- Colorectal cancer
- Haemorrhoids
- Anal fissure
More DifferentialsGuidelines
- NCCN clinical practice guidelines in oncology: colorectal cancer screening
- Evidence-based clinical practice guidelines for management of colorectal polyps
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