Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- family history
Other diagnostic factors
- rectal bleeding
- mucus discharge
- weight loss
- tenesmus
- change in bowel habit
- symptoms and signs of anaemia
Risk factors
- increasing age
- family history of colorectal cancer or colorectal polyps
- previous history of polyps
- male sex
- acromegaly
Diagnostic investigations
1st investigations to order
- colonoscopy
- CT colonography
- chromoendoscopy
- histology
Investigations to consider
- flexible sigmoidoscopy
Emerging tests
- autofluorescence
- cap-assisted colonoscopy
- virtual chromoendoscopy techniques
Treatment algorithm
suitable for endoscopic resection
unsuitable for endoscopic resection
Contributors
Authors
Edward T. Pring, FRCS
Specialty Registrar
University College Hospital
London
UK
Disclosures
ETP declares that he has no competing interests.
Laura E. Gould, MRCS
Specialty Registrar
St Mark’s Hospital
Harrow
UK
Disclosures
LEG declares that she has no competing interests.
George Malietzis, PhD, FRCS
Consultant General and Colorectal Surgeon
Mediterranean Hospital
Cyprus
Honorary Clinical Lecturer
Department of Surgery and Cancer
Imperial College London
London
UK
Disclosures
GM declares that he has no competing interests.
Ioanna Drami, MRCS
Specialty Registrar
St Mark’s Hospital
Harrow
UK
Disclosures
ID declares that she has no competing interests.
Dinh Mai, MRCS
Specialty Registrar
St Mark’s Hospital
Harrow
UK
Disclosures
DM 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 Edward T. Pring, Dr Laura E. Gould, Dr George Malietzis, Dr Ioanna Drami, Dr Dinh Mai, and Dr John T. Jenkins would like to gratefully acknowledge Dr Phil Tozer, a previous contributor to this topic.
Disclosures
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
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