What are the main surgical procedures for bowel cancer. How does colon cancer surgery differ from rectal cancer treatment. When is a stoma necessary after bowel cancer surgery. What are the advantages of laparoscopic colectomy compared to open surgery.

Colon Cancer Surgery: Removing the Affected Area

Colon cancer treatment often involves surgical intervention to remove the cancerous tissue. The extent of the surgery depends on the stage and location of the cancer. Let’s explore the main surgical options for colon cancer:

Local Excision: Minimally Invasive Approach

For very early-stage colon cancer, a local excision may be sufficient. This procedure involves removing only a small piece of the colon wall lining. How is it performed? A surgeon uses specialized tools to remove the cancerous tissue without making large incisions in the abdomen.

Colectomy: Removing a Section of the Colon

When cancer has spread into the surrounding muscles of the colon, a more extensive surgery called a colectomy is typically necessary. This procedure involves removing an entire section of the colon. There are two main approaches to performing a colectomy:

• Open colectomy: The surgeon makes a large incision in the abdomen to access and remove the affected section of the colon.
• Laparoscopic (keyhole) colectomy: This minimally invasive technique involves making several small incisions in the abdomen. The surgeon uses specialized instruments guided by a camera to remove the cancerous section of the colon.

During both types of colectomy, nearby lymph nodes are also removed to check for cancer spread and improve treatment outcomes.

Advantages of Laparoscopic Colectomy

While both open and laparoscopic colectomies are equally effective at removing cancer, laparoscopic procedures offer some distinct advantages:

• Faster recovery time
• Less postoperative pain
• Smaller incisions, resulting in less scarring

Due to these benefits, laparoscopic colectomy is becoming the preferred method in many hospitals. However, not all surgeons are trained in this technique, so it’s essential to discuss your options with your healthcare team.

Rectal Cancer Surgery: Tailored Approaches for Optimal Outcomes

Rectal cancer treatment often requires a different surgical approach compared to colon cancer. The specific procedure depends on the cancer’s location and extent. Let’s examine the main surgical options for rectal cancer:

Local Resection: Early-Stage Treatment

For very small, early-stage rectal cancers, a local resection (also called transanal resection) may be possible. How is this procedure performed? The surgeon uses an endoscope inserted through the anus to remove the cancer from the rectal wall. This minimally invasive approach can be effective for carefully selected cases.

Total Mesorectal Excision (TME): A Comprehensive Approach

In many cases of rectal cancer, a more extensive surgery called total mesorectal excision (TME) is necessary. This procedure involves removing a larger area of the rectum, including:

• A border of rectal tissue free of cancer cells
• Fatty tissue surrounding the bowel (mesentery)

Why is TME important? Removing the mesentery helps ensure all cancerous cells are eliminated, reducing the risk of cancer recurrence. Depending on the cancer’s location within the rectum, one of two main TME operations may be performed:

1. Low Anterior Resection

This procedure is used when the cancer is in the upper section of the rectum. The surgeon removes the upper part of the rectum and nearby tissue, then reattaches the colon to the remaining rectum or upper anal canal. In some cases, an internal pouch may be created to replace the removed rectum.

2. Abdominoperineal Resection

When cancer affects the lowest part of the rectum, an abdominoperineal resection may be necessary. This operation involves removing the entire rectum, surrounding muscles, and the anus. As a result, a permanent stoma is required after this procedure.

Stoma Surgery: Temporary and Permanent Solutions

In some cases of bowel cancer surgery, a stoma may be necessary. A stoma is an opening created in the abdominal wall to divert stool out of the body. But when is a stoma required, and how long does it last?

Temporary Stomas

Temporary stomas are often created to allow the bowel to heal after surgery. This is particularly common when:

• A section of the bowel has been removed and rejoined
• The surgeon wants to protect the surgical site from stool passage

How long does a temporary stoma last? The duration varies, but it typically remains in place for several weeks to allow for proper healing. Once the bowel has healed sufficiently, another surgery is performed to close the stoma and restore normal bowel function.

Permanent Stomas

In some cases, a permanent stoma is necessary. This is often required after an abdominoperineal resection, where the entire rectum and anus are removed. While surgeons strive to avoid permanent stomas when possible, they may be essential for some patients to maintain quality of life and bowel function.

Types of Stomas

There are two main types of stomas, depending on which part of the bowel is used to create the opening:

• Ileostomy: Created from the small bowel (ileum)
• Colostomy: Created from the large bowel (colon)

The Role of Stoma Care Nurses in Patient Support

Stoma care nurses play a crucial role in supporting patients before and after stoma surgery. These specialized healthcare professionals provide valuable assistance in several areas:

Pre-Surgery Planning

Before surgery, a stoma care nurse helps determine the best location for the stoma. What factors do they consider?

• The patient’s body shape
• Lifestyle considerations
• Clothing preferences
• Optimal placement for easy self-care

This personalized approach helps ensure the stoma is positioned in a way that minimizes complications and maximizes the patient’s quality of life.

Post-Surgery Care and Education

In the days following surgery, stoma care nurses provide essential support and education. Their responsibilities include:

• Teaching patients how to care for their stoma
• Recommending appropriate stoma bags and accessories
• Demonstrating proper cleaning and changing techniques
• Addressing concerns and answering questions
• Providing emotional support during the adjustment period

This comprehensive care helps patients adapt to life with a stoma and regain confidence in their daily activities.

Recovery and Follow-up Care After Bowel Cancer Surgery

The recovery process after bowel cancer surgery varies depending on the type of procedure performed and individual patient factors. However, there are some common elements to expect during the post-operative period:

Immediate Post-Operative Care

In the days following surgery, patients typically receive:

• Pain management
• Wound care
• Monitoring for complications
• Gradual reintroduction of food and drink
• Assistance with mobility to prevent blood clots

Hospital Stay Duration

How long do patients usually stay in the hospital after bowel cancer surgery? The length of stay can vary, but generally:

• Laparoscopic surgery patients may be discharged after 3-5 days
• Open surgery patients typically stay for 5-7 days or longer

The exact duration depends on the individual’s recovery progress and any complications that may arise.

Long-Term Recovery and Follow-up

After discharge, patients continue their recovery at home. This process may include:

• Gradually increasing physical activity
• Following a specific diet to promote healing
• Attending follow-up appointments with the surgical team
• Participating in rehabilitation programs, if necessary
• Monitoring for signs of complications or cancer recurrence

Regular follow-up care is crucial for monitoring recovery and detecting any potential issues early.

Potential Complications and How to Manage Them

While bowel cancer surgery is generally safe, like any major operation, it carries some risks. Understanding potential complications and how to address them is essential for patients and caregivers:

Common Complications

Some potential complications after bowel cancer surgery include:

• Wound infection
• Bleeding
• Anastomotic leak (where the reconnected bowel separates)
• Ileus (temporary paralysis of the bowel)
• Deep vein thrombosis (blood clots)
• Stoma-related issues (for those with stomas)

Managing Complications

How are these complications typically addressed?

• Prompt medical attention for any concerning symptoms
• Antibiotics for infections
• Additional surgery if needed (e.g., for anastomotic leaks)
• Blood thinners to prevent or treat blood clots
• Specialized care for stoma-related problems

Early detection and intervention are key to managing complications effectively.

Life After Bowel Cancer Surgery: Adjusting to a New Normal

Recovering from bowel cancer surgery often involves adjusting to changes in daily life. Patients may experience:

Physical Changes

• Altered bowel habits
• Changes in diet and nutrition needs
• Fatigue during the recovery period
• Potential sexual function changes

Emotional and Psychological Impact

The emotional journey after bowel cancer surgery can be complex. Patients may experience:

• Anxiety about cancer recurrence
• Body image concerns, especially with a stoma
• Depression or mood changes
• Stress related to lifestyle adjustments

Support and Resources

Various support systems can help patients navigate life after bowel cancer surgery:

• Support groups for bowel cancer survivors
• Counseling or psychological support services
• Nutritional guidance from dietitians
• Occupational therapy for adapting to daily activities
• Regular check-ups with the oncology team

Engaging with these resources can significantly improve quality of life and help patients adjust to their new normal.

Bowel cancer symptoms & treatments – Illnesses & conditions

If colon cancer is at a very early stage, it may be possible to remove just a small piece of the lining of the colon wall. This is known as local excision.

If the cancer spreads into muscles surrounding the colon, it will usually be necessary to remove an entire section of your colon. This is known as a colectomy.

There are two ways a colectomy can be performed:

• an open colectomy – where the surgeon makes a large cut (incision) in your abdomen and removes a section of your colon
• a laparoscopic (keyhole) colectomy – where the surgeon makes a number of small incisions in your abdomen and uses special instruments guided by a camera to remove a section of colon

During surgery, nearby lymph nodes are also removed. It is usual to join the ends of the bowel together after bowel cancer surgery, but very occasionally this is not possible and a stoma is needed.

Both open and laparoscopic colectomies are thought to be equally effective at removing cancer and have similar risks of complications.

However, laparoscopic colectomies have the advantage of a faster recovery time and less postoperative pain. It is becoming the routine way of doing most of these operations.

Laparoscopic colectomies should be available in all hospitals that carry out bowel cancer surgery, although not all surgeons perform this type of surgery. Discuss your options with your surgeon to see if this method can be used.

Surgery for rectal cancer

There are a number of different types of operation that can be carried out to treat rectal cancer, depending on how far the cancer has spread.

Some of the main techniques used are described below:

Local resection

If you have a very small, early-stage rectal cancer, your surgeon may be able to remove it in an operation called a local resection (transanal resection).

The surgeon puts an endoscope in through your back passage and removes the cancer from the wall of the rectum.

Total mesenteric excision

In many cases, however, a local resection is not possible. Instead, a larger area of the rectum will need to be removed.

This area will include a border of rectal tissue free of cancer cells, as well as fatty tissue from around the bowel (the mesentery). This type of operation is known as total mesenteric excision (TME).

Removing the mesentery can help ensure all the cancerous cells are removed, which can lower the risk of the cancer recurring at a later stage.

Depending on where in your rectum the cancer is located, one of two main TME operations may be carried out. These are outlined below.

Low anterior resection

Low anterior resection is a procedure used to treat cases where the cancer is in the upper section of your rectum.

The surgeon will make an incision in your abdomen and remove the upper section of your rectum, as well as some surrounding tissue to make sure any lymph glands containing cancer cells are also removed.

They will then attach your colon to the lowest part of your rectum or upper part of the anal canal. Sometimes they turn the end of the colon into an internal pouch to replace the rectum.

You will probably require a temporary stoma to give the joined section of bowel time to heal.

Abdominoperineal resection

Abdominoperineal resection is used to treat cases where the cancer is in the lowest section of your rectum.

In this case, it will be necessary to remove the whole of your rectum and surrounding muscles to reduce the risk of the cancer regrowing in the same area.

This involves removing and closing the anus and removing its sphincter muscles, so there is no option except to have a permanent stoma after the operation.

Bowel cancer surgeons always do their best to avoid giving people permanent stomas wherever possible.

Stoma surgery

Where a section of the bowel is removed and the remaining bowel joined, the surgeon may sometimes decide to divert your stool away from the join to allow it to heal.

The stool is temporarily diverted by bringing a loop of bowel out through the abdominal wall and attaching it to the skin – this is called a stoma. A bag is worn over the stoma to collect the stool.

When the stoma is made from the small bowel (ileum) it is called an ileostomy, and when it is made from the large bowel (colon) it is called a colostomy. 

A specialist nurse, known as a stoma care nurse, can advise you on the best site for a stoma prior to surgery.

The nurse will take into account factors such as your body shape and lifestyle, although this may not be possible where surgery is performed in an emergency.

In the first few days after surgery, the stoma care nurse will advise on the care necessary to look after the stoma and the type of bag suitable.

Once the join in the bowel has safely healed, which can take several weeks, the stoma can be closed during further surgery.

In some people, for various reasons, rejoining the bowel may not be possible or may lead to problems controlling bowel function, and the stoma may become permanent.

Before having surgery, the care team will advise you about whether it may be necessary to form an ileostomy or colostomy, and the likelihood of this being temporary or permanent.

There are patient support groups available that provide support for patients who have just had or are about to have a stoma. You can get more details from your stoma care nurse, or visit the groups online for further information.

These include:

Learn more about coping with a stoma after bowel cancer

Side effects of surgery

Bowel cancer operations carry many of the same risks as other major operations, including bleeding, infection, developing blood clots, or heart or breathing problems. 

The operations all carry a number of risks specific to the procedure. One risk is that the joined-up section of bowel may not heal properly and leak inside your abdomen. This is usually only a risk in the first few days after the operation.

Another risk is for people having rectal cancer surgery. The nerves that control urination and sexual function are very close to the rectum, and sometimes surgery to remove rectal cancer can damage these nerves.

After rectal cancer surgery, most people need to go to the toilet to open their bowels more often than before, although this usually settles down within a few months of the operation.

Radiotherapy

There are two main ways radiotherapy can be used to treat bowel cancer. It can be given before surgery to shrink rectal cancers and increase the chances of complete removal, or be used to control symptoms and slow the spread of cancer in advanced cases (palliative radiotherapy).

Radiotherapy given before surgery for rectal cancer can be performed in two ways:

• external radiotherapy – where a machine is used to beam high-energy waves at your rectum to kill cancerous cells
• internal radiotherapy (brachytherapy) – where a radioactive tube is inserted into your anus and placed next to the cancer to shrink it

External radiotherapy is usually given daily, five days a week, with a break at the weekend. Depending on the size of your tumour, you may need one to five weeks of treatment. Each session of radiotherapy is short and will only last for 10 to 15 minutes.

Internal radiotherapy can usually be performed in one session before surgery is carried out a few weeks later.

Palliative radiotherapy is usually given in short daily sessions, with a course ranging from 2 to 3 days, up to 10 days.

Short-term side effects of radiotherapy can include:

• feeling sick
• fatigue
• diarrhoea
• burning and irritation of the skin around the rectum and pelvis – this looks and feels like sunburn
• a frequent need to urinate
• a burning sensation when passing urine

These side effects should pass once the course of radiotherapy has finished. Tell your care team if the side effects of treatment become particularly troublesome. Additional treatments are often available to help you cope with the side effects better.

Long-term side effects of radiotherapy can include:

If you want to have children, it may be possible to store a sample of your sperm or eggs before treatment begins so they can be used in fertility treatments in the future.

Chemotherapy

There are three ways chemotherapy can be used to treat bowel cancer:

• before surgery – used in combination with radiotherapy to shrink the tumour
• after surgery – to reduce the risk of the cancer recurring
• palliative chemotherapy – to slow the spread of advanced bowel cancer and help control symptoms

Chemotherapy for bowel cancer usually involves taking a combination of medications that kill cancer cells. They can be given as a tablet (oral chemotherapy), through a drip in your arm (intravenous chemotherapy), or as a combination of both.

Treatment is given in courses (cycles) that are two to three weeks long each, depending on the stage or grade of your cancer.

A single session of intravenous chemotherapy can last from several hours to several days.

Most people having oral chemotherapy take tablets over the course of two weeks before having a break from treatment for another week.

A course of chemotherapy can last up to six months, depending on how well you respond to the treatment. In some cases, it can be given in smaller doses over longer periods of time (maintenance chemotherapy).

Side effects of chemotherapy can include:

• fatigue
• feeling sick
• vomiting
• diarrhoea
• mouth ulcers
• hair loss with certain treatment regimens, but this is generally uncommon in the treatment of bowel cancer
• a sensation of numbness, tingling or burning in your hands, feet and neck

These side effects should gradually pass once your treatment has finished. It usually takes a few months for your hair to grow back if you experience hair loss.

Chemotherapy can also weaken your immune system, making you more vulnerable to infection.

Inform your care team or GP as soon as possible if you experience possible signs of an infection, including high temperature (fever) or a sudden feeling of being generally unwell.

Medications used in chemotherapy can cause temporary damage to men’s sperm and women’s eggs. This means that for women who become pregnant or for men who father a child, there is a risk to the unborn baby’s health. 

It is therefore recommended you use a reliable method of contraception while having chemotherapy treatment and for a period after your treatment has finished.

Find out more about chemotherapy  

Biological treatments

Biological treatments, including cetuximab, bevacizumab and panitumumab, are a newer type of medication also known as monoclonal antibodies.

Monoclonal antibodies are antibodies that have been genetically engineered in a laboratory. They target special proteins found on the surface of cancer cells, known as epidermal growth factor receptors (EGFR).

As EGFRs help the cancer grow, targeting these proteins can help shrink tumours, and improve the effect and outcome of chemotherapy.

Biological treatments are therefore usually used in combination with chemotherapy when the cancer has spread beyond the bowel (metastatic bowel cancer).

These treatments are not available to everyone with bowel cancer. The National Institute for Health and Care Excellence (NICE) has specific criteria that need to be met before these can be prescribed.

Cetuximab is only available on the NHS when:

• surgery to remove the cancer in the colon or rectum has been carried out or is possible
• bowel cancer has spread to the liver and cannot be removed surgically
• a person is fit enough to undergo surgery to remove the cancer from the liver if this becomes possible after treatment with cetuximab

Cetuximab, bevacizumab and panitumumab are available on the NHS through a government scheme called the Cancer Drugs Fund. All these medications are also available privately, but are very expensive.

More information on all of the above is available from:

Is it normal to have thin stools? 4 possible explanations

While finishing your business in the bathroom, you might look at your stool just to make sure everything is okay. While observing stool if you notice that your stool is pencil-thin over a length of time, it might be a sign of a health condition that could be a cause for concern. Here are 4 possible explanations for your thin stools.

Constipation

While everyone might struggle with staying regular from time to time, it becomes constipation when your bowel movements drop to less than three times a week. While thin stools are not always a sign of constipation, they can be if your stools do not always look that way. Constipation usually occurs due to a lack of fiber and exercise. Other signs that it might be constipation is if your poop becomes hard to pass, hard and dry.

Having thin stools for a period of time is nothing to worry about, though it might require some lifestyle changes.  However if looks this way all the time and begins to narrow over time, you should let your doctor know. 

Colorectal Cancer

It used to be that doctors believed that pencil-thin stools were a sign of colorectal cancer, indicating that some sort of growth was creating a blockage, narrowing the space for stool to pass through.

However, years of research have concluded that stools narrowing over time is usually the sign of a far less serious medical condition.

That being said if your stool narrowing coincides with symptoms such as:

• Blood in your stool
• Diarrhea, incontinence, constipation
• Anemia
• Belly pain or bloating
• Unexpected weight loss
• Vomiting

It is advised that you consult a medical professional.

Anal Cancer

While rare, Thin stools could also be a sign of anal cancer. Anal cancer forms in your anus or the outer part of your rectum. Anal cancer is usually caused by infection with the human papillomavirus (HPV)

If anal cancer is causing your thin stools it might also come with symptoms such as:

• Anal pain, bleeding, and itching of the rectum
• Strange rectal discharge
• Lumps felt around the anus
• Swollen lymph nodes around the anus

If you believe you have these symptoms, consult a medical professional for more information.

Irritable Bowel Syndrome

Another common cause of thin stools is Irritable bowel syndrome (IBS). Those who suffer from IBS suffer from stools that change in shape and texture, suffer from diarrhea,  as well as:

• Gas, bloating, constipation
• Strong urge to go, mucus in your poop
• Belly cramps

To manage IBS, doctors recommend more fiber in the diet, and to manage your stress levels.

If you or a loved one suffer from thin stools and any of the other symptoms listed above and would like more information, consult a medical professional right away.

Losing my mind with fear of colon cancer.

About 6 weeks ago I started feeling quite bloated and gassy then I had some massive loose stools and some diarreah, I also started having night sweats. I’ve been through a very stressful time lately with a divorce and moving out of the family home and I was eating a lot of rubbish and drinking a lot. Then I noticed blood on my poop and sometimes on the paper when I wiped. I’m not sure if it’s bright red, sometimes it is but is definitely red, this has happened about 8 times in 6 weeks. 

I went to the walk in centre and the doctor I saw did a rectal exam and didn’t find any evidence of piles, she said it was probably an infection and that if I wanted to I could take a stool sample to my gp and talk to him, she didn’t seem overly concerned. 

Saw my GP 2 days later. I was extremely anxious at this point and told him the full story including the divorce and my anxiety. He was very nice and said rectal bleeding is very common and that I shouldn’t worry. He said he wouldn’t be worried as he’s a similar age to me (45) and that I should come back in 3 weeks if I was still concerned. 

This really eased my mind for a while, all my symptoms went away for around 10 days but the blood came back, not much but enough to terrify me. At this point I’d also got an upset stomach, it seemed like if I ate anything slightly spicy it would make me have loose stools. One day at work after a loose stool in the morning I felt like my rectum was full all day and that I hadn’t finished pooping. When I got home I forced one out and there was blood on the toilet paper.  

This sent me running back to the gp, a different one this time who was very dismissive and said it was probably piles but if I booked another appointment they would do another rectal exam.

I went back 2 days later and the doctor said he found a very small internal pile. Again this eased my mind for about a week, the bleeding stopped but I started getting what I can only describe as a dodgy tummy. My anxiety at this point was through the roof and I was checking through my stools constantly trying to find any blood.

Yesterday I thought I finally had a grip on it and told myself I was being silly and decided to go back to work, however in the morning I went for my usual morning poo and afterwards my stomach felt really dodgy and I felt like I hadn’t finished, this sent me into a massive panic attack and I went straight back to the doctors. He again said he wasn’t concerned and thinks my anxiety is responsible for the symptoms. I pushed him to refer me for a colonoscopy, he was reluctant but did refer me and said it might be a long wait as I didn’t fit the cancer profile but did take some blood and another stool sample.

The reason I write this is because I’m going out of my mind with worry. All I want to do is stay in bed all day, I can’t cope with the uncertainty and I’m having regular panic attacks. I feel like I just want to sleep until the blood test results come back. I can’t eat and don’t want to see anyone, he signed me off work for another week.

I don’t know what I want to get out of posting this on here but I’ve found writing it down quite therapeutic and any replies would be greatly welcomed.

Thanks.

Jason.

What Causes Thin or Narrow Stool?

For the majority of people, normal stool is one or two inches in diameter, so suddenly producing a thin or narrow stool can be startling. To have it happen once or twice may not be harmful, but if you have narrow, thin stools on a regular basis, it could be a sign of an underlying health problem that requires medical intervention.

So what is narrow stool? When we look at the anatomy of the colon, stool is really a thick liquid as opposed to a solid as it enters the colon. As stool makes its way into the lower colon, it absorbs water and salt to become solid. By the time it reaches the descending and sigmoid colon on the left side of the abdomen it should be solid. Narrow stools are stools that are not exactly solid — they are thin, pencil-like, or as some people describe them, “ribbon-like.”

What Are the Causes of Narrow or Thin Stools?

More often than not, a change in bowel movements has something to do with diet, but there are cases where certain health conditions can play a role in the development of narrow or thin stool.

The following outlines what causes narrow stools:

Constipation

A lack of liquids and a low-fiber diet can lead to constipation. Adding fiber to your diet adds bulk to the stool, increasing its size. Many people find that if they don’t consume enough fiber, their stools become thin and stringy.

You can get more fiber by adding whole grain, such as bran and oats, to your diet. Fruits and vegetables can also increase your fiber intake.

Also read: Essential oils for constipation: Benefits, usage, and warnings

Cancer

One of the most common cancers in the developed nations is colorectal cancer. Pencil thin stools are a persistent symptom of colon cancer and are accompanied by weight loss and rectal bleeding. Thin stools can also occur with anal cancer, but it’s less common.

IBS

This is a term for irritable bowel syndrome, a condition that can lead to smaller, larger, or narrower than usual stools. Some IBS sufferers experience constant, severe diarrhea while others have constant constipation. With diarrhea, the stools become thin and runny, and with constipation, the stools come out either lumpy or hard.

Also read: IBS back pain: How irritable bowel syndrome causes back pain and what to do about it

Diarrheal Illness

There are illnesses that can cause diarrhea, such as food poisoning, infections, inflammatory bowel disease (IBD), and IBS. While we think of diarrhea as watery stools, it can also be defined by having more than three bowel movements in one day. Not eating the way you normally do along with constant stool movement can lead to thinner stools.

Also read: 14 essential oils for diarrhea and various ways to use them

Colon Polyps

This is a small clump of cells that can form on the lining of the colon. Most of these polyps are harmless; however, some colon polyps can develop into colon cancer. When colon cancer is found in the later stages, it’s often fatal. The polyps are essentially growths that extend from the bowel wall and can create thin stool when they occur near the end of the colon. This is due to the fact that the growth is causing an obstruction.

Also read: Colon polyps: Diet and natural home remedies

Foreign Object

This means any object in the stomach that is indigestible and not food. Usually, foreign objects are a problem for small children. For instance, some kids swallow toys. There are also foreign objects developed within the body, such as gallstones. A large stone released from the gallbladder can cause an obstruction in the bowel, which can lead to thin or narrow stools.

Bowel Obstruction

Any blockage that keeps food or liquid from passing through the small or large intestine is referred to as a bowel obstruction. Adhesions in the abdomen, inflamed intestines, infections, hernias, and colon cancer all have the potential to cause a bowel obstruction.

Also read: Partial Bowel Obstruction: Causes, Symptoms, and Diet

Fecal Impaction

This is a hard mass of stool that becomes so hard that you can’t push it out. It is a condition that can be very serious if not addressed. The overuse of laxatives can cause fecal impaction. Fecal impaction is common in older people who have bowel issues.

Hernia

An abdominal hernia can happen when an organ or a piece of tissue protrudes through a weak spot in one of the muscle walls of the abdominal cavity. A sac that bulges through the weak spot may include a piece of intestine or lining of the colon. If a portion of the bowel gets trapped within a hernia, the bowel becomes narrow. There are even severe situations where the trapped bowel gets strangled and blood supply to a section of the bowel wall is cut off.

Volvulus

Having volvulus means that you have a twisted bowel. It’s like a loop that obstructs fecal matter from moving through the intestines. If volvulus is not treated, it can lead to cell death since blood flow to the area is often compromised.

Volvulus occurs in about 1.7 to 6.2 percent of adults living in the western world, and may be due to adhesions, tumors, or diverticula, but research into the causes is ongoing.

Also read: Sigmoid volvulus: Causes and treatment of twisted sigmoid colon

Anorectal Stricture

Also referred to an anal stenosis, anorectal stricture means that a tubular organ has become extremely narrow and can’t perform the way it’s supposed to. With anal stenosis, the anal canal narrows, making it difficult to pass normal stool. An enlarged prostate or bladder cancer can cause an anorectal stricture.

Symptoms That May Accompany Narrow Stools

Now that we have addressed the causes of narrow stools, let’s look at the warning signs. These narrow stools symptoms are not meant to scare you. Again, there are cases where you might have a day or two of thin stool and then go back to normal fecal size and shape. You should be concerned when symptoms persist.

• Bloody stools
• Dizziness and confusion
• Abdominal pain
• Vomiting
• Fever
• Unexplained weight loss
• Dehydration (dry mouth and reduced tear production)
• The prolonged passing of thin stools

How Are Narrow Stool Causes Diagnosed?

To diagnose the cause of narrow stool, a doctor may require a fecal occult test to check for blood in the stool. A stool sample to test for the presence of bacteria or parasites may be a doctor’s focus. Some people notice a change in bowel movements if they suffer from celiac disease, so blood tests may also be used even if it is to simply rule out a condition like celiac. There are also the following tests and procedures for diagnosing the cause of narrow stool:

• Flexible Sigmoidoscopy: Helps examine the lower colon.
• Colonoscopy: An examination of the entire colon.
• X-ray: Along with a contrast (barium), this provides a view of the gastrointestinal tract.
• CT Scan: This allows for a view of abdominal organs.

If you have the occasional narrow, thin, or stringy poop, there is no reason to panic or call your doctor. If symptoms occur for more than one week and you also experience vomiting, abdominal pain, rectal bleeding, or fever, then you should see a doctor as soon as possible. As with any condition associated with narrow stool, the sooner it’s addressed, the better chance there is of a positive outcome.

Related:

Please tell me it’s normal to have stringy poop

Have you ever noticed that you have stringy poop? Here’s what it could mean.

Be real for a second: You probably inspect your poop so often you could do a PowerPoint presentation on your daily BMs. (No shame, really! Examine that poo all you want.)

Most of the time, whatever’s in the toilet looks pretty standard: Brown and log-like. So when something’s very clearly off ­– like if your poop is pencil-thin and kind of stringy-looking – it’s alarming.

First: Take a deep breath – stringy poop is likely not as bad as you think. Yes, even if your poop looks like you ran it through a Play-Doh pasta maker.

Okay, why does my poop look stringy?

Let’s get something out of the way first: You’ve probably heard that stringy poop can be a sign of colorectal cancer and, yes, that’s true, says Dr Kyle Staller, a gastroenterologist at Massachusetts General Hospital. But it’s way more common that stringy poop is caused by something much more innocent, he says.

Namely, it could be that your poop is just moving through your colon really fast and creating a thin, stringy appearance in the process. That could be due to something as simple as a change in your diet, says Dr Benjamin Lebwohl, a gastroenterologist at NewYork-Presbyterian/Columbia University Medical Center.

“Aside from diet, other factors that can affect the frequency of bowel movements include a change in physical activity, fluid intake, travel, stress or other disruptions to one’s routine,” he says. “Typically, moving around less, sitting for prolonged periods and being relatively dehydrated can slow the bowels down, and this can result in a change in shape.”

Read more: 6 reasons why you’re pooping a whole lot more than usual

Should I be worried about my stringy poop?

Not really, says Dr Anton Bilchik, professor of surgery and chief of gastrointestinal research at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, California. “This can be a normal type of stool,” he says. “Some people have thin and stringy stools; some people have larger bowel movements. ”

That said, you should be a little concerned if you’ve been having big, bulky poop and then suddenly you’re having thin, stringy poop that won’t quit, says Dr Ashkan Farhadi, a gastroenterologist at MemorialCare Orange Coast Medical Center and director of MemorialCare Medical Group’s Digestive Disease Project in Fountain Valley, California. That’s especially true if it also comes along with bloody poop and abdominal pain, Dr Staller says, who recommends seeing your doctor ASAP, if that’s the case.

Read more: 8 natural laxatives that actually work to relieve constipation

How can I take care of my stringy poop situation?

If you’re just having stringy poop and you have no other symptoms, it’s a good idea to try to bulk up the fibre in your diet and see where that gets you, Dr Staller says. That could mean eating more high-fibre foods (like whole grains and beans) or taking a supplement.

But if you’re having other symptoms along with your stringy poop, or it came out of nowhere and won’t stop, it’s a good idea to check in with a doctor, just in case. Your doctor will typically examine you and, if they think it’s necessary, may order a colonoscopy, Dr Lebwohl says.

One thing to keep in mind (and put you at ease), “When we do a colonoscopy to evaluate long stringy bowel movements, the great majority of the time we find no structural abnormality and no cancer,” he says.

Again, if you’re just having stringy poop here and there, don’t panic. You probably ate something funky or you’ve changed up how much you’re drinking – and it’s totally normal.

^{This article was originally published on www.womenshealthmag.com}

^{Image credit: iStock} 

Are your symptoms IBS or colorectal cancer?

Last updated Oct. 4, 2021

Colorectal cancer shares some symptoms with a less serious, but much more common disease: irritable bowel syndrome (IBS). So how do you know if your symptoms are cancer, IBS or something else?

We talked to David Richards, M. D., about the symptoms of irritable bowel syndrome and colorectal cancer, and what action you should take if you are experiencing either.

What are the symptoms of irritable bowel syndrome?

IBS can be hard to diagnose. It’s not something a doctor can see, feel or detect under a microscope, and the symptoms come and go. The main symptoms of IBS are constipation, diarrhea or a combination of the two, accompanied by abdominal pain.

Someone with IBS may also experience one or more of the following:

• Abdominal bloating
• Mucus in your stool
• The feeling that you haven’t finished a bowel movement
• Relief of symptoms after a bowel movement

You can gauge whether these are IBS symptoms based on how long you’ve had them. “The symptoms have to go back at least six months, with at least one day a week of pain in the last three months,” Richards says.

What are the symptoms of colorectal cancer?

Diarrhea, constipation and abdominal pain are all symptoms of colorectal cancer. However, there are additional symptoms that are more concerning.

“Sudden and unexplained weight loss, rectal bleeding or blood in the stool are all cause for concern,” says Richards.

Other colorectal cancer symptoms include:

• A change in the size or shape of your stool, which may suddenly be thin like a pencil
• A new need for straining to evacuate stool
• Fatigue
• Discomfort or urge to have a bowel movement when there is no need
• Bloating or feeling full constantly
• Change in appetite

“I would be especially concerned if these symptoms came on suddenly,” says Richards.

When should you see a doctor about symptoms?

Symptoms lasting more than two weeks should trigger a trip to the doctor. Based on your age, symptoms and family cancer history, your doctor will decide if you need a diagnostic test like a colonoscopy or CT scan.

In addition to colorectal cancer, your doctor will want to rule out inflammatory bowel disease (IBD). This family of disorders shares symptoms with IBS and colorectal cancer.

The two most common inflammatory bowel diseases are ulcerative colitis and Crohn’s disease. These are autoimmune diseases that inflame the GI tract. This prolonged inflammation raises the risk of colorectal cancer.

“A lot of the concerning symptoms may not be cancer, but they could be something more than IBS,” says Richards.

Does IBS affect your cancer risk?

Unlike IBD, IBS does not cause inflammation, a key factor in colorectal cancer risk.

“IBS does not raise your risk for colorectal cancer, no matter how long you’ve had it,” says Richards.

What should cancer patients know about IBS?

A lot of cancer treatments can trigger stomach issues. For example, traditional chemotherapy affects any rapidly dividing cells, including cells in the GI tract. So, blood in the stool and abdominal pain are not uncommon.

If you are in cancer treatment or about to start treatment, talk to your doctor about side effects that you might experience and how to manage potential GI side effects.

When is colorectal cancer screening needed?

Men and women at average risk for colorectal cancer should get a screening colonoscopy every 10 years beginning at age 45. 

If you are under the regular screening age or between screenings and you experience prolonged symptoms of gastrointestinal disease, see your doctor as soon as possible. The earlier cancer is detected, the more likely it is to be treated successfully.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

How Can I Tell the Difference Between Irritable Bowel Syndrome and Colorectal Cancer?

Published: November 18, 2019

• Abdominal pain, cramps, and changes in bowel habits are symptoms associated with both colorectal cancer and irritable bowel syndrome.
• Colorectal cancer may have additional symptoms of blood in the stool, weight loss, fatigue, and a feeling of incomplete bowel movements.
• Early detection of colon cancer through screening can be key to better outcomes and survival.

Medically reviewed by Jeffrey A. Meyerhardt, MD, MPH

Irritable bowel syndrome (IBS) is a chronic disorder in which the large intestine undergoes abnormal contractions, producing abdominal pain, cramps, diarrhea, constipation, or a mix of these symptoms. (It is a different condition from inflammatory bowel disease (IBD), which most often occurs as ulcerative colitis or Crohn’s disease.) Colorectal cancer, which involves the uncontrolled growth of cells in a portion of the large intestine called the colon or rectum, can produce similar symptoms, so it is important to be aware of the differences between the two conditions.

What are the early warning signs of colorectal cancer?

In its early stages, colorectal cancer often doesn’t produce any symptoms, but as the cancer grows and penetrates the walls of the colon, a variety of symptoms may arise, including:

• Changes in bowel habits
• Blood (either bright red or very dark) in the stool
• Vomiting, diarrhea, constipation, or feeling that the bowel does not fully empty
• Stools that are narrower than usual
• Frequent gas pains, bloating, fullness, or cramps
• Weight loss for unknown reasons
• Fatigue
• Vomiting
• Anemia (low red blood cell count)

Because IBS, colorectal cancer, and other digestive disorders, such as IBD, can produce similar symptoms, it’s a good idea to consult your doctor or primary care provider as soon as possible if you experience these symptoms, especially if they last more than a few days.

While colorectal cancer often doesn’t produce symptoms until it has grown and spread, screening tests — including fecal occult blood testing, colonoscopies, and sigmoidoscopies — can detect the disease at its earliest stages. The American Cancer Society (ACS) recommends regular colorectal cancer screening starting at age 45 for people at average risk. People with a family history of the disease or who have certain other risk factors should talk to their physician about starting screening at a younger age, the ACS advises.

An image of colon cancer, with cancer cells forming circled structures.

When colorectal cancer is found early, before it spreads, the five-year survival rate is 92% — meaning more than nine out of 10 people who are diagnosed with an early stage of the disease, and treated, are alive five years later. Survival rates drop as the cancer becomes more advanced through the colon or rectum and surrounding lymph nodes, or if it spreads outside the colon or rectum.

To diagnose colorectal cancer, doctors may order blood tests as well as X-ray or CT scans. If colorectal cancer is strongly suspected, a colonoscopy is likely to be performed to view the lining of the colon or rectum and collect small samples of abnormal tissue for testing.

Can IBS lead to colorectal cancer?

People with IBS need not be concerned that the condition increases their chances of developing colorectal cancer. A 2010 study by researchers at the University of Michigan found that patients with IBS are at no greater risk of having intestinal polyps (growths that can be a precursor to colorectal cancer), colorectal cancer, or inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease than healthy people undergoing colonoscopies. The research indicates that colonoscopies are unnecessary for patients with IBS unless they show other signs specifically associated with colorectal cancer, such as bleeding from the gastrointestinal tract, weight loss, or anemia.

90,000 “For what reasons does blood appear in feces in adults?” – Yandex.Qu

The presence of blood in the feces of an adult is the first sign of a violation of the integrity of the vessels of the mucous membrane and intestinal tract. But it must be borne in mind that the appearance of red mucus in the feces is not always bloody discharge.

Sometimes the color of feces changes due to the consumption of various foods, such as beets, tomatoes, bell peppers or gelatin-based desserts.

If the feces are colored red, do not panic.First, think about what foods could trigger this color.

Reasons for the presence of blood in feces in an adult

The main cause of bleeding from the anus or the appearance of traces of blood in the feces in adults are various diseases of the rectum and other parts of the large intestine.

The detection of this problem often occurs unexpectedly – there is no feeling of discomfort, pain or other signs of illness. Nevertheless, this is a dangerous symptom indicating an unfavorable state of the body.You should not panic, but the cause of the appearance of blood impurities in the feces should be established as soon as possible.

As already mentioned, the detection of blood in the feces of an adult may indicate the presence of certain diseases.

Here are the most popular ones:

The above diseases can to some extent affect the integrity of the mucous membranes or cause gastrointestinal, internal bleeding.

Harmless reasons

The appearance of black feces and even red inclusions does not always indicate bleeding.Sometimes this is associated with the use of certain foods and drugs:

1. Semi-digested remains of eaten berries (blueberries, currants), tomatoes may resemble blood clots in appearance.
2. The use of activated carbon, iron preparations lead to the appearance of black stools.
3. Red beet foods may turn raspberry-colored stools.
4. May alter the color of the stool and food colors found in various desserts and drinks.

However, it is better to be overly vigilant than to miss the threatening signal.

Blood character

To answer the question of why blood appeared in the feces of an adult, you need to see exactly how it looks. So, it can be fresh (scarlet), burgundy, black and hidden (meaning that blood in the feces cannot be detected with the naked eye).

1. The analysis reveals occult blood. Bleeding of the upper gastrointestinal tract – stomach ulcer, colon polyps, colon cancer, stomach cancer, esophagus.As well as rectal cancer, helminthic invasions.
2. Bright red fresh blood. The presence of blood on toilet paper indicates possible diseases such as hemorrhoids, cracks in the anus, rectal cancer.
3. Diarrhea with blood, pain, fever. Intestinal infections – salmonellosis, dysentery, etc.
4. Mucus and blood in the feces of an adult is observed in ulcerative colitis, polyps, proctitis, tumors in the rectum.
5. Dark red clots, streaks of blood.Symptoms of inflammatory gastrointestinal diseases – dysbiosis, Crohn’s disease, ulcerative colitis, etc.

In order to establish the presence of occult blood in the stool, it is necessary to conduct appropriate tests.

Latent blood in the stool

This research method allows you to determine the presence of bleeding of the internal organs of the digestive system. The test is preceded by an endoscopy of the stomach and intestines.

Discovered occult blood in the feces of an adult, a symptom of such ailments as:

• duodenal or stomach ulcer.
• violation of the integrity of the mucous membrane.
• for ulcerative colitis.
• malignant oncology.

90,025 polyps.

The preparation period for the fecal occult blood test takes 7 days. During this time, it is necessary to adhere to a special diet, do not eat foods containing iron, any medications, food additives.

It is important to detect latent blood in feces in time and draw a conclusion about the current disease in order not to miss an important time for the most effective treatment.

What do the streaks of blood in the stool mean?

In many cases, blood streaks during bowel movements are the result of prolonged inflammation in the large intestine. The reasons can be violations of microflora, as well as the presence of parasites. In addition, scarlet streaks of blood appear after prolonged diarrhea, during intestinal, infectious diseases such as dysentery or intestinal flu.

Bacteria and viruses violate the integrity of the vessel walls located close to the internal, intestinal surfaces.Intravascular, disseminated blood coagulation occurs, which is why such alarming signs appear.

It is worth paying attention to the permanent streaks of blood in the stool in the following cases:

• if it lasts more than 3 days in a row;
• there is a loss of body weight;
• nagging pains appeared along the intestines and in the lower abdomen;

90,025 appetite was disturbed;

• The appearance of traces of blood was not preceded by constipation or diarrhea.

In such cases, blood in the stool can be a sign of diseases such as:

• intestinal polyps;

90,025 diverticulitis;

• rectal fissure;
• bowel cancer.

The sooner you start treating these diseases, the more chances you have for full recovery and full health.

Treatment of bleeding from the anus

As already shown above, a wide variety of diseases can be the causes of bleeding from the anus. For this reason, there is no single treatment that can solve the problem in every situation.

If, after visiting a doctor, you have established the exact cause of bleeding (for example, hemorrhoids or fissures in the anus), then you can find detailed recommendations on the treatment of these diseases among other articles on the site.

Material provided

simptomy-lechenie.net

14 March 2014

Precancerous conditions and changes in the colon, rectum and small intestine

To date, the risk factors for the development of cancer of the colon and rectum have been clearly identified. One of them is a genetic predisposition to the development of such cancer. There are diseases on the background of which colorectal cancer occurs more often than in healthy people: intestinal polyposis, chronic ulcerative colitis, cancer of the female genital organs, as well as a history of cancer of another localization (the likelihood of metachronous primary multiplicity).

Anamnesis plays an important role in the recognition of precancerous diseases of the rectum and colon. If polyps were found in the patient’s direct relatives, such a patient should be included in the risk group, he should be examined using X-ray and endoscopic methods, biopsy of the rectum and colon. It must be borne in mind that with polyposis of the colon and rectum, the stomach is often affected. The only method for early diagnosis of cancer of this localization during mass examinations is well-organized screening with the formation of risk groups.In addition, fecal occult blood test is commonly used when screening for colon cancer, although there are many disadvantages.

Precancerous conditions

Among diseases of the colon, the background on which cancer or precancerous conditions occurs more often than in healthy individuals include: colon polyps, diffuse familial colon polyposis, familial juvenile polyposis, Gardner’s, Peitz-Jeghers, Tyurko’s, Kronkite’s syndromes Canada, colon diverticulosis, Crohn’s disease, and chronic ulcerative colitis.

Colon polyps

Pretumor diseases play a leading role in the development of colon cancer, among which adenomatous polyps – single and multiple villous tumors – occupy the first place.

Polyps are growths of the glandular epithelium and the underlying connective tissue in the form of small papillae or round formations that rise above the surface of the mucous membrane.

Polyps may be single or multiple, pedunculated or broadly based.By histological structure, there are:

1. non-neoplastic polyps: hyperplastic, hamartoma (juvenile, Peitz-Jegers syndrome), inflammatory;
2. epithelial neoplasms: tubular, villous (villous) adenomas, diffuse (familial) polyposis;
3. submucosal benign non-epithelial tumors: lipomas, leiomyomas, neuromas, lymphangiomas, lymphoid hyperplasia, lymphomas.

Hyperplastic polyps are the result of the proliferation of epithelial glands without changing the structure of the intestinal mucosa.The probability of malignant transformation of hyperplastic polyps is only 1%. It is important to know the histological structure of a polyp, since the potential for its malignancy depends on the degree of its transformation.

There is evidence that in 50% of cases, one or more polypoid formations are found on sections in the examination of the colon. With endoscopy and colon irrigoscopy in older persons, similar changes are found in 24% of autopsies: 27% in men and 14% in women (D.A. Johnson et al, 1990; R. Carter, 1987).

During routine examinations, polyps are found in 2.4-2.9% of all examined individuals.

However, the polypoid-cancer relationship requires an accurate classification of polypoid formations. Allocate (histologically) hyperplastic (regenerative) polyps, which are 10 times more common than adenomatous. In 75% of cases, they are detected in the rectum in persons over 40 years old, they are often multiple, with a diameter of about 5 mm.Histologically, they have a mucous structure. Large polyps can have areas of adenomatous structures. Hyperplastic polyps are believed to have no malignant potential.

According to the recommendation of the WHO working group (1976), according to the classification of intestinal tumors, there are three variants of adenomatous polyps: predominantly tubular structure, mainly villous and mixed tubulovili structure. This division is artificial, since in almost all cases there are signs of both.Dysplasia of the epithelium in tubular adenoma is less pronounced than in the villous structure. Moreover, it is clearly shown that with an increase in the area of ​​villous structures, the tendency to an increase in the degree of dysplasia increases (R. Carter, 1987).

Hamartoma (juvenile) polyps are considered a malformation. Often these are single, large pedunculated polyps. Very rarely they are multiple (more than 5 polyps), and then referred to as juvenile polyposis.

Peutz-Jeghers syndrome is characterized by a combination of pigmentation of the gums, lips with multiple jejunal hamartomas (in 50% of patients, polyps are found in the colon).Hamartoma polyps are not prone to malignancy, but sometimes foci of dysplasia appear in these polyps.

Inflammatory polyps, or pseudopolyps, are found in many patients who have had an inflammatory disease (ulcerative colitis, Crohn’s disease). They don’t get cancerous.

It is known that cancer of the colon and rectum develops from adenomatous polyps in 90% of cases. Adenomatous polyps are present in 5-10% of people over 40 years of age and the vast majority are asymptomatic (J.G. Guillem et al, 1988). The incidence of adenomas increases with age. Moreover, the older the person, the greater the percentage of detection. So, at 50-59 years old, polyps are found in 25-50% of people. At the age of 60 years, colon polyps are malignant in 2-3% of patients, over 60 years – in 6-8% (L. Valenkevich, 1987). Moreover, the frequency of malignancy of adenomatous polyps in close relatives of patients with colon cancer reaches 25%.

In addition to age, the degree of malignancy of polyps is influenced by the peculiarities of their histological structure – the tendency to malignancy is the higher, the larger the polyp and the degree of its villousness.With tubular adenomas, the likelihood of malignancy is higher than with hyperplastic polyps. So, the index of malignancy in tubular adenomas is 5%, with tubular-villous – 23%, and with villous – from 41% to 90%. It is believed that villous tumors are malignant from the very beginning and even in the absence of invasion into the submucous layer of the intestine, they should be considered as carcinoma in situ (N. Napalkov et al., 1989).

There has been a relationship between smoking and the development of colorectal polyps, the number of the latter being directly proportional to the duration of smoking (G.Hoff et al, 1986).

As noted above, the frequency of malignancy of adenomatous polyps depends on their size, localization, duration of the disease, as well as on the severity of villi and the degree of dysplasia. With a polyp diameter of 0.5 to 1 cm, the risk of malignancy ranges from 1% to 5%, with adenomas from 1 to 2 cm, this risk is 20-50%, with larger polyps it increases to 70%, almost all polyps with a diameter of 4 -5 cm are malignant (Y. Yoshida, T. Aisawa, 1984; N.Trapeznikov, A. Shine, 1992; R. Hesterberg et al, 1987).

Thus, adenomatous polyps are classified as precancerous diseases.

The group of high oncological risk should include patients with adenomas of any histological type, especially with villous adenomas and mixed adenomas.

It should be noted that villous adenomas do not have legs, are on a broad base, resemble a lobed sponge in structure and bleed at the slightest touch.Villous adenomas differ from other intestinal tumors in that they secrete a large amount of water and electrolytes into the intestinal lumen. Malignancy of villous adenomas occurs much more often than tubular adenomas. Erosive and ulcerative lesions of villous polyps should be considered as the beginning of the process of malignancy.

There is little chance of malignancy in the presence of a well-defined thin stem. If the base is oblong, and the width of the polyp is greater than its height, then the likelihood of malignancy increases approximately to the same extent as in the case of the growth of polyps with an uneven surface.Cancer from polyps located on a wide base develops 2.5-3 times more often than from polyps on a thin stem.

It should be remembered that in 40-50% of cases, the simultaneous occurrence of adenomas in several areas of the colon mucosa is possible. Therefore, a thorough examination of the patient’s intestines using a colonoscopy or fluoroscopy is necessary. In addition, in about half of cases, colon cancer can be combined with adenomas of the colon and relatively often (in 1.5-5% of cases) – with a malignant tumor in another part of the intestine.

With an increase in the number of polyps in the gastrointestinal tract, the risk of developing colorectal cancer increases significantly, which reaches 22-100% if a patient has 8-50 polyps of the colon and rectum.

According to some authors, endoscopic removal of only polyps with a diameter greater than 5 mm is recommended. Other gastroenterologists consider it appropriate to perform a total polypectomy, regardless of the size of the tumor. A thorough histological examination shows that polyps even less than 5 mm in diameter in 60-70% of cases have areas of the type of tubular adenomas.Despite the fact that polypectomy can reduce the incidence of colon cancer by 20%, it, unfortunately, does not guarantee against the development of benign and malignant intestinal tumors in the future. Among those operated on for adenomas of the colon, colorectal cancer develops 6 times more often than in the general population. All adenomatous polyps should be completely removed and closely monitored.

In epidemiological studies on the incidence of polyposis of the sigmoid and rectum, it has been shown that usually after removal of polyps with a diameter of more than 5 mm within 2 years, there are no relapses.Hence, recommendations were made on the need for a second endoscopy no earlier than 2 years later (G. Hoff et al., 1986).

Diffuse family polyposis

Diffuse familial polyposis appears as early as prepubertal age. It belongs to the obligate forms of precancerous diseases of the colon. An autosomal dominant form of inheritance of the disease is noted, in which multiple colon polyps develop with the inevitable development of colorectal cancer.It has been noted that in relatives of patients with diffuse polyposis (first and second degree of relationship), there is an increase in the incidence of adenomas with age (S. Grossman, M.L. Milos, 1988). According to V. Fedorov and A. Nikitin (1985), among the closest adult relatives of one family, polyposis was detected in 29.5%, and then in their offspring – in 33.2% of members.

If the frequency of malignancy of intestinal polyps ranges from 10% to 50%, then with diffuse familial polyposis it reaches 100% (V.Fedorov, A. Nikitin, 1985; A. Kalinin et al., 2009). Polyp malignancy can occur at any age, but up to the age of 40, colon cancer develops in 100% of cases, if prophylactic colectomy has not been performed. The older the patient is, the higher the risk of cancerous degeneration of such polyps. Moreover, the number of cases of multiple cancers increases in direct proportion to the degree of cell atypia. Often there are multiple synchronous cancers. In untreated cases, on average, death occurs before the age of 45.Therefore, surgical treatment of such patients should be recognized as the only reliable method.

In familial polyposis, the picture of the colon mucosa is a whole scattering of hundreds and thousands of small polyps. The risk of developing a malignant neoplasm increases with the size and number of polyps. In persons over 50, regardless of the morphological form of polyps, malignant transformation is observed in all cases. Relatives of patients in a straight line should be carefully examined using colonoscopy (S.Grossman, M.L. Milos, 1988). It is believed that cancer develops inevitably if left untreated. Given the high risk of malignancy of adenomas, one should not waste time on dispensary observation of patients – it is necessary, if possible, to carry out colectomy and proctocolectomy as quickly as possible.

In juvenile polyposis, Peitz-Jegers, Gardner, Tyurko syndromes, the risk of developing colorectal cancer is significantly lower than in familial diffuse colon polyposis. Patients with these syndromes and their relatives should be registered at the dispensary and periodically (1-2 times a year) undergo endoscopic examination.

Syndrome of familial adenomatous polyposis of the colon

This disease is inherited in an autosomal dominant manner and is classified as precancerous.

About 10% of colorectal cancer cases are hereditary. The most common hereditary adenomatous polyposis, characterized by the presence of multiple polyps throughout the colon. The sizes of polyps range from a pinhead to 2 cm or more.They can be on a wide base or on a leg.

By the age of 10, 15% of people with hereditary polyposis usually develop adenomatous neoplasms; by the age of 20 – in 75%, after 30 years – in more than 90%. If this disease is detected in first-degree relatives, it is recommended to screen for colorectal cancer, starting in childhood.

Clinical manifestations of the syndrome are usually observed in the 3-4th decade of life.The polyps themselves are detected in adolescence or earlier. Multiple adenomatous polyps are localized mainly in the distal colon. The small intestine and / or stomach is involved in less than 5% of cases.

Sometimes the syndrome in children is manifested by diarrhea, there may be bleeding, paroxysmal pain in the abdomen. With familial polyposis, the release of blood from the rectum is observed in almost 100% of patients. There are no extraintestinal manifestations. A family history of the disorder may be suspected.

For differential diagnosis, endoscopy or double-contrast X-ray examination should be performed, in which multiple filling defects can be detected. Polyps have an extremely high tendency to malignancy (J. Alexander-Williams, H.J. Binder, 1985).

Treatment consists of performing proctocolectomy in advance.

Generalized adolescent polyposis syndrome

The disease is inherited in an autosomal dominant manner.Has a family predisposition, manifests itself in childhood or adolescence. A characteristic feature of this syndrome is the presence of benign hamartomas growing from the stroma of the mucous membrane of the large intestine and, less often, of the small intestine or stomach. Sometimes adenomatous polyps develop in the colon, which tend to degenerate into adenocarcinoma.

Clinically manifested by intestinal bleeding or intestinal obstruction, diarrhea is sometimes noted. The diagnosis is confirmed by endoscopic and X-ray examination using the double contrast method.Radiographically, polyps appear as round filling defects. Localized more often in the rectum and sigmoid colon.

Juvenile polyposis

Juvenile polyposis of the small and large intestine is rare, manifests itself mainly in childhood, it is classified as hamartomas of the stroma of the mucous membrane and inflammatory polyps.

Other developmental abnormalities can be seen in patients with juvenile polyposis – malrotation, heart defects, congenital amyotonia, porphyria, and hydrocephalus.

Juvenile loliposis is characterized by the secretion of glandular epithelium in polyps. Polyps reach 1 to 2 cm and are usually located close to each other. They have a smooth surface, they are round, hemispherical or cylindrical in shape, of dense consistency, less often they sit on a thin leg, and have ulceration.

The probability of juvenile polyposis malignancy is quite high – up to 20%.

A characteristic clinical feature of the course of juvenile polyposis is metabolic disorders associated with indigestion, absorption and intestinal motility.When polyps are localized in the small intestine, malabsorption syndrome develops. Patients are worried about abdominal pain without a specific localization, frequent loose stools mixed with mucus and blood.

Severity is determined by the extent of the intestinal lesion.

The main diagnostic methods for juvenile polyps are X-ray and intestinal biopsy. When polyps are localized in the colon, colonoscopy with biopsy is crucial for diagnosis.On histological examination, juvenile polyps are distinguished by the presence of a large number of cysts filled with goblet cell secretions. As the size increases, the polyp becomes lobular, which gives it an outward resemblance to a villous tumor. It is believed that, unlike adenomatous polyps, with juvenile polyps there are no signs of atypia, and malignancy does not occur. However, observations of patients with juvenile polyps showed that adenomatous areas with signs of severe atypia of the epithelial glands can be detected in large polyps.According to V. Fedorov and A. Nikitin (1985), the malignancy index of juvenile polyps reaches 21%.

In juvenile polyposis, the differential diagnosis should be carried out with other hamartomas (Peutz-Jaegers syndrome, Cronkite-Canada), diffuse familial polyposis, adenomatous and hyperplastic polyps. Ulcerative colitis, Crohn’s disease, and other inflammatory bowel diseases must be ruled out.

The main method of treatment, given the rather high probability of malignancy, is the surgical removal of polyps.

Syndromes

Peutz-Jeghers syndrome is a rare disease. It is inherited in an autosomal dominant manner. It is characterized by generalized polyposis of the gastrointestinal tract with a predominant localization in the small intestine.

Combines with focal pigmentation on the skin of the face (cheeks, near the mouth), the mucous membrane of the lips and oral cavity, the skin of the dorsum of the fingers and small joints, around the natural openings.Pigmentation can be limited or widespread when spots of different shapes and sizes coalesce. In some cases, age spots on the face resemble freckles, but they appear regardless of exposure to sunlight. Pigmented spots are usually visible at birth or occur during infancy.

The likelihood of malignancy of polyps in Peitz-Jeghers syndrome is low, but increases with advanced polyposis in about 38% of cases.

Diagnosis is based on x-ray or endoscopic detection of polyps. Pigmentation of the skin and mucous membranes, the family nature of the disease are taken into account.

Treatment consists of monitoring patients and family members. However, if polyps cause any disturbances in the body, treatment should be aimed at their surgical removal (if possible, endoscopic polypectomy). The prognosis of the disease is favorable with complete removal of polyps.

Gardner’s syndrome is characterized by the presence of three features: familial diffuse colon polyposis, osteomas of flat and tubular bones (osteoma, osteofibroma of the skull, exostosis) in combination with various benign tumors of the skin and subcutaneous tissue (atheromas, lipomas, epidermoid cysts, myomas etc.), which are located on the face, neck, trunk. It is a type of familial adenomatous polyposis.

The disease is inherited in an autosomal dominant manner.The morphological picture is based on mesenchymal dysplasia.

Generally, cutaneous, bone and soft tissue tumors are detected earlier than colon polyposis. Polyps can be found in the stomach, rarely in the small and large intestines. Most often they are found by the age of 40, but they can be diagnosed at a younger age. Later, patients experience disorders of the digestive organs: abdominal pain, unstable stools, diarrhea, loss of appetite, weight loss, intestinal bleeding.This symptomatology is an expression of polyposis of the colon and rectum.

Intestinal polyps are prone to malignancy in 45-55% of patients. In some cases, there is a regression of the polyps of the fundus of the stomach after 5-10 years.

In a large percentage of cases, polyps become malignant. This fact must be taken into account, especially when examining patients with an appropriate family history and tumors of soft tissues or bones.

Such patients should be strongly advised to have a bowel examination.If a polyposis is detected, patients are subject to surgical treatment. In some cases, the disappearance of stomach polyps after colectomy is noted.

The prognosis is poor due to a high degree of malignancy of polyps. There is an increase in the frequency of tetraploidy in the culture of skin cells (epithelioid cells) and colon polyps. Tetraploidy is believed to be a marker of the mutant genome of hereditary colon cancer.

Cronkite-Canada syndrome is characterized by a peculiar complex of congenital anomalies in combination with generalized gastrointestinal polyposis.Refers to extremely rare diseases. It is inherited in an autosomal dominant manner.

The syndrome is manifested by cystic polyposis of the greater curvature of the stomach, duodenum and initial parts of the jejunum. Enteropathic protein loss, hypocalcemia, hypomagnesemia are noted. Dystrophic changes are typical (diffuse skin hyperpigmentation, alopecia, atrophy of the nail plates).

A patient complains of pain in the epigastric region, vomiting of stomach contents mixed with blood, liquid tarry stools, general weakness, weight loss.

Described isolated cases involving only the stomach in the process, while skin changes are insignificant. More often, with this symptom complex, selective hyperplasia of the mucous membrane of the stomach and small intestine is noted. Many authors consider this phenomenon to be a consequence of giant hypertrophic gastritis or chronic enteritis, or regard it as an abnormal polyposis of the gastrointestinal tract.

There is no malignancy of polyps in Cronkite-Canada syndrome.

Türko’s syndrome is a hereditary disease that is detected in childhood. It is a type of Gardner’s syndrome, in which colon polyposis is combined with tumors of the central nervous system and pigmented spots on the skin. Polyps – adenomatous with a high degree of malignancy – from 36% to 100%.

Often, brain tumors lead to death of the patient before clinical manifestations of colon polyposis develop.

Submucosal benign non-epithelial tumors (lipomas, leiomyomas, or neurofibromas) are rarely localized in the colon and are of little clinical significance.

Concomitant diseases

Patients with chronic inflammatory bowel disease are at increased risk of colon cancer. The main factors that increase the risk of developing colon cancer in these diseases (ulcerative colitis, Crohn’s disease) are the prevalence of colon and rectal lesions and the duration of the disease.

Ulcerative colitis . In ulcerative colitis, a tumor can appear 7-10 years after the onset of the disease, which is possible in 3-6% of cases (J. Alexander-Williams, H.J. Binder, 1985; N. Napalkov et al., 1989; G. Vorobieva , I. Khalifa, 2008).

The cumulative risk of developing cancer after 10 years of history ranges from 0.5% to 6%, after 20 years of history – up to 8% and after 30 years – up to 12%. Moreover, colon cancer in patients with ulcerative colitis appears at a younger age than in the general population.The risk of malignancy increases with a greater prevalence of colon lesions and a longer duration of the disease, with the onset of ulcerative colitis in childhood. The risk of cancer is more real with total colitis than with left-sided colitis. In the latter case, carcinoma occurs approximately 10 years later. However, 20 years after the onset of the disease, cancer is registered equally often in any part of the colon. At the same time, the likelihood of the appearance of a tumor increases in every fourth patient.

In ulcerative proctitis, the risk of developing cancer is very low.

The five-year survival rate after surgery for colon cancer in patients with ulcerative colitis does not exceed 20%, in contrast, after removal of the primary cancer, it reaches 50%. In addition, it should be borne in mind that multiple primary tumors of the colon in cancer of this localization occur in 2-4% of cases, while in ulcerative colitis this figure is much higher – up to 30-35%.

Conducting active dispensary observation of risk groups and treatment of patients with ulcerative colitis, especially with a long history of this disease, helps to increase survival and delay surgery (B.A. Lashner et al, 1990).

Crohn’s disease . In Crohn’s disease, the incidence of colorectal cancer is lower than in ulcerative colitis, but about 20 times higher than in the healthy population. The risk increases with the disease at an early age and with the increase in the duration of the suffering.Colorectal cancer is often multiple; tumors are often localized in the proximal colon. Crohn’s disease can be associated with adenocarcinoma of the small or large intestine.

Epithelial dysplasia is a marker of a high risk of developing colon cancer in ulcerative colitis and Crohn’s disease. It can be detected in about 80% of patients with ulcerative colitis. With a sharp degree of its severity, 45% of patients develop colorectal cancer. Many authors now equate severe dysplasia with precancer, or carcinoma in situ.

Diabetes mellitus . One of the diseases that predispose to the development of colorectal cancer is diabetes mellitus. In patients with diabetes mellitus, the risk of colon cancer is 1.3-1.5 times higher than in healthy people.

Given these data, patients with diabetes mellitus should be classified as a risk group with annual endoscopic examination of patients.

Colon diverticulosis .In patients with colon diverticulosis, colorectal cancer is detected in 4-8% of cases, and on sectional material the combination of diverticulosis and colon cancer reaches 30%. Interestingly, this disease, along with ulcerative colitis, appendicitis, hemorrhoids, rarely occurs in those geographic areas and among those population groups where colon cancer is rare.

The occurrence of cancer against the background of intestinal diverticulosis is primarily associated with the nature of the diet, namely, with the predominance of fats and other foods rich in cholesterol in the diet, as well as with a low amount of plant foods.A high content of fat and cholesterol in the diet leads to an increase in the secretion of bile acids, which affect the composition of the bacterial flora in the intestine and the concentration of neutral sterols and acids in the feces. An increase in the content of these compounds and their metabolites in the lumen of the colon (the latter have a co-carcinogenic or carcinogenic effect) contributes to the emergence of neoplasms.

Diverticulosis in itself is not a disease predisposing to the development of tumors; rather, it can be considered as a marker of increased risk (B.Volkov, 1991).

Source: Medical newspaper

ZONE OF SPECIAL ATTENTION – SPINE

The spine is a complex structure. The vertebrae form its basis, the intervertebral cartilage, the joints of the vertebral processes and the ligamentous apparatus fasten the vertebrae together.

The spine is:

• Rigid rod that supports the torso; head and belt of the upper limbs;
• reliable support of all levers from bones and muscles;
• Robust “protective sheath” for the spinal cord;
• flexible chain that allows the torso to bend and rotate;
• elastic spring that absorbs shocks and shocks and maintains the balance of the body.

The spine should be mobile, stable and strong enough.

He is forced to adapt to different living conditions: uncomfortable furniture, a car seat, working at a counter or machine, heavy bags and bus braking during rush hour. The muscles surrounding the spine provide two opposite functions – mobility and stability. The individual mobility in each intervertebral joint is small, but the spine as a whole is a rather flexible system.The coordination of muscle work ensures harmonious movements of the spine. The main role in maintaining an upright posture is played by the back muscles, which straighten the spine and the iliopsoas muscles. The pressure in the chest and abdomen is very important for the stability of the spine. The abdominal muscles are just as important for maintaining posture and protecting the vertebrae from displacement and injury as the back muscles. Muscle traction develops the curves of the spine, stimulates its normal development. A well-developed muscle corset is able to protect the spine from traumatic stress.

Violation of muscle tone occurs with any malfunctions in the spine. Weakness of the muscle corset, uneven muscle tone are inevitably associated with the strengthening or flattening of the physiological curves of the spine or its lateral curvature.

There is no clear line between “simple” posture disorders and diseases of the spine. The two most common “troubles” associated with the spine – posture disorders and osteochondrosis – are two sides of the same coin, links in the same chain.

Posture

Determination of posture: the usual posture of a naturally standing person, which he takes without undue muscle tension. In a broader sense, posture is both the position of the body in various static poses, and the features of muscle work when walking and when performing various movements. Posture depends on the shape of the spine.

In a newborn, the spine has the shape of a uniform arc. The formation of the first bend – cervical lordosis – begins after the birth of the baby, when the baby raises its head.The second bend – thoracic kyphosis – begins to form when the child sits down and crawls on all fours. When the child begins to stand and walk, a third bend is formed – lumbar lordosis, and, starting from three to four years, an arched shape of the bones of the foot is formed.

In preschool and primary school age, posture in children is unstable; with age, it continues to form and acquires individual characteristics. Poor physical development and inattention of parents to the formation of correct posture are most harmful to the child’s spine.

Posture disorders in themselves are not a disease, but they create conditions for diseases not only of the spine, but also of internal organs.Poor posture is either a manifestation of an illness or a condition of pre-illness. The main danger of postural disorders is that nothing hurts until degenerative changes in the intervertebral discs begin (osteochondrosis).

Poor posture reduces the body’s margin of safety: the heart beats in a cramped chest, a sunken chest and forward-turned shoulders prevent the lungs from expanding, and a bulging abdomen disrupts the normal position of the abdominal organs.A decrease in the physiological curves of the spine (flat back) in combination with flat feet, leads to permanent microtrauma of the brain and increased fatigue, headaches, memory and attention disorders.

Most often, poor posture is combined with poor muscle development and a reduced general tone of the body, with impaired blood supply to the brain due to improper position of the head, and poor eyesight.

Typically “childhood” diseases of the spine – juvenile kyphosis and scoliosis – are considered systemic (that is, common) diseases that are often accompanied by metabolic disorders.

Good posture

With correct posture, all parts of the body are located symmetrically relative to the spine, there are no turns of the pelvis and vertebrae in the horizontal plane and no bends of the spine or oblique position of the pelvis in the frontal, spinous processes of the vertebrae are located along the midline of the back. The projection of the center of gravity of the body in good posture is within the support area of ​​the feet, approximately on the line connecting the front edges of the ankles.

Correct posture in a preschooler, a schoolboy, and also in a boy and a girl during puberty is different.

Normal posture of a preschooler

The chest is symmetrical, the shoulders do not protrude to the front, the shoulder blades protrude slightly backward, the abdomen protrudes forward, the legs are straightened, lumbar lordosis is outlined. The spinous processes of the vertebrae are located in the midline of the back.

Normal student posture

The shoulders are horizontal, the shoulder blades are pressed against the back (not protruding).Physiological curves of the spine are moderately expressed. The protrusion of the abdomen decreases, but the anterior surface of the abdominal wall is located anterior to the rib cage. The right and left halves of the torso are symmetrical when viewed from the front and from the back. The sagittal plane divides the body into right and left halves. In this plane, flexion (forward bend) and extension (backward bend) occur.

Normal posture of boys and girls

The spinous processes are located in the midline, the legs are straightened, the shoulder girdle is lowered and located at the same level.The shoulder blades are pressed to the back. The chest is symmetrical, the mammary glands in girls and the nipples in boys are symmetrical and at the same level. The waist triangles (gaps between the arms and torso) are clearly visible and symmetrical. The abdomen is flat, retracted in relation to the chest. The physiological curves of the spine are well expressed, in girls, lumbar lordosis is emphasized, in boys, thoracic kyphosis.

In healthy, harmoniously developed people, youthful posture is maintained until old age.

Correct posture and typical options for its violations:

The sagittal plane divides the body into right and left halves. In this plane, flexion (forward bend) and extension (backward bend) occur.

Test for correct posture in the sagittal plane – stand with your back to the wall without a plinth. The back of the head, shoulder blades, buttocks, calf muscles and heels should touch the wall, the distance between the wall and the body in the region of the cervical and lumbar lordosis is about 2-3 fingers.

The frontal plane divides the body into front and back sides. In the frontal plane, the body bends sideways. Curvature of the spine in the frontal plane and asymmetry of the right and left parts of the body are a clear sign of pathology of the musculoskeletal system. Postural disorders in the frontal plane are often combined with an oblique position of the pelvis.

In the horizontal plane, the vertebrae rotate when the body turns. Twisting the spine in the horizontal plane is a hallmark of scoliosis.

Poor posture in the sagittal plane

Slouching. The thoracic kyphosis is enlarged, its apex is in the upper part of the thoracic region. The lumbar lordosis is smoothed. The shoulders are lowered and brought forward, the shoulder blades are not in contact with the back (pterygoid shoulder blades).

Round back. Kyphosis is evenly increased throughout the thoracic region, the lumbar lordosis is somewhat smoothed, the head is tilted forward, the shoulders are lowered and brought forward, the shoulder blades are not adjacent to the back.The round back is characterized by a sunken chest and flat buttocks. Due to the shortening of the pectoral muscles, the child cannot fully raise his arms up.

Round-concave back. All bends of the spine are increased, the head, neck, shoulder girdle are tilted forward, the stomach protrudes and hangs down. The knees are extended as far as possible to keep the center of gravity within the supporting surface. The muscles of the abdomen, back, hamstrings and buttocks are stretched and thinned. Due to the flabbiness of the abdominal press, the omission of the internal organs is possible.

Flat back. All bends of the spine are smoothed, lumbar lordosis is poorly expressed and displaced upward. The lower abdomen protrudes forward. The skeletal muscles are poorly developed, the muscles of the trunk and back are thinned. A flat back is a consequence of the functional inferiority of the muscles. With a flat back more often than with other posture disorders, scoliosis and other degenerative-dystrophic diseases of the spine develop. With this posture, compression fractures are more common.

Flat-concave back. The thoracic kyphosis is reduced, the lumbar lordosis is slightly increased. The pelvis is, as it were, shifted back and tilted forward, because of which the buttocks are set back, and the stomach protrudes forward and sags downward. The ribcage is narrow, the abdominal muscles are weakened.

Posture disorders in the frontal plane

They are characterized by an arcuate displacement of the line of the spinous processes of the vertebrae away from the midline of the back. Such postural disorders are difficult to distinguish from the early stages of scoliosis.

Unlike scoliosis, in case of functional impairment of posture in the frontal plane, the curvature of the spine and asymmetry of the right and left sides of the body disappear when muscles are unloaded in the supine position.

The main difference between scoliosis and “simple” posture disorders in the frontal plane is the twisting of the spine around its axis. The vertebrae are located like the steps of a spiral staircase.

Everyone has a slight asymmetry of the body, but if posture disorders in the frontal plane are noticeably pronounced, it’s time to go to the doctor.

PREVENTION OF POSTURE DISORDERS

Let’s talk about what to do so that your posture does not deteriorate and your spine remains healthy.

In the first years of a child’s life, good nutrition, massage and exercise are necessary both for health and for the normal formation of the spine. Regular visits to the doctor will promptly identify those disorders of the musculoskeletal system that appear when posture as such does not yet exist.Prevention of rickets and flat feet, hardening – at first this is enough for normal physical development

What else a child needs is from the first weeks of life. make friends with a good neurologist. More or less pronounced perinatal encephalopathy is now present in almost every newborn and often requires long-term treatment.

If the baby is relatively healthy, then up to about three years old, his spine usually develops normally.A healthy child must move a lot, because of the peculiarities of the child’s nervous system and muscles, it is more difficult for him to maintain a fixed posture than running, jumping, twirling and jumping.

In a sitting or standing position, especially if it takes more than a few minutes to be in the same position, the child “sags”, the vertical load is transferred from the muscles to the ligaments and intervertebral discs, and the formation of an incorrect motor stereotype and poor posture begins. Small but regular physical activity (swimming, home exercise equipment, more outdoor games and less TV, daily exercise) are necessary conditions for the normal development of the musculoskeletal system.

Poor posture is guaranteed to almost every student without observing the basic rules. From the first day at school, the child’s spine begins to experience increased stress. The old comfortable desks are no longer made, and schoolchildren from the first to the eleventh grade sit on chairs and at tables designed for a fifth-grader of average height. We cannot influence the situation at school.

And how should a schoolchild’s workplace be organized at home?

• The seat depth of the chair should be slightly less than the distance from the sacrum to the popliteal fossa.
• To make sitting even more comfortable, a small soft cushion should be attached to the back of the chair at the level of the apex of the lumbar lordosis.
• The tabletop should be at the level of the solar plexus. At the same time, slightly spaced elbows rest freely on it, relieving the weight of the cervical spine from the weight of the hands, and the surface of the notebook is at the optimal distance from the eyes – 30 – 35 cm.
• Buy an expensive but comfortable chair with screws and hinges, where you can adjust the height of the seat, its depth, and the inclination of the back.
• Place a bench at such a height under your feet so that they do not dangle in the air and do not rise up.
• It is advisable to put books on the music stand at arm’s length from the eyes.
• Teach your child to sit up straight with equal support on both legs and buttocks.
• From time to time, the child must change position. After every 30 – 45 minutes of classes, you should get up and move for 5-10 minutes.
• Make sure that the child does not develop the habit of sitting cross-legged, twisting one leg under him, removing from the table and hanging his non-working hand, sitting sideways to the table.

What else can be done to prevent postural disorders and diseases of the spine?

• Eat well
• Sleep on a flat bed with a hard base and a soft mattress, with a low, preferably special orthopedic pillow.
• After school, the student needs to lie down for at least an hour so that the muscles relax and rest.
• You cannot carry a bag, even a light one, on your shoulder: you always have to keep your shoulder raised.You cannot carry a briefcase in the same hand.
• The child needs to move more and exercise at least 20-30 minutes a day.

The most – the most important means of prevention is the development of skills for correct posture.

90,000 Why hugging boys should be as often as girls, and up to what age it can be done: a word to the expert

How many times have you hugged today? A popular question that can be found not only in books on psychology, but also on the streets of cities.Stickers and graffiti with this phrase appear regularly around the world – as a reminder that hugs are necessary for everyone, regardless of age and status. They are not only pleasant, but also good for your health.

Family psychologist Anastasia Kovaleva
talked about how to properly hug children and adolescents and why the lack of hugs for boys is dangerous. And also compiled a list of five simple and useful tactile games.

Why hugging is good for your health and development

The norm of 8 hugs a day is well-replicated by popular psychologists and is known even to those who are not interested in science.The author of this theory is a psychologist from the United States, Virginia Satir. Indeed, without hugs and touching, people are more likely to experience depression, illness, and even early aging.

Multiple experiments confirm that 20 seconds of hugs noticeably improve mood, stimulate the production of endorphins, relieve anxiety, give confidence, activate the immune system, and induce blood flow to those parts of the body that are in contact.This is a universal way of communication, understandable to people of all continents.

Hugging a person, you can feel his tension or relaxation, understand how ready he is to get closer, support and receive positive emotions in return. In the case of hugs between parents and children, this is a way to show love, affection, care. A child in the arms of a mother or another significant adult relaxes, calms down, warms up, feels safe, that is, satisfies important needs.An adult, hugging a child, also receives a release of endorphins, improves mood, shows his responsibility and care for another person, confirms his need and importance, which is also very important for normal well-being.

Leading experts in the field of psychology have repeatedly proved that without hugs and physical contact, a person feels lonely and useless, becomes irritable and withdrawn.

The year when it is especially important to cuddle

The child establishes contact with the mother while still in the stomach.He hears a voice, reacts to mother’s touch and emotions. And therefore, immediately after the birth of a child, it is so important to hug and hug him as often as possible: after all, birth for him is stress, a separation from his mother. Physical contact gives the baby a sense of security, familiar environment, support and a foundation for further development. The child will be calmer and more confident, with pleasure and without fear, will begin to study the world around him, if he knows that his mother is nearby.

In the first year of life, it is especially important for children to feel the so-called skin-to-skin contact.Therefore, every time you change the diaper, do not forget to stroke the baby’s tummy and back. Touch his legs and arms with warm palms, while applying cream or powder, do a light massage. Do not hesitate to hug and kiss your baby for no reason – every such time will definitely be very necessary, and not superfluous.

Hugging boys less often than girls is a big mistake

One of the most common misconceptions in raising boys is that they shouldn’t be hugged, kissed, praised, and undead too often.Otherwise, they say, they will not grow up to be real men, but will be “mama’s sons” all their lives. This is not true. Children in the first three years of life do not have serious psychological differences in upbringing based on gender. Simply put, mom’s love, hugs, protection and support are equally needed by both boys and girls. It is important for them that they are taken in their arms, put on their knees, held by the handle.

From about 4 years old, mom can hear “Leave me alone!” trying to hug or kiss your grown up baby.This is a signal that bodily communication needs to be changed, but in no case stopped. The time has come for various “squeezing” games, tickling, comic wrestling, catch-grabbing, pillow battles. Do not refuse your child if he wants to sit on his knees and read your favorite book with you or hug when he is upset or bumped.

Do not stop trying to embrace with the words: “What are you like little? You are already big. ” Hug your big baby as tenderly and tightly as a one-year-old, share your warmth with him, let him feel protected.Just a couple of minutes will be enough for him to recharge for new games and pranks.

And one more important point: boys who, under the age of 7, have not received the amount of love, hugs and other “calf tenderness” they need, grow into men who will look for an opportunity to satisfy this child’s need. How can this end? Traumatic relationships with women, addiction and excessive attachment to the mother, all kinds of psychological and sexual deviations.As you can see, the effect is the opposite.

How to hug schoolchildren and adolescents

It is more or less clear with preschool children: most often they themselves are happy to make contact, love to hug, or at least do not resist manifestations of love and affection. What about teenagers? The older the child gets, the more he moves away from his parents, and this is normal. However, he still needs physical contact.

You can work out a secret sign with your grown up baby: for example, by shaking hands twice.It will mean: “I love you.” Such a secret will help in a difficult situation. For example, if you are standing with a child in front of a teacher who complains and scolds him. You can always imperceptibly shake the child’s hand, and he will feel more confident, he will know that, despite the pranks and misdeeds, you are still with him and love him.

A friendly pat on the shoulder, ruffling your hair, kissing the top of the head of a child bent over a notebook, hugging at a meeting or before going to school – all these seemingly insignificant actions are very important for sustainable psychological development.

If the child is hurt, scared, offended, sad, your touch will help to feel protection and support without words. Even a teenager’s heart broken by first love will heal a little faster if mom hugs her shoulders and brings tea with something delicious to the room.

In psychology, there is also the concept of “verbal stroking.” These are all kinds of compliments, kind words, praise, approval. Something that rebellious adolescents lack so much, and something that they rarely want to say because of their behavior.However, it is very important to do this in order to help overcome a difficult age with the least possible losses. Of course, sincerely and to the point.

Five simple bodily play with children of all ages

• Dancing. You can take the baby in your arms and circle to the music, with an older child you can dance, holding the arms, pick up, circle and tickle in the process.
• Tactile drawing. Draw shapes or familiar letters on the child’s back with your finger and ask them to guess.Then have him paint on your back. You can write a whole “letter” on the child’s back, then wrap it in an “envelope” blanket and even carry a valuable kicking message to the next room as a postman.
• Massages. You can play the game “Guess who is coming” with the little ones. Use your fingers to depict on the child’s back how a bunny gallops, a fox dodges, an elephant stomps.