Colorectal cancer, also known as bowel cancer, colon cancer or rectal cancer, is any cancer (a growth, lump, tumor) of the colon and the rectum.

A colorectal cancer may be benign or malignant. Benign means the tumor will not spread, while a malignant tumor consists of cells that can spread to other parts of the body and damage them.

The colon and rectum

The large intestine is also called the colon or large bowel.

The colon and rectum belong to our body’s digestive system – together they are also known as the large bowel.

The colon reabsorbs large quantities of water and nutrients from undigested food products as they pass along it.

The rectum is at the end of the colon and stores feces (stools, waste material) before being expelled from the body.

Symptoms of colorectal cancer

• Going to the toilet more often.
• Diarrhea.
• Constipation.
• A feeling that the bowel does not empty properly after a bowel movement.
• Blood in feces (stools).
• Pains in the abdomen.
• Bloating in the abdomen.
• A feeling of fullness in the abdomen (maybe even after not eating for a while).
• Vomiting.
• Fatigue (tiredness).
• Inexplicable weight loss.
• A lump in the tummy or a lump in the back passage felt by your doctor.
• Unexplained iron deficiency in men, or in women after the menopause.

As most of these symptoms may also indicate other possible conditions, it is important that the patient sees a doctor for a proper diagnosis. Anybody who experiences some of these symptoms for four weeks should see their doctor.

Causes of colorectal cancer

Experts say we are not completely sure why colorectal cancer develops in some people and not in others. However, several risk factors have been identified over the years – a risk factor is something which may increase a person’s chances of developing a disease or condition.

The possible risk factors for colorectal factors are:

• Being elderly – the older you are the higher the risk is.
• A diet that is very high in animal protein.
• A diet that is very high in saturated fats.
• A diet that is very low in dietary fiber.
• A diet that is very high in calories.
• A diet that is very high in alcohol consumption.
• Women who have had breast, ovary and uterus cancers.
• A family history of colorectal cancer.
• Patients with ulcerative colitis.
• Being overweight/obese.
• Smoking. This study found that smoking is significantly associated with an increased risk for colorectal cancer and death.
• Being physically inactive.
• Presence of polyps in the colon/rectum. Untreated polyps may eventually become cancerous.
• Having Crohn’s disease or Irritable Bowel Disease have a higher risk of developing colorectal cancer.

Most colon cancers develop within polyps (adenoma). These are often found inside the bowel wall.

TMJ Disorders

TMJ disorders are a family of problems related to your complex jaw joint. TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull. If you have had symptoms like pain or a clicking sound in your jaw, you’ll be glad to know these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the joints of the jaw and the chewing muscles do not work together correctly. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

Causes

• Clenching or grinding your teeth.
• Tightening your jaw muscles and stressing your TM joint.
• You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments.

As a result of the above, the disk which is made of cartilage and functions as the “cushion” of the jaw joint can slip out of position.

Regardless of the cause, the results may include a misaligned bite, pain, clicking or grating noise when you open your mouth, or you may have trouble opening your mouth wide.

Do You Have a TMJ Disorder?

• Are you aware of grinding or clenching your teeth?
• Do you wake up with sore, stiff muscles around your jaws?
• Do you have frequent headaches or neck aches?
• Does the pain get worse when you clench your teeth?
• Does stress make your clenching and pain worse?
• Does your jaw click, pop, grate, catch or lock when you open your mouth?
• Is it difficult or painful to open your mouth, eat or yawn?
• Have you ever injured your neck, head or jaws?
• Have you had problems (such as arthritis) with other joints?
• Do you have teeth that no longer touch when you bite?
• Do your teeth meet differently from time to time?
• Is it hard to use your front teeth to bite or tear food?
• Are your teeth sensitive, loose, broken or worn?

The more times you answered “yes”, the more likely it is that you may have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.

Treatment

Once an evaluation confirms a TMJ diagnosis, our doctors will determine the proper course of treatment. It is important to note that the treatment typically works better with a team approach of self-care joined with professional care.

• The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory agent or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation.

• Self-care treatments often work well and include resting your jaw, keeping your teeth apart when you are not swallowing or eating, eating soft foods, applying ice and heat, exercising your jaw and practicing good posture.

• Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. The splint (or night guard) fits over your top and bottom teeth and helps keep your teeth apart, thereby relaxing the muscle and reducing pain.

• Different types of appliances serve different purposes. A night guard helps you stop clenching or grinding your teeth and reduces muscle tension at night, helping to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relieves pressure on parts of your jaw and aids in disk repositioning. An orthotic stabilization appliance is worn 24 hours/day or just at night to move your jaw into proper position.

• If your TMJ disorder has caused problems with how your teeth fit together, you may need treatment such as bite adjustment, orthodontics with or without jaw reconstruction, or restorative dental work.

• Surgical options such as arthroscopy and open joint repair restructuring are sometimes needed, but are reserved for severe cases. TMJ surgery is generally only considered when the jaw can’t open, is dislocated and nonreducible, has severe degeneration, or if the patient has undergone appliance therapy treatment unsuccessfully.

Ankylosing spondylitis is a type of arthritis that affects the spine. Ankylosing spondylitis symptoms include pain and stiffness from the neck down to the lower back. The spine’s bones (vertebrae) fuse together, resulting in a rigid spine. These changes may be mild or severe, and may lead to a stooped-over posture. Early diagnosis and treatment helps control pain and stiffness and may reduce or prevent significant deformity.

What are spondyloarthropathies?

Bacteria cause most types of finger infections. The exception to this is the herpetic whitlow, which is caused by a virus. How the infection starts and is found in a particular location is what makes each specific type of infection unique. Usually, some form of trauma to the finger or hand is the initial event. This may be a cut, animal bite, or puncture wound.

• Paronychia: The offending bacteria are usually staphylococcal and streptococcal organisms. Rarely, a fungus causes this infection, which usually begins as a hangnail. Often a person will attempt to bite off the piece of nail that is at the corner of the nail, leading to local infection. This infection can also be caused by aggressively shoving back or trimming cuticles. This results in an open wound that allows the bacteria on the skin and the bacteria in the mouth to infect the wound. The infection can then spread to the surrounding tissue next to the nail and cuticle.
• Felon: This bacterial infection of the finger pad, caused by the same organisms that cause paronychia, is usually the result of a puncture wound. The wound allows the introduction of bacteria deep into the fingertip pad. Because the fingertip has multiple compartments, the infection is contained in this area.
• Herpetic whitlow: The offending viral organism is the herpessimplex virus type I or II. This is the same virus that causes oral or genital herpes infections. People in certain occupations are more at risk for this infection. These include dentists, hygienists, physicians, nurses, or any other person who may have contact with saliva or body fluids that contain the virus. People with oral or genital herpes may also infect their own fingers.
• Cellulitis: The most common causes of this bacterial infection are staphylococcal and streptococcal organisms. This infection is usually the result of an open wound that allows the bacteria to infect the local skin and tissue. The infection can also spread to the hand and fingers by blood flow carrying the organisms.
• Infectious flexor tenosynovitis: This bacterial infection is usually the result of penetrating trauma that introduces bacteria into the deep structures and tendon sheaths, which allows the spread along the tendon and associated sheath.
• Deep space infection: This bacterial infection is usually the result of a puncture wound or deep cut that introduces the bacteria to the deep tissue. The collar button abscess is associated with the web space between the fingers. The deep structures of the hand create many potential compartments for this infection to invade. 

There are several risk factors for developing finger infections, including the following:

• Puncture wounds
• Deep cuts
• Any open wound
• Penetrating trauma
• Picking hangnails
• Nail biting
• Aggressive manicuring or cuticle trimming

Some individuals may be at higher risk for finger infections, including

• people with diabetes;
• people with compromised immune systems;
• people in certain occupations, such as dentists, hygienists, physicians, and nurses; and
• people in occupations involving extended exposure of the hands to water (such as dishwashers).

Each of the main finger infections has specific signs and symptoms that make identification unique and may cause confusion if not properly evaluated.

• Paronychia: Symptoms and signs of paronychia include redness and swelling of the area next to the fingernail. A visible collection of pus may be seen under the skin and nail. This fluid may be leaking out of the wound. The area will be tender and painful to the touch. The drainage from the area is usually a cloudy white-yellow color.
• Felon: Symptoms of a felon include a swollen and painful fingertip. The swelling usually develops over several days and is located in the pad area of the fingertip. The area will have a throbbing pain and be painful to the touch. The area is usually red, and a visible collection of pus may be seen under the skin. The swollen area may have a portion that feels soft as if it contains fluid. As the swelling continues, the area may become tense or hard to the touch.
• Herpetic whitlow: Symptoms of herpetic whitlow include redness and tenderness of the fingertip area. A burning or itching sensation may be present in the area. There may be mild swelling but not as extensive as in the felon. There may be a single or many open wounds in the area affected. These open wounds often occur in clusters after the formation of a small blister-like lesion. The fluid in these lesions is usually clear in appearance but may be slightly cloudy. The affected individual may also have a low-grade fever and have swollen and tender lymph nodes in the area.
• Cellulitis: Symptoms of cellulitis include skin area redness and warmth to the touch. The area may be slightly swollen and tender. This is usually a superficial infection so the deep structures should not be involved. The motion of the fingers and hand should not be difficult or painful. If painful or difficult, this may indicate a deep space infection of some type.
• Infectious flexor tenosynovitis: Four major signs often are found with infectious flexor tenosynovitis.
  • First is tenderness over the flexor or palm side of the finger. This pain is found over the tendons in the finger.
  • Second is uniform swelling of the finger.
  • Third is pain on extending or straightening of the finger.
  • Fourth, the finger will be held in a slightly flexed or partially bent position.

These signs are called Kanavel cardinal signs. All four signs may not be present at first or all at once.

• Deep space infections: The deep space infection that arises in the web space of the fingers is also called a collar button abscess. Symptoms and signs of deep space infections include pain and swelling in the space between the fingers. The area may also be red and warm to the touch. As the abscess becomes larger, the fingers will be slightly spread apart by the increasing pressure. The central area may have a soft spot that represents a collection of pus under the skin.