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In recent years, India has witnessed a marked increase in colorectal diseases, including colorectal cancer, Inflammatory Bowel Disease (IBD), Irritable Bowel Syndrome (IBS), and other related disorders. This surge is closely linked to urbanization, dietary transitions, sedentary lifestyles, and improved diagnostic practices.

What are Colorectal Diseases?

Colorectal diseases affect the colon and rectum and encompass a spectrum of conditions:

• Colorectal Cancer: Originates from polyps in the colon or rectum. If untreated, these polyps can turn malignant. The incidence of colorectal cancer is rising rapidly in Indian urban centers, now ranking among the top cancers in cities.
• Inflammatory Bowel Disease (IBD): A chronic condition involving inflammation of the digestive tract, especially the colon and small intestine. Subtypes include Crohn’s disease and ulcerative colitis. Once rare in India, IBD is now on the rise due to industrialization, Western diets, and enhanced medical diagnostics.
• Irritable Bowel Syndrome (IBS): A non-inflammatory, functional bowel disorder marked by abdominal pain, bloating, and altered bowel habits (constipation or diarrhea) without visible bowel damage. IBS is highly prevalent in India.
• Diverticular Disease: Characterized by the formation of small pouches (diverticula) in the colon wall. Inflammation or infection of these pouches leads to complications and discomfort.
• Hemorrhoids and Anal Fissures: Swollen veins or tears in the rectal region, leading to pain, bleeding, and itching—often caused by hard stools or chronic constipation.

Why are these diseases increasing?

• Dietary Shifts: Increased intake of processed foods, red meat, and low-fiber diets (lacking fruits and vegetables) have significantly raised the risk of colorectal cancer and other digestive disorders.
• Physical Inactivity: Sedentary behavior, especially in urban populations, heightens susceptibility to these conditions.
• Rising Obesity: Obesity, closely associated with lifestyle disorders, is a contributing factor for colorectal cancer and IBS.
• Ageing Population: Risk increases with age, and India’s growing elderly demographic intensifies disease burden.
• Genetic and Lifestyle Factors: A family history of colorectal conditions, coupled with habits like smoking and alcohol consumption, further elevate risk levels.
• Gut Microbiota Disruption: Imbalance in gut bacteria and possible infections are emerging as factors in the etiology of IBD; ongoing research aims to establish clearer links.

Common Symptoms

• Persistent changes in bowel habits: constipation, diarrhea, or narrow stools.
• Rectal bleeding: presence of bright red or dark blood in the stool.
• Abdominal pain, bloating, or cramps.
• Unexplained weight loss.
• Chronic fatigue and weakness.
• Sensation of incomplete bowel emptying.

Diagnosis

• Physical Examination and clinical history evaluation.
• Stool Tests for blood, infections, or abnormalities.
• Colonoscopy (gold-standard diagnostic tool) to inspect the colon and collect biopsies.
• Sigmoidoscopy for lower colon and rectum.
• Imaging: CT, MRI, or X-rays to detect abnormalities.
• Blood Tests to assess inflammation and exclude other conditions.

Treatment Modalities

• Medication: Anti-inflammatory drugs (for IBD), antibiotics, pain relief, and symptom-specific treatments.
• Lifestyle Interventions: High-fiber diets (for IBS, diverticulitis), regular physical activity, and stress reduction.
• Surgery: Required in advanced cases of colorectal cancer or severe IBD/diverticular disease.
• Chemotherapy and Radiation Therapy: Used post-operatively or in advanced malignancies.
• Targeted Biological Therapies: Including monoclonal antibodies for immune modulation in IBD.