HOW TO TREAT 31
ausdoc. com. au 11 APRIL 2025
HOW TO TREAT 31
Emmanuelm at English Wikipedia / CC BY 3.0 / bit. ly / 3M4k2qH
Figure 5. Gross appearance of an opened colectomy specimen containing an invasive colorectal carcinoma and two adenomatous polyps.
agents are made by the treating endoscopist.
Proceduralists who perform colonoscopy now require recertification. Every three years, the Gastroenterological Society of Australia( GESA) invites proceduralists to submit a logbook of 150 cases, demonstrating that they reached the caecum in more than 95 % of cases and detected an adenoma in 25 % of eligible colonoscopies. This is one of the first programs of its type and is important to maintaining colonoscopic quality.
CASE STUDIES
Case study one
JAMES, 28, presents to the GP complaining of bright red rectal bleeding. He reports that he recently started a low-carbohydrate diet and has been straining when he goes the toilet. There are no other changes in his bowel habits, and he
Colorectal cancer remains the second highest cause of cancerrelated death in Australia.
Figure 6. CT colonography – red arrow indicates a sigmoid cancer. does not have any abdominal pain or weight loss. James’ family history is negative for bowel cancer.
Rectal examination in the rooms confirms a small haemorrhoid. Routine FBC and iron studies are normal. James is treated with fibre supplementation, stool softeners and a one-week course of over-thecounter steroid ointment.
He returns for GP review six weeks later and reports his symptoms have resolved. His GP discusses further investigations, but the risk of perforation likely outweighs the yield from colonoscopy. James does not proceed with
Figure 7. Endoscopic colon cancer.