Our colorectal program specializes in benign and malignant diseases of the small and large intestine, rectum and anus, including:

• Inflammatory Bowel Disease
• Colorectal Cancer and Cancer Screening
• Anorectal Disorders
• Enterostomal Therapy

Inflammatory bowel disease

The specialists who focus on inflammatory bowel disease deal with the diagnosis and treatment of Crohn’s disease, ulcerative colitis and other inflammatory conditions of the small and large intestine. Inflammatory bowel disease can be associated with diarrhea, cramps, rectal bleeding, lack of energy, weight loss, anemia and malnutrition. Prolonged disease duration can result in an increased risk of colon cancer. The disease is managed with medical and surgical techniques as well as nutritional counseling and emotional support. The Digestive Health Center’s focus is to preserve function and quality of life.

Our gastroenterologists specialize in the medical management of inflammatory bowel diseases. They are actively seeking new and improved medications and methods to reduce the inflammatory changes in the bowel associated with both Ulcerative Colitis and Crohn’s Disease.

When medical therapy fails to control these conditions surgery may become necessary. This surgery generally necessitates removal of all or a portion of the large colon. Along with the referring physician, the gastroenterologist and the surgeon combine forces to coordinate the most effective care of the patient with Ulcerative Colitis or Crohn’s disease.

The surgical team has broad experience in all current surgical options for these diseases, including ileoanal pouch procedures, laparoscopic bowel resection, and stricturoplasty. We serve as a resource for the region in assessing and treating patients with recurrent or complex Crohn’s disease.

Colorectal cancer and cancer screening

Colon cancer is the third most common form of cancer and the second leading cancer killer in the United States; yet, it is preventable and curable. For those people at risk for colon or rectal cancer, the most important factor in a successful outcome is early detection.

If surgery is necessary, our specialty surgeons—experienced in modern cancer surgery techniques—are adept at providing positive outcomes and smooth recoveries. A permanent colostomy, a major concern for most patients, is now usually avoided.

Colonoscopy screening

Research performed at OHSU reveals that colonoscopy screening is the best means for early detection of colon cancer. A long, thin, flexible tube with a tiny video camera is used to examine the colon, which transmits detailed images to help identify precancerous colonic neoplasms. Colonoscopy screening can also biopsy suspect polyp growths.

Anorectal disorders

OHSU Digestive Health Center provides diagnosis and treatment for anorectal disorders, including hemorrhoids, complex anal fistulas, infections, fecal incontinence and cancer. Our physicians are involved in the development of a number of diagnostic technologies, including ultrasound for staging rectal cancers. Rectal ultrasound creates images of the pelvic area, the rectal wall and tumor size and depth to characterize the stages of growth and guide treatment recommendations. Ultrasound can also be used to characterize the structure of the anal sphincter muscles in patients with incontinence.

The philosophy of using combined modalities, including integrating the latest immune therapy drugs with surgical techniques, is especially beneficial to patients with anal and rectal cancer. Radiation and medical oncologists utilize the newest techniques and medications available to treat anal and rectal cancer.

High-Resolution Anoscopy (HRA)

High-resolution anoscopy (HRA) is an important tool in diagnosing anal cancers and pre-cancers.

Our team uses a powerful microscope to look inside the anal canal. We focus on an area about an inch inside the canal where two types of cells meet. Starting at the opening, the canal is lined with skin cells. Further inside, the canal is lined with mucous cells. The cells meet in a zone called the squamous epithelial junction. Most anal cancers and pre-cancers arise in this area.

In HRA, our team looks closely at the junction for signs of abnormal cells, also known as anal dysplasia. Doctors divide these abnormal cells into four types:

• Low-grade squamous intraepithelial lesions (LSIL): The cells look slightly different from normal. This is not cancer. You probably don’t need treatment but you should come back for monitoring.
• High-grade squamous intraepithelial lesions (HSIL): The cells look more different. This is not cancer, but it turns into cancer in a small portion of cases. You may need the lesions removed.
• Anal carcinoma in situ: These are cancer cells on the surface of the anal canal.
• Squamous cell carcinoma: These are cancer cells that have spread beyond the surface.

Read more about High-Resolution Anoscopy, including what to expect during your HRA and how to prepare for your visit.

To schedule your HRA, call the Digestive Health Center at 503 494-4373

Enterostomal therapy

Specially trained enterostomal therapy (ET) nurses are devoted to helping patients by offering preoperative counseling prior to ostomy surgery; caring for patients after surgery; and providing education to patients about post surgery needs and stoma care. OHSU ET nurses are board-certified by their professional organization and have advanced, specialized training to also counsel patients with complex wounds, intestinal fistulas, and urinary and fecal incontinence. Individual appointments with our nationally prominent ET team may be made with or without physician input through the OHSU Digestive Health Center.