Türkçe
Intestinal diseases are a broad group of health conditions that affect the structure or function of the small and large intestines, which are among the most important parts of the digestive system. This category includes many different diagnoses, ranging from infections and inflammatory conditions (such as diverticulitis) to emergencies requiring urgent surgery, such as appendicitis; from chronic immune system disorders such as Crohn’s disease or Ulcerative Colitis to serious oncological pathologies such as colorectal cancer. Each disease has its own specific symptoms, causes, and modern treatment approaches. Disorders of intestinal health are complex processes that can affect the entire body.
| Things You Should Know | Information |
| Definition | Intestinal diseases are a broad group of disorders involving functional, inflammatory, infectious, or structural abnormalities affecting the small and large intestines. |
| Common Diseases | Includes conditions such as irritable bowel syndrome (IBS), ulcerative colitis, Crohn’s disease, diverticulitis, polyps, intestinal cancer, celiac disease, and infectious enterocolitis. |
| Symptoms | A wide variety of symptoms may occur, including abdominal pain, bloating, gas, diarrhea, constipation, blood in the stool, weight loss, fatigue, and anal discharge. |
| Causes | Genetic predisposition, dietary habits, stress, autoimmune disorders, infections, environmental factors, and immune system problems may all play a role. |
| Diagnostic Methods | Diagnosis may be made through physical examination, blood and stool tests, colonoscopy, endoscopy, imaging methods (CT, MRI), and biopsy. |
| Treatment Approaches | Depending on the type of disease, treatment may include medical therapy (medications), dietary modifications, lifestyle changes, probiotic use, and surgical interventions. |
| Drug Therapy | Antibiotics, anti-inflammatory drugs, immunosuppressants, antispasmodics, probiotics, and hormone-regulating medications may be used. |
| Surgical Intervention | Surgical treatment may be required in cases such as cancer, severe inflammation, intestinal obstruction, fistula, abscess, or bleeding. |
| Dietary Pattern | A diet rich in fiber, adequate water intake, avoiding processed foods, and an individualized diet based on food intolerance are important. |
| Complications | May result in chronic diarrhea, intestinal perforation, malabsorption disorders, anemia, reduced quality of life, and an increased risk of cancer. |
| Prevention Methods | Balanced nutrition, adequate water intake, regular physical activity, avoiding stress, and regular health check-ups are among the preventive measures. |
| Lifestyle Impact | Nutrition, stress, sleep patterns, and physical activity directly affect intestinal health. |
| Follow-up and Monitoring | In chronic diseases, regular physician follow-up, repeat examinations, and adherence to treatment are important. |
Which symptoms may indicate an intestinal disease?
Our body usually gives signals when something is wrong. Taking these signals seriously is very important for the early diagnosis of intestinal diseases. The main warning signs are:
New and persistent changes in bowel habits
- Diarrhea
- Constipation
- Blood in the stool (bright red, dark red, or tar-black in color)
- Narrowing of the stool (pencil-thin stools)
- A feeling of incomplete evacuation even after using the toilet
- Persistent abdominal pain or cramps
- Excessive gas and bloating
- Losing weight without dieting or exercising (unexplained weight loss)
- Nausea or vomiting
- High fever
How is an intestinal disease diagnosed?
Accurate treatment is only possible with an accurate diagnosis. Modern diagnostic methods used to visualize the inside of the intestines and evaluate their structure play a key role in identifying the underlying problem.
- Colonoscopy and Endoscopy: These methods allow direct visualization of the inside of the digestive system. Colonoscopy is considered the “gold standard” particularly for the large intestine. The entire colon is examined using a flexible tube equipped with a camera. The greatest advantage of this examination is that it not only provides a diagnosis but also allows treatment. For example, precancerous lesions called “polyps” can be removed as soon as they are detected. In this way, disease progression to cancer can be prevented. It also allows tissue samples (biopsies) to be taken from inflamed areas or suspicious masses.
Advanced Imaging (CT and MRI):
- Computed Tomography (CT): Especially in emergency situations such as an “acute abdomen” (severe pain, suspected perforation, or obstruction), it is the preferred rapid and detailed imaging method. It is of vital importance in diagnosing conditions such as appendicitis, diverticulitis, or intestinal obstruction.
- Magnetic Resonance Imaging (MRI): This radiation-free method provides much more detailed images of soft tissues. It is indispensable especially for staging rectal (the last part of the large intestine) cancers, mapping the depth of the tumor and its relationship with neighboring organs. It is also used to understand complex conditions such as fistulas (abnormal passages between intestines) associated with Crohn’s disease.
What is colorectal cancer and what are its risks?
Colorectal cancer consists of malignant tumors that develop from the cells lining the inner surface of the large intestine (colon) or its terminal portion, the rectum. The vast majority of these cancers develop when benign growths called “polyps” gradually become malignant (undergo cancerous transformation).
The most important risk factors are:
- Being over the age of 50
- A family history of colorectal cancer or polyps
- A personal history of polyps or cancer
- Inflammatory Bowel Disease (Crohn’s disease, Ulcerative Colitis)
- Certain hereditary genetic syndromes
- A diet high in processed meat and low in fiber
- Obesity
- A sedentary lifestyle
- Smoking and alcohol consumption
Why is colorectal cancer screening so important?
Colorectal cancer is a type of cancer with a very high treatment success rate (over 90%) when detected at an early stage. However, the main problem is that it usually progresses “silently” in its early stages and causes no symptoms. By the time symptoms appear, the disease may already be advanced. This is why screening programs, especially colonoscopy, are life-saving. The goal is to detect and remove asymptomatic polyps before they become cancerous.
What is the primary goal of cancer surgery?
The main goal of colorectal cancer surgery is “oncological radicality.” This means removing the tumor together with the lymph nodes and vascular roots that have the potential for spread in one single block, leaving no cancer cells behind (with clear surgical margins).
Why does rectal cancer surgery (TME) require a special technique?
Rectal cancer surgery differs from surgery on other parts of the large intestine because the rectum is located within a narrow and deep bony structure called the pelvis. This area is surrounded by very important nerve networks responsible for urinary and sexual functions.
The technique called Total Mesorectal Excision (TME) is the “gold standard” of rectal cancer surgery. In this technique, the tumor and the fatty tissue surrounding it (mesorectum) are meticulously removed following a precise surgical plane, much like peeling an orange without damaging the fruit inside. This minimizes the risk of local recurrence while preserving the functional nerves as much as possible.
Is a permanent stoma mandatory after cancer surgery?
This is one of the issues patients worry about the most. The answer is: No, it is not mandatory. The choice of surgery depends on the distance of the tumor from the anus.
- Sphincter-Preserving Surgery (Low Anterior Resection – LAR): If the tumor is high enough above the anal sphincter muscles, the diseased portion of the rectum is removed and the remaining intestine is reconnected to the anus (anastomosis). In this case, a permanent stoma is not required. Sometimes a temporary stoma (ileostomy) may be created to protect the new connection, and it can be closed a few months later.
- Permanent Stoma (Abdominoperineal Resection – APR): If the tumor involves the anal sphincter muscles or is very close to them, the anus must be removed together with the rectum to completely eliminate the cancerous tissue. In this case, intestinal continuity cannot be restored, and a permanent colostomy is created.
Modern surgical techniques and preoperative treatments (chemotherapy/radiotherapy) now make sphincter-preserving surgery possible for an increasing number of patients.
Prof. Dr. Ebru Ayvazoğlu Soy is a physician known for her academic background and surgical experience in the field of general surgery. After graduating from TED Ankara College in 1998, she completed her medical education at Hacettepe University Faculty of Medicine in 2005. She completed her residency training in the Department of General Surgery at Başkent University Faculty of Medicine in 2012, obtained the title of Associate Professor in 2019, and became a Professor in 2024. She currently serves as a faculty member in the Department of General Surgery at Ankara Medipol University Faculty of Medicine. With nearly 100 publications in international indexed journals and numerous scientific presentations, Prof. Dr. Ayvazoğlu Soy is a member of the International College of Surgeons, The Transplantation Society, Turkish Surgical Association and the Ankara Surgical Association. In addition to her academic position at Ankara Medipol University, she also sees patients in her private clinic in Çankaya, specializing in general surgery, breast surgery, and endocrine surgery.
