colonandrectalspecialists

*Ano ang kulugo sa puwit?                         

Ang kulugo sa puwit o tinatawag ding “condyloma acuminate” ay parang mga butlig na nakapalibot sa puwit at maari ring hanggang sa may genital area. Ang sakit na ito ay maaring ituring na sexually transmitted disease (STD) o nakukuha sa pakikipagtalik. Ito ay maaring magsimula nang napakaliliit, parang ulo lang ng aspili o karayom at maaring lumaki nang lumaki at mapuno ang buong paligid ng puwitan. Karaniwang walang mararandamang pagkirot ang mga mayroon nito at maaring hindi mamalayan ang pagkakaroon nito. Kalaunan ay maaring makaranas ng mga sintomas tulad ng pangangati, pagkirot, at pagkakaroon ng mga maliliit na umbok o butlig sa puwitan.

Ano ang sanhi?                                               

Ang kulugo sa puwit ay sanhi ng papilomang birus na pantao (human papilloma virus o HPV). Ito ay naisasalin sa pamamagitang ng direktang kontak mula tao sa tao. Maari rin itong maisalin sa pakikipagtalik. Hindi kailangan ang anal sex upang magkaroon nito.

Dapat bang tanggalin ang mga kulugo?

Oo. Kapag ito ay hindi naalis, ito ay maaring lumaki at kumalat. Pag pinabayaan, tumataas ang panganib na ito ay maging kanser sa lugar na kinaroroonan.

Ano ang mga pwedeng ipanglunas?

Kung ito ay nasa maliit na lugar lamang, maari itong gamitan ng mga pamahid na gamot. Maari ring gumamit ng liquid nitrogen na magpapayelo (freeze) ng mga kulugo. Pwede rin itong tanggalin sa pamagitan ng operasyon (surgery) kung ito ay malalaki na o kaya ay nasa loob ng tumbong (rectum) o puwit. Ang operasyon ay karaniwang paghiwa o pagsunog sa mga kulugo. Ginagamitan din ito ng pampamanhid (anesthesia).

Kailangan bang maospital para sa opersyon?

Hindi. Ito ay karaniwang ginagawa lamang sa klinika bilang out-patient procedure.

Ang impormasyong ito ay hindi pamalit sa mga payong medikal. Magtanong at sumangguni sa mga espesiyalista.

2nd Floor, Podium Building, The Medical City,

Ortigas Avenue, Pasig City, Metro Manila

Tel No. (632) 9881000 or (632) 6356789 ext. 7789

www.colonandrectalspecialists.com , www.crsi.com.ph

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it.

Clinic Hours: Mondays to Saturdays – 8:00 AM to 5:00 PM except Wednesdays

Ang Mga Espesiyalista

Manuel Francisco T. Roxas, M.D.

Robert L. Chang, M.D.

Catherine S. Co, M.D.

Carlo C. Cajucom, M.D.

Marc Paul J. Lopez, M.D.

Dione P. Sacdalan, M.D.

The colorectal cancer doctors are in: Dr. Marc Lopez and Dr. Dione Sacdalan are only the 20th and 21st graduates of the 29-year-old PGH program for colorectal cancer specialists. They’re available for consult at the country’s first outpatient colorectal specialty clinic in the country, located at the MEDICard Lifestyle Center in Makati.

In the Philippines, we can take heart in the fact that we have a lot of competent cardiologists around. And for those with sagging spirits who need a lift somewhere, they can revel in the fact that we do have a lot of very good plastic surgeons/dermatologists. But did you know that there are less than 40 colorectal surgeons in the Philippines, and that MEDICard Lifestyle Center has launched the first outpatient colorectal specialty clinic in the country?

  The clinic, which opened only last October, is designed to make cost-effective care for colorectal problems accessible to the public, what with colorectal diseases now the fourth leading cause of cancer deaths globally.

  “We can see patients for consult. We can also do out-patient procedures under local anesthesia. We can do endoscopies, minor operations like excisions of hemorrhoids, management of fissures in the operating room of this building,” says Dr. Dione Parreño-Sacdalan, one of only two practicing female colorectal surgeons in the country today, the other being Dr. Catherine Sim Co. Both are affiliated with PGH and The Medical City.

 Dr. Sacdalan had her post-residency training in colorectal surgery at the Philippine General Hospital (PGH). She also had further training focusing on anorectal diseases and minimally invasive surgery at the Chulalongkorn Memorial Hospital in Thailand and had colorectal observership stints in the University of Minnesota Medical Center in Minnesota and Memorial Sloan-Kettering Cancer Center in New York, USA.

 “We’re the first organized group of colorectal surgeons offering outpatient clinic services in the country,” Dr. Marc Paul Jose Lopez introduces himself. “There are a lot of concerns among a good part of the population about colorectal diseases, anorectal diseases such as hemorrhoids, abscesses (pigsa) and fissures (punit sa puwit). The spectrum goes further down to colorectal cancer, which is at present on the rise.”

 Dr. Marc Paul Jose Lopez is one of the two male colorectal surgeons in the clinic, the other one being Dr. Carlo Cajucom. Dr Lopez had his post-residency training in colorectal surgery at PGH and his post-fellowship training in advanced laparoscopic colorectal surgery in Vietnam. He also had further training in colorectal surgery specializing in anorectal diseases and laparoscopic colorectal surgery in Thailand. He is currently a consultant at PGH, Asian Hospital and Medical Center, and Manila Doctors Hospital.

While there’s no clear shred of evidence on what causes colorectal cancer, the problem is mostly associated with low fiber and high animal fat intake.  

 Dr. Sacdalan gives us the lowdown: “There are different regions in the gastrointestinal tract. From the mouth, the food goes to the esophagus and then to the stomach. And then it goes to the small intestines, then the large intestines or the colon, and then down into the rectum and out into the anus. In cases of colorectal cancer, we have to differentiate where the mass is because the management differs. That’s one of the things we’re able to provide to our patients: an in-depth discussion not only of the disease but how it will affect them and their families.”

 What are the symptoms?

 “Still most common when it comes to the colon is abdominal pain; for rectum, it’s blood in the feces,” Dr. Lopez asserts. “Symptoms of abdominal pain, difficulty in defecation, blood in your stools may already indicate that in all likelihood your tumor may be in an advanced stage or it may already be huge. That’s why we advocate screening for the general population when they’re not feeling anything yet. The recommendation is that at 50 years of age, particularly for those with no family history of colorectal cancer, without any symptoms, they come in and we can perform a screening procedure on them. It can start earlier if the patient’s father or mother has colorectal cancer.”

 “We catch these patients already in an advanced stage because we don’t have a screening program similar to what they have in the States or Australia, where patients have access to medical care,” Dr. Sacdalan explains. “And if we recommend colonoscopy, for instance, for an average-risk patient, it would cost a lot. The cost in itself is prohibitive (a colonoscopy generally costs P15,000 to P25,000, depending on who will do it, where it will be done, etc.).”

 She points out, “Screening will demonstrate possibly polyps and hinder growth later on. Or if there’s a cancerous mass already, we can recommend treatment while it is still at an early stage.”

 Dr. Lopez laments, “The sad part is that screening is not part of our national health program, even in hospitals, there’s no hospital-based screening program. Unfortunately, this being the state of health of the country, we get most of our patients in Stage III already. When in fact we can get them in the earlier stage, of course it follows that the prognosis or outcomes are expected to be better.”

 Dr. Sacdalan notes with concern, “What’s sad is people don’t know that screening is needed at age 50, or as early as 40, if there’s a history of colorectal cancer in the family.”

 Sadder still is the fact that today, there are more young people, as young as 20, getting colorectal cancer in an advanced stage.

“There have been studies by one of our colleagues, that for Filipinos, the average age at time of diagnosis is earlier than that of Westerners and that it’s more aggressive,” says Dr. Sacdalan.

 “MEDICard accommodates cardholders who come for screening,” Dr. Lopez assures patients.  

What took the colorectal clinic so long to open?

Dr. Lopez hastens to reply, “It took long to have this because there’s only a limited number of colorectal surgeons in the country. In the society, there are only around 40 colorectal surgeons. Right now, there are only three training programs in the country — one at PGH, Jose Reyes Memorial Medical Center, and a new one in Davao.”       

 Marc and Dione are only the 20th and 21st graduates of the 29-year-old PGH program. The focus should be on prevention, early consult, and early detection.

 There comes a ray of hope: “If we catch them in the late stages, there’s still very much a chance for cure,” Dr. Lopez stresses. “When it comes to survival for colorectal cancer, it’s very good now as opposed to, say, when I was just a trainee because there have been a lot of improvements not only in the surgical techniques but also in terms of the other therapies, like chemotherapy and radiation. Even patients in Stage IV whom we would write off already before, now have a chance of even a cure, if not a better life. For Stage I patients, more than 90 percent are doing well in five years. It’s really better to catch it early for a better prognosis and there will be better outcomes.”

 The MEDICard Lifestyle Center Colorectal Clinic is now in the forefront of colorectal care in the Philippines. They utilize the multi-disciplinary team approach of management. “It’s not just the surgeon who decides or recommends whatever’s needed for the patient,” Dr. Sacdalan points out. “We also involve the medical oncologist, radiation oncologist, and other specialties like palliative care if it’s Stage IV or a pain specialist. The permutation of options is endless. It’s important that all the specialties are around so they can come up with the best approach for this particular patient. We try to tailor the treatment, depending on the patient’s preferences, their goals for treatment, their financial capability.”

 Colorectal Specialists offers diagnostic examinations such as examination for common anorectal conditions, sexually transmitted diseases, endorectal and endoanal ultrasonography. It offers treatments for hemorrhoids and fissures, acute and chronic anal pain, fecal incontinence and constipation, anal abscess/anal fistula, anal warts, inflammatory bowel disease, colorectal tuberculosis. And of course, it specializes in comprehensive management of colon and rectal cancer.

 Its staff offers state-of-the-art treatment options for hemorrhoids like rubber band ligation, stapled hemorrhoidopexy and trans-anal hemorrhoidal dearterialization (or THD).

For colorectal cancer which will entail hospital admission, the colorectal specialists offer minimally invasive surgery or laparoscopic surgery, robotic colorectal surgery, and anal sphincter preservation, which can be done at their affiliate hospitals. Some benign anorectal diseases can be managed in the clinic setting under local anesthesia while others can be performed in the operating room but still as a day or out-patient procedure. Not all colorectal and anal problems are managed surgically. Non-operative treatment options may be recommended when deemed necessary.

 For any problems, embarrassing as they may seem, down there on your bottom, help is always available since there are colorectal specialists in the house!

It has claimed the lives of famous and powerful people – from local and Hollywood stars, to politicians, models, etc. The fact that they succumbed to this deadly disease is proof that colon cancer does not discriminate between rich and poor, young and old or male and female.

And despite the media exposure it has been getting lately, the number of colon cancer patients continue to rise. In 2008, it has caused 608,000 and experts say this number will continue to grow in the coming years. To date, colon cancer is now the fourth leading cause of cancer deaths globally.

However daunting the scenario may be, there are ways to prevent colon cancer.  Awareness, prevention, early detection and screening are the main weapons against this menacing disease.  Fortunately, cost-effective care for colorectal problems is easily accessible at Colorectal Specialists, Inc., (CSI) located at the MediCard Lifestyle Center.

CSI is the only specialty clinic in the country where colorectal surgeons are grouped together to offer outpatient clinic services.  It is at the forefront of colorectal care in the Philippines, utilizing a multi-disciplinary team approach of management.  This means that it’s not only the surgeon who decides or recommends what a patient needs.  The medical oncologist, radiation oncologist and other specialties like palliative care are involved.  CSI at the MediCard Lifestyle Center offers state-of-the-art treatment options for haemorrhoids like rubber band ligation, stapled hemorrhoidopexy and tran-anal hemorrhoidal dearterialization or THD.

“We deal with all kinds of colorectal pathology, from benign to malignant cysts, even anorectal, which means from the anus to the anal canals including haemorrhoids, fistula, fissures, incontinence, constipation and of course colon diseases like infections, inflammations and cancers,” says Dr. Carlo Angelo Cajucom, one of four colorectal surgeons in CSI.

Dr. Cajucom earned his medical degree from the University of Santo Tomas and did his general surgery residency at Quirino Memorial Medical Center.  He then had his fellowship training in colorectal surgery at the Jose Reyes Memorial Medical Center, as well as post fellowship training in Sydney’s Royal Prince Alfred Hospital.

Dr. Cajucom underscores the importance of early detection of signs and symptoms so patients can easily be diagnosed and treated before the disease becomes advanced.  This is especially important in a country like the Philippines, where the majority of patients are diagnosed in the very late stages and where there is no screening.  Unlike countries like the US or Australia, the Philippines does not have a screening program. 

Dr. Cajucom adds that people who belong to the general risk population, meaning those who are not predisposed to having colorectal cancer, must have themselves screened at age 50, every three to five years.  Those at high risk must undergo screening at least upon reaching 40 or 10 years before.

“Supposing you have a relative who was diagnosed with colorectal cancer at 38 years old, then you must have yourself screened at 28 years old,” explains Dr. Cajucom.  He adds that those who are extremely high risk must be screened as early as 10 – 12 years old.    

Dr. Cajucom notes that people should watch out for the following risk factors for colorectal cancer: strong family history or genetics, aging, low fiber intake and those who like to eat grilled or red meat.  He adds that the symptoms to watch out for include abdominal pain, fecal blood, and difficulty in defecation.

More than being mindful of the risks, Dr. Cajucom encourages people not to feel embarrassed to seek medical attention in case they experience symptoms of colorectal disease.  After all, the stigma won’t help anyone recover from cancer.

To know more about colorectal diseases and how you can prevent or cure them, visit Colorectal Specialists, Inc. at the MediCard Lifestyle Center, 51 Paseo de Roxas corner Buendia Avenue, Makati City from Mondays through Fridays, 1-7 pm and Saturdays from 9 am – 3 pm. You may also call them 555-0832.  Equally competent doctors in the said facility include Dr. Catherine Co, Dr. Dione Sacdalan and Dr. Ancoy Lopez.

MEDICARD recently opened its Colorectal Specialist Clinic - a first in the HMO industry.

Located at the MEDICard Lifestyle Center at the corner of Paseo and Buendia St., Makati, the clinic offers the latest technology and expertise in colorectal healthcare.

This specialist clinic provides comprehensive, advanced and efficient care to wide range of colorectal conditions. Its expertise is in the management of colorectal cancer, diverticulitis, inflammatory bowel diseases, and other benign disorders like hemorrhoids, fissures, fistulae, polyps, constipation, fecal incontinence, sexually transmitted diseases (STDs), and other colorectal problems. It always strives to provide comfort, privacy and total quality service to its clienteles.

MANILA, Philippines - Hemorrhoids are actually present in all individuals whether healthy or not. They are the vascular cushions which surround the general area of the rectum and anus.

The term hemorrhoids is associated with the symptoms when this part of the body becomes enlarged, inflamed, thrombosed or prolapsed.

Many people have them without suffering from any symptoms, and therefore these may be safely left alone. Treatment is usually required for those whose hemorrhoidal symptoms such as excruciating throbbing pain affect quality of life and daily living. 

There are many traditional remedies and non-surgical treatments for hemorrhoids. However, if none of these work, surgical procedures may be required as a last resort. 

Below are some misconceptions about hemorrhoids treatment and the truth behind each:

Premier health institution The Medical City announces the opening of its Colorectal Clinic, the first hospital-based specialty clinic in the Philippines that offers leading-edge medical and surgical interventions and treatment for a broad spectrum of colon and rectal disorders.

The Colorectal Clinic is managed by a nationally-renowned team of board-certified experts in the Philippines headed by Dr. Manuel Francisco Roxas, president of the Philippine Society of Colorectal Surgeons and president-elect of the ASEAN Society of Colorectal Surgeons.

Dr. Roxas is joined by Dr. Robert Chang, vice president of the Philippine Society of Colorectal Surgeons and Dr. Angelo Cajucom. The team also includes the Philippines’ only two female colorectal surgeons - Dr. Cathy Co and Dr. Dionne Parreno-Sacdalan. They are also joined by TMC’s high-quality roster of gastroenterologists headed by Dr. Carla Sibulo.

*Ano ang Kolon Kanser ?

 

Ang kolon kanser ay kanser ng malaking bituka (large intestine). Ito ay nasa ibaba o panghuling bahagi ng sistemang panunaw (ng pagkain) o “digestive system” ng ating katawan. Ang rektal kanser naman o kanser sa tumbong  ay nasa huling labing-limang sentimentrong (15 cm.) bahagi ng malaking bituka. Kapag magkasama, ito ay karaniwang tinataguriang kolorektal kanser (colorectal cancer).

 

Ang kolorectal kanser ay pangatlo sa pinakalaganap na kanser sa Pilipinas at maging  sa buong mundo. Ang kolon kanser ay lubhang nakamamatay subalit ito ay maaring mabigyan ng lunas kung maaagapan.

 

Pangkaraniwang ang kolon kanser ay nagsisimula bilang maliit na polip (polyp). Ito ay para lamang maliit na butlig o nunal sa loob ng ating malaking bituka. Sa paglipas ng maraming taon, ang ilan sa mga polip na ito ay maaaring maging kanser. Bihirang may sintomas na mararamdaman kapag mayroong polip. Ang pinakamainam gawin ay regular na magpasuri sa doktor upang maalis ang mga polip bago pa ito maging kolon kanser.

 

*Paano malalaman kung mayroong kolon kanser?

 

Maraming kaso ng kolon kanser ay walang sintomas, bagamat ang mga sumusunod ay maaring maging palatandaan nito:

 

  1. 1.Mga pagbabago sa ugaling pagdumi –pagtatae (diarrhea) o pagtitibi (constipation).
  2. 2.Dugo o bahid ng dugo sa dumi.
  3. 3.Walang lubay na pananakit ng tiyan o puson at pagkakaroon ng kabag (gas or cramps).
  4. 4.Pananakit ng tiyan/puson habang dumudumi.
  5. 5.Pakiramdam na parang hindi lubos ang pagdumi.
  6. 6.Hindi maipaliwanag na Anemya o pagkukulang sa dugo.
  7. 7.Panghihina at pagkahapo.
  8. 8.Pagbaba ng timbang na walang maipaliwanag na dahilan.
  9. 9.Pagkitid ng sukat ng dumi.

10.Pagkaduwal (nausea) at pagsusuka.

 

Sa pamamagitan ng tamang pagsusuri, ang kolon kanser ay maaring matuklasan bago pa magkaroon ng mga sintomas, kung kalian ito ay pinakamadaling maagapan at mapagaling.

 

*Sino ang nanganganib magkaroon ng kolon kanser?

 

*EDAD - halos siyamnapung bahagdan (90%) ng mga taong nagkakaroon ng kolon kanser ay nasa edad limampu (50 years old) pataas. Bagamat ang mga kabataan ay maari ring magkaroon, ito ay mas bihira.

 

*KASAYSAYAN SA PAMILYA – kung  may miyembro ng pamilya ang nagkaroon ng polip o kolon kanser, mas mataas ang posibilidad ng pagkakaroon nito.

 

* INFLAMMATORY BOWEL DISEASE – ang mga  taong may kundisyon o malalang sakit na pamamaga ng kolon tulad ng ulcerative colitis o Crohn’s disease ng mahabang panahon ay mas nanganganib magkaroon ng kanser sa kolon. Sa kabutihang palad, bihira lamang ang mga ganitong sakit sa bansa.

 

*PAGKAKAROON NG KOLON KANSER – ang taong nagkaroon na ng kolon kanser ay maaring magkaroon uli sa pangalawang pagkakataon.  Ang mga babaeng nagkaroon ng kanser sa matris, obaryo at suso ay mas nanganganib magkaroon ng kolon kanser.

 

*DIYETA – ang kolon kanser ay maaring maiugnay sa  diyetang mababa sa hibla (fiber), mataas sa taba (fats), kaloriya (calories), pulang karne (red meat), at naprosesong pagkain (processed foods).

 

*HINDI MALUSOG NA GAWAING PAMUMUHAY – kulang sa aktibong mga gawain; paninigarilyo; malakas na pag-inom ng alak.

 

*MAY KATABAAN (OBESITY) O  MAY TYPE II DIYABETIS (DIABETES).

 

*Ano ang mangyayari kapag  may kolon kanser?

 

Ang kolon kanser ay kadalasang nagsisimula sa panloob na balot (lining) ng malaking bituka. Sa paglaki ng tumor, maaari itong bumara sa dinaraanan ng dumi kung kaya nagkakaroon ng mga sintomas. Ang tiyan ay maari ring lumaki at ang malaking bituka ay maaring mabutasAng kolon kanser ay maaring  kumalat sa ibang mga bahagi ng katawan (metastasis) sa pamamagitan ng dugo at sistemang limpatika. Ang karaniwang pinipuntahan ay ang atay, baga at peritonyo (peritoneum).

 

Ang kolon kanser ay may mga antas (stages) ayon sa kalubhaan (severity).

 

Stage 1 – ang kanser ay nasa loob lamang ng dinding (wall) ng malaking

                  bituka.

Stage 2 – ang kanser ay lumabas na sa dinding  ng malaking bituka.

Stage 3 - ang kanser ay kumalat na sa mga kulani (lymph nodes)     

                  na nakapalibot sa kolon.

Stage 4 - ang kanser ay kumalat na sa ibang bahagi ng katawan.

 

*Paano sinusuri ang kolon kanser?

 

Ang kolon kanser ay dapat matuklasan nang maaga, habang wala pang sintomas. Ito ay maaaring matamo sa pamamagitan ng pagsusuri  gamit ang colonoscopy, fecal occult blood test (FOBT) na may kasamang  flexible sigmoidoscopy; barium enema o CT virtual colonoscopy.

 

 Sa isang banda, kung meron ng nararanasang mga palatandaan ng kolon kanser or polip, ang  colonoscopy ang naaangkop na gamitin. Kung ang polip

 ay matagpuan, ito ay maaari nang tanggalin at ipasuri sa laboratory upang malaman kung ito ay malignant. Ang pagtanggal ng mga polip ay makatutulong upang ito ay hindi na maging kanser sa paglipas ng mga taon. Ganito rin ang gagawin kung tumor ang matagpuan sa bituka.

 

*Paano mapapagaling ang kolon kanser?

 

Ang pangunahing lunas sa kolon kanser ay operasyon (surgery). Ang mga bahagi ng bituka na apektado gayun din ang mga kulani ay tatanggalin.

Kung ang kanser ay maliit pa, ito ay pwedeng gamitan ng minimally-invasive laparoscopic surgery. Bukod sa maliliit ang butas, ito ay mas hindi masakit at mas mabilis ang pagpapagaling. Ang ibang kaso na kanser ay maaring mangailangan ng chemo at radiation therapy.

 

Ang impormasyong ito ay hindi pamalit sa mga payong medikal. Magtanong at sumangguni sa mga espesiyalista.

2nd Floor, Podium Building, The Medical City,

Ortigas Avenue, Pasig City, Metro Manila

Tel No. (632) 9881000 or (632) 6356789 ext. 7789

www.colonandrectalspecialists.com , www.crsi.com.ph

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it.

Clinic Hours: Mondays to Saturdays – 8:00 AM to 5:00 PM except Wednesdays

Ang Mga Espesiyalista

Manuel Francisco T. Roxas, M.D.

Robert L. Chang, M.D.

Catherine S. Co, M.D.

Carlo C. Cajucom, M.D.

Marc Paul J. Lopez, M.D.

Dione P. Sacdalan, M.D.

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