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Diagnosis & Treatment of Colorectal Cancer


Crohn's and Colitis Foundation's Take Steps Walk - May 20, 2023 - Jefferson Park in Seattle

VMFH and the Center for Digestive Health are sponsoring the Crohn's and Colitis Foundation's Take Steps Walk on May 20, 2023 at Jefferson Park in Seattle. We invite you to support this important event benefiting the Crohn's and Colitis Foundation by supporting the VMFH "Royal Flush" team! Timothy Zisman, MD, our captain for the event, encourages you to consider joining us in person for this fun, family-friendly event. Join the Royal Flush team, or donate.

Colorectal conditions can cause a range of symptoms from diarrhea and constipation to abdominal pain, rectal bleeding and weight loss. It’s important to listen to your body and see a doctor if you experience chronic or worsening symptoms. A gastroenterologist can determine the cause of your symptoms and help you find treatment for colorectal and intestinal disorders.

Diagnosing colorectal conditions

Our experts diagnose and treat complex colorectal conditions every day, and you benefit from the depth of experience we have as a high-volume center for digestive health. We perform thousands of colonoscopies every year with the goal of making strides in the early detection of colorectal cancer. Your gastroenterologist may order the following tests to understand the full picture of your gastrointestinal symptoms:

  • Blood tests may be taken to measure red and white blood cell counts. A low red blood cell count can indicate anemia caused by bleeding within the colon and rectum. Elevated white blood cells, which fight infection, indicate inflammation within the colon and rectum. A blood test can also reveal if symptoms are caused by an endocrine disorder, such as low thyroid levels or increased calcium levels.
  • A stool sample may be taken to rule out an infection and to measure the flora (bacteria) in the intestines.
  • An abdominal X-ray can reveal how many stools are present within the colon.
  • A CT scan can determine which areas of the rectum and colon are inflamed.
  • A barium enema or lower gastrointestinal (GI) series uses X-rays and a contrast agent to view the lower gastrointestinal tract.
  • A motility study of the small bowel measures muscle activity in the colon by passing a thin, flexible tube down the throat into the stomach and small intestine through an endoscope.
  • Small bowel enteroscopy or double-balloon enteroscopy (DBE) is an endoscopic procedure that uses a flexible tube with a miniature camera to view the esophagus, stomach and part of the small intestine. 
  • A small intestinal biopsy involves inserting a thin, flexible tube through the mouth into the intestine while you’re sedated. Biopsy samples of your small intestine can be removed and examined under a microscope.
  • A colonoscopy uses a flexible tube to look into the colon and rectum. The instrument used to examine your colon, called a colonoscope, has a miniature camera that allows your doctor to view the inside of your colon. A colonoscopy is routinely used for colorectal cancer screening and prevention, and it’s helpful for diagnosing other colorectal and intestinal disorders.

Take a colorectal cancer risk assessment

Take this short assessment to find your risk level for colorectal cancer.

Why get a colonoscopy?

Everyone over age 45 should have a colorectal cancer screening test—earlier if you have a family history of colorectal cancer. Colorectal cancer is the third-leading cause of cancer-related deaths in men and in women in the United States. However, colorectal cancer is largely preventable with regular screening and is treatable with early detection. There are many good reasons to schedule a colonoscopy—for you and for those you love. Other screening tests for colorectal cancer include stool tests (such as Cologuard®, FIT or gFOBT) and sigmoidoscopies. Speak with your provider about which test is right for you.

Treating colorectal conditions

Once the cause of your symptoms has been determined, your gastroenterologist can determine the best treatment options for you, which may include:

Nutrition counseling

Your doctor may recommend making changes to your diet to manage symptoms, such as:

  • Eating a balanced and nutritious diet, including nonstarchy vegetables, leafy greens, lean proteins and healthy fats.
  • Avoiding certain foods and liquids that trigger your symptoms.
  • Consuming small, frequent meals to avoid large amounts of food sitting in the stomach. 
  • Taking vitamin and mineral supplements to correct nutritional deficiencies.
  • Adding probiotics to restore normal gut flora and promote healthy digestion.


Drug therapy for colorectal conditions may include antibiotics, anti-inflammatory medications, corticosteroids, probiotics and immune modulators, a type of medication that suppresses the body's immune system to reduce inflammation in the GI tract. New drugs coming onto the market are available within clinical trials, as are drugs used for other conditions that have been found to be effective against chronic ulcerative colitis and Crohn's disease.


If surgery is needed to treat colon cancer or remove polyps or infected areas of the colon, our care team at Virginia Mason Franciscan Health will guide you every step of the way. 

  • Colorectal cancer treatment may include surgery, chemotherapy, radiation and targeted therapies using antibodies to target specific molecules within cancer cells.
  • Colon resection  is when surgeons remove the affected part of the colon laparoscopically or with open surgery, and join the remaining ends together, allowing for normal bowel movements.
  • Colostomy is used in cases where there is too much inflammation to rejoin your colon and rectum. A surgeon may perform a colostomy—an opening in the abdominal wall connected to the colon for stool to pass into a bag. Once inflammation has improved, the surgeon can rejoin the ends of the colon and close the opening in the abdomen.

Colorectal and intestinal disorders we treat

  • Celiac disease is a chronic inflammatory disease of the small intestine triggered by dietary exposure to gluten, a protein found in wheat, barley and rye. When affected individuals ingest foods containing gluten, the lining (mucosa) of the intestine becomes damaged by the body’s immune response. For most people with celiac disease, following a strict gluten-free diet will stop symptoms, heal existing intestinal damage and prevent future damage. Learn more

  • Clostridium difficile, also known as C. diff, is a bacteria that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. C. diff most commonly affects older adults in hospitals or in long-term care facilities and typically occurs after use of antibiotic medications. Learn more

  • Colitis is inflammation of the lining of the colon (large intestine) that causes abdominal pain, diarrhea and bloody stools. A bout of colitis that lasts for several days and then decreases may result from certain foods, medications or an infection. Chronic ulcerative colitis, however, is a more serious immune system disorder that can last decades and require long-term medical therapy. This type of colitis is closely associated with Crohn's disease, another inflammatory bowel disease (IBD). Learn more

  • Colorectal cancer often begins as small, noncancerous “polyps” in the large intestine (colon) that can, over time, become cancerous. There may be few or no symptoms. With regular screenings, polyps can be found and treated early before they turn into cancer. When colon or rectal cancer is suspected, it’s vital to determine a precise diagnosis followed by a targeted treatment plan developed especially for you. Learn more

  • Colorectal polyps are clumps of cells that form on the lining of the colon or rectum. They’re quite common and often do not cause symptoms. However, almost all cancers in the colon and rectum develop from a polyp, so when they’re found they’re removed. Colon or rectal polyps may be discovered incidentally during a colonoscopy screening or may be diagnosed when symptoms warrant having a diagnostic colonoscopy. Learn more

  • Constipation is the inability to have a bowel movement and is a common medical ailment. It may be of short duration, occur suddenly or be a chronic condition that presents intermittently over time. In serious cases, stools can become impacted in the rectum, which requires medical intervention to remove. Learn more

  • Crohn's disease is a form of inflammatory bowel disease (IBD) affecting the lining of the digestive tract that runs from the mouth to the anus. More commonly, it affects the lower part of the small intestine called the ilium, but it can occur anywhere along the gastrointestinal tract. Learn more

  • Diarrhea is a common medical disorder that afflicts almost everyone at some point during their lives. It may be caused by a viral or bacterial infection, medications, certain foods or alcoholic beverages, a parasitic infestation or from disorders of the gastrointestinal tract that include colitis, chronic ulcerative colitis and Crohn's disease. Diarrhea that is persistent and severe—and accompanied with a fever—should always be brought to your doctor’s attention because of risks associated with dehydration, malnutrition and infection. Learn more

  • Diverticulosis is a condition where small pouches protrude outwardly from the colon. These pouches, called diverticula, are formed by increased pressure from gas, waste or liquid on weakened spots in the colon’s lining. Diverticulosis has no symptoms unless diverticula bleed or become inflamed or infected, a condition known as diverticulitis. Learn more

  • Gastrointestinal (GI) bleeding is a symptom of a disorder in your digestive tract. The blood often appears in stool or vomit but isn't always visible. The level of bleeding can range from mild to severe and life-threatening. Learn more

  • Hemorrhoids are painful, swollen veins in the lower portion of the rectum or anus and may be caused by straining during bowel movements, constipation, sitting for long periods of time, anal infections and certain diseases, such as liver cirrhosis. Learn more

  • Inflammatory bowel disease (IBD) is an autoimmune disorder in which the body's own immune system attacks cells within the bowel. Chronic ulcerative colitis and Crohn's disease are the most common forms of IBD. Common symptoms include chronic diarrhea, abdominal pain, bleeding, anemia and weight loss. Learn more

  • Irritable bowel syndrome (IBS) is a common disorder that affects your large intestine. IBS symptoms include cramping, abdominal pain, bloating, diarrhea and constipation. Despite these uncomfortable symptoms, IBS doesn't cause inflammation or permanent damage to your colon. Most people can ease IBS symptoms with changes in diet, medicine and stress management. Learn more

  • A small bowel obstruction occurs when your small intestine is partially or completely blocked. The blockage prevents food, fluids and gas from moving through the intestines in the normal way and may cause severe pain. The most common cause of small bowel obstruction are adhesions from previous abdominal surgeries. Small bowel obstruction may also be caused by gallstones, hernias, tumors or inflammatory bowel diseases, such as Crohn's disease. Learn more

  • Small intestinal bacterial overgrowth (SIBO) means that an excessive amount of bacteria are present in the intestine or “gut.” While bacteria are essential for proper digestion, the majority of gut bacteria reside in the colon. When the number of bacteria in the small bowel increase, they sometimes migrate backward from the colon into the small intestine, which can lead to digestive distress, poor nutrient absorption and even a leaky gut, where toxins and bacteria leak through the intestinal wall. Learn more

Find a colon and rectal surgeon

If you have symptoms of a colorectal disorder, such as abdominal discomfort or bleeding, our gastroenterologists can help.