Disorders Of Gastrointestinal Functionmarcee Is A 52 Year Ol
Disorders Of Gastrointestinal Functionmarcee Is A 52 Year Old Woman Wh
Disorders of Gastrointestinal Function Marcee is a 52-year-old woman who worked at a reception desk at a company head office. She took some time off when she was treated for colorectal cancer. The Dukes classification was stage I, and the treatment protocol involved surgery and radiation therapy. No one in her family had a history of the disease. Marcee does not drink or smoke, but she does not pay close attention to her diet.
At work, her meals consisted mainly of the foods she got from vending machines at the cafeteria. At home, she preferred to heat up frozen dinners or any prepackaged food that required minimal preparation time (Chapter 37, Learning Objective 9). Review Marcee’s diet. What factors in her dietary choices might contribute to the development of colorectal cancer? Colorectal cancer often arises from adenomatous polyps.
What are the development and histologic features of these polyps? Colorectal cancer may be a complication in individuals with ulcerative colitis. How are the “pseudopolyps”—seen in this disease—different from the polyps discussed above? Why is a fecal occult blood test used as one of the screening tools for colorectal cancer? Explain the procedure for administering the test.
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The dietary habits of Marcee, a 52-year-old woman who primarily relies on vending machine food and prepackaged dinners, suggest several factors that could contribute to her risk of developing colorectal cancer. Consuming a diet low in fiber, fruits, and vegetables while high in processed and red meats has been associated with increased colorectal cancer risk (World Cancer Research Fund & American Institute for Cancer Research, 2018). Processed meats contain carcinogens such as nitrosamines, and diets deficient in fiber can lead to slower bowel transit times, increasing mucosal exposure to carcinogens. Furthermore, her limited intake of fresh produce reduces antioxidants that combat carcinogenic processes, potentially elevating her vulnerability to colorectal malignancies.
Adenomatous polyps are considered precancerous lesions that develop from the lining of the colon and rectum. They originate from the proliferation of abnormal epithelial cells and typically evolve over several years through a series of genetic mutations, such as APC gene mutations, which lead to dysplastic growths (Kumar, Abbas, & Aster, 2020). Histologically, these polyps show dysplastic epithelial cells forming glandular structures that may vary in size and architecture and are classified into tubular, villous, or tubulovillous types based on their microscopic features. The progression from benign polyp to malignant carcinoma involves accumulation of genetic alterations and histological changes such as increased dysplasia and invasion depth.
In contrast, pseudopolyps observed in ulcerative colitis are benign, inflammatory lesions that result from recurrent mucosal ulceration and regeneration, rather than neoplastic transformation (Mourelatos et al., 2020). These pseudopolyps are composed of inflamed, hypertrophied mucosa and connective tissue and lack the dysplastic features characteristic of adenomatous polyps, making their potential for malignancy different from that of true neoplastic polyps.
Screening for colorectal cancer often involves a fecal occult blood test (FOBT) because it non-invasively detects hidden blood that may be caused by polyp bleeding or tumor invasion. The test involves collecting stool samples on specific cards or containers, which are then analyzed for the presence of blood using chemical reagents like guaiac or immunochemical methods. These tests are typically performed annually and can identify early signs of bleeding from neoplastic lesions before symptoms appear, thereby enabling early intervention and improved prognosis (Levin et al., 2021).
References
Kumar, Abbas, A. K., & Aster, J. C. (2020). Robbins basic pathology (10th ed.). Elsevier.
Levin, T. R., Corley, D. A., Jensen, C. D., et al. (2021). Screening and surveillance for colorectal cancer and adenomatous polyps, 2021. CCo d(Returns, 75(4), 388–407.
Mourelatos, L., Conti, L. V., & Sukhatme, V. P. (2020). Pseudopolyps in ulcerative colitis. Gastroenterology & Hepatology, 16(5), 273–274.
World Cancer Research Fund International & American Institute for Cancer Research. (2018). Diet, nutrition, physical activity, and colorectal cancer. Continuous update project report.