Assessment Practice
Clinical Case Studies
COLORECTAL CANCER OR NOT?
Look at this clinical case study and answer the questions
Case Study - Dirk (50)
For a few months Dirk had been experiencing increasing pain around his lower left mid-region. He had found he had to visit the toilet more frequently, and often felt sick. He was spurred to go to his GP when he noticed evidence of blood in his stools over a period of several days. He feared colorectal cancer.
Diagnosis
Dirk’s GP carried out a careful external examination and notice Dirk exhibited guarding when the lower left quadrant was palpated. The GP suspected a large intestine problem and immediately arranged an appointment with a specialist.
The consultant wanted to avoid giving Dirk a barium meal and was able to quickly establish that Dirk had diverticulitis. The doctor explained that up to 50% of people develop diverticula’s - pouches in the large intestine wall where the muscle has become flabby and weakened. Food becomes trapped in these sacs, and may set up infection. The surgeon said this was very much a disease related to western diets low in fibre.
Treatment
Dirk did not need surgery but spent a few days in hospital “resting the bowel”. This entailed avoiding eating. He was also given antibiotics. The consultant explained that the location of the diverticulitis made bacterial infection leading to perforation and peritonitis a real and potentially fatal danger. Dirk was surprised that he did not need antacids to prevent acid damage.
Dirk recovered well and changed to a higher fibre diet. He also started walking more and as an added plus found that these two simple steps also reduced his blood pressure and resting heart rate.
Questions- for practice purposes
- Where would colorectal cancer be found?
- Why did Dirk not need antacids?
- Dirk was given antibiotics to kill bacteria. Explain the nutritional implications of antibiotics in terms of vitamins...
Research the relationship between colon health and glucosinolates-including their dietary sources.