NO VISITING STUDENTS
The following Colon & Rectal specialty objectives are to be covered through clinical experience and reading: 1. Diarrhea: Know the differential diagnosis in adults. Acute versus chronic. Inflammatory vs. infectious vs. malabsorptive vs. secretory. 2. Constipation: Know the differential diagnosis in adults. Acute vs. chronic. Causes, including large bowel obstruction, volvulus, carcinoma, fecal impactions, Ogilvie's sydrome, stricture and anal stenosis. 3. Peri-anal discomfort – know the disease characteristics and treatment of: Hemorrhoids, Fissure, Peri-anal abscess, Fistula-in-ano,, Pruritus ani, Rectal prolapse: Know the differential diagnosis, Know the physical signs associated with prolapse, Describe the treatments available for prolapse. 5. Incontinence: Know the causes of anal incontinence, Describe the workup of incontinence, Describe methods of treatment both non-surgical and surgical. 6. Diverticulitis and Diverticulosis: Know the causes of each, their natural history and complications, Describe the workup of suspected diverticular disease, Describe the treatment of diverticular disease. 7. Colonic Neoplasia: Know the relationship between polyps and cancer, Know the screening and surveillance guidelines for polyps and cancer, Presentation and treatment of polyps, including endoscopic and surgical, Presentation and treatment of non-obstructing and obstructing colon carcinoma, Presentation and treatment of rectal carcinoma. 8. Inflammatory Bowel Disease: Know the differential diagnosis and distinguishing characteristics of inflammatory bowel disease, Know the complications, surveillance, and treatment of chronic ulcerative colitis, Know the presentation, natural history, complications and treatment of Crohn’s Disease. 9. Sexually Transmitted Diseases: Describe the differential diagnosis and physical findings in perianal lesions; Be aware of diseases associated with HIV infection. 10. Vascular Disease: Know the presentation of ischemic colitis and treatment, Know the workup and treatment of lower GI bleeding. 11. Radiation proctitis: Know the presentation, evaluation and treatment of radiation proctitis. 12. The student shall also be exposed to the following skills/procedures: Inspection and demonstrations of fissures, Digital rectal exam,, Anoscopy, Rigid or flexible sigmoidoscopy where available, Exposure to colonoscopy, Exposure to biopsy, Exposure to polypectomy.