Category: Colorectal Cancer

ABSTRACT

The word was coined around the 1860s by Holmes who was a british pathologist .This pathology is viciously spreading in nature and is known by the name ” Neoplasms”. They are often termed to be Villous papilloma,papillary adenomas,columnar papilomas, mucous papillomas or villomas etc. Most commonly they are found in Rectum,sigmoid and right part of the colon. Similar kinds of lesions too can be found anywhere as in the stomach, gallbladder etc. This epithelial tumor although is benign in nature yet is associated with a lot of pain ,morbidity and there are chances it transforms into carcinoma adenoma. Despite its cruel nature,it is very rarely mentioned in the radiological literature.This article is about the description of this ailment in terms of its nature, Signs – symptoms, investigations and the management protocols undertaken.

INCIDENCE

The finding of this kind of structure is predominantly seen among the individuals that are in their mid fifties. Although this has no link to be seen with any sort of heredity or sexual inclination. Of all rectal and sigmoidal lesions it constitues around 0.1 to 6.6 percent . 2.3 % of colon tumors are said to be villous adenomatous in nature.

INTRODUCTION

The adenomas can generally be subdivided into three types: Tubular adenoma ( found 80% of the times),Tubulovillous adenoma ( found in 10 to 15% of the times) and Villous adenoma ( found in 5% of the cases).

The benign epithelial tumor ( proliferative dysplasia) of mucosa can morphologically be classified into the ” Villous adenoma” and the “Adenomatous polyp”. The former is a soft, sessile and relatively rare tumor without a pedicle. The latter on the other hand is said to occur in about 7 percent of all the adults.

The morphology of the tumor is spongy, red or red-gray in color, and usually sessile, with a broad flat base.Its base looks like a juncture where all the villi( finger like projections) join giving it a soft velvety appearance. The covering of the lesion is composed of thick, and viscid mucus. If the tumor comes out to be pedunculated then it is felt by the stretching of the surrounding mucosa ( due to its own weight).Ayurvedic correlation of this disease is made to Arbuda or granthi and the treatment protocol is ,the use of herbal preparations that would balance the vitiated doshas.

CAUSES

The cause of this disease is the vitiation of doshas due to ” Ahitkar aahar Vihar” and other aggravating factors such as

• Smoking
• Obesity
• Gender and body size
• Metabolic changes
• Chronic inflammation conditions
• Rectal bleeding
• Sedentary lifestyle
• Hereditary (Gardner syndrome, Peutz- Jeghers syndrome)
• Bad dietary habits

SYMPTOMS

This pathology is accompanied with the following signs and symptoms

• Rectal bleeding
• Anemia
• Change in the colour of stool
• Abdominal pain
• Change in bowel habits

SIZE

Villous adenomas are an advanced version of adenoma. The size of these lesions is larger than tubular adenomas’s size. Most of them are larger than 2 cm and possess potential chances of getting malignant. Some of these neoplasms spread enough to cover large areas and turn out to become ” carpet” lesions. The findings have shown that the villous adenoma can range in size from a nodule of several centimeters in diameter to an entire mass of enormous size, completely encircling the bowel.

RISKS WITH VILLOUS ADENOMA

Although they are benign in nature, they have the potential to cause serious health complications, this is because they compress other structures and produce large amounts of hormones in an unregulated and non-feedback-dependent manner. This may lead to paraneoplastic syndromes .If the pathological reports show low grade dysplasia( abnormal cells) then the cells are at the lesser chance of getting malignant. But if the dysplasia nature is more then there are chances it converts into adenocarcinoma.

INVESTIGATIONS

A lot of imaging protocols are followed to detect a case of Villous adenomas.

• The lesions are seen nodular or frond-like surface on BE or CT colonography
• Its common sites of location discovered are: Rectosigmoid > cecum > ascending colon > stomach > duodenum
• Villous adenoma bears true neoplasms
• Risk of cancer is directly proportional to to tumor size, location, and proportion of villous change in adenoma
• There still is a greater risk of Carcinoma in villous tumors of stomach and duodenum than in  colon . The incidences have shown that Carcinoma of stomach in  50% of lesions 2-4 cm and in 80% of lesions > 4 cm in size
• CT finding gives corrugated, feathery appearance due to trapping of enteric contrast
• Stool examination
• Sigmoidoscopy, Colonoscopy

MANAGEMENT

Modern medicine treats it via-

• Removal during a colonoscopy,
• Rectal mucosectomy
• Transanal excision
• Snare/fulguration.
• Certain hormones, and / or steroids can also be indicated
• Surgery

Ayurveda however works on the pacification of vitiated doshas for its management. There are herbs whose action has proven to be magical in the management of symptoms associated with Villous adenoma.

Herbal remedies of Villous adenoma from Planet Ayurveda

Planet Ayurveda has made use of the ancient wisdom and has come up with the very effective results against Villous adenoma.

Planet ayurveda is a globally emerging herbal manufacturing hub that formulates herbomineral /herbal formulation that are obtained from 100% natural sources with strict adherence to ayurvedic texts and principles .These herbal medications are being made under strict vigilance and guidance of expert ayurvedic physician using ancient time tested formula.

Planet Ayurveda offers a Villous adenoma care pack which includes the following

1. Mahashankh Vati
2. Avipattikar Churna
3. Pitta Balance
4. Acido Plan Syrup
5. Digestion Support
6. Kanchnaar Guggul
7. Graviola Capsules

PRODUCT DESCRIPTION

1. Mahashankh Vati

This formulation is known for its properties like that of an appetizer,digestive , analgesic etc.  It is composed of Chitrak ( Plumbago zeylanica), Saikharika (Achyranthes aspera),Amla ( Phyllanthus emblica),Pippali ( Piper longum), Hingu ( Ferula asafoetida),Shunthi (Zingiber officinale), Marich ( Piper nigrum), Shudh shankh bhasam ( Ash of conch shell), Vali (Purified and processed sulphur), Rasa ( Mercury) etc.All these makes it very useful in digestive troubles associated with indigestion, dyspepsia , abdominal bloating etc.

Dose: 2 tablets twice daily.

2. Avipattikar Churna

This herbal preparation is composed of Vaividang ( Embelia ribes), Haritaki( Terminalia chebula), Bibhitaki ( Terminalia bellerica), Amla ( Emblica officinale),Tejpatr (Cinnamomum tamala) , lavang ( Syzygium aromaticum)and Nishoth (Operculina turpethum) etc.This makes it excellent against gastritis, acid reflux and heartburn associated with Villous adenoma.

Dose: ½ teaspoon twice daily with plain water.

3. Pitta Balance

This herbal preparation is composed of the ingredients like  Praval Pishti, Akik Pishti , Jahar Mohra Pishti, Kamdudha Ras, Mukta Pishti, Giloy Satva( Tinospora cordifolia). This formulation is very effective with the management of Acidity, Ulcers, bleeding piles etc. The ingredients of this formulation works by pacifying the aggravated Pitta dosha and soothing the digestive system.

Dose: 1 capsule twice daily.

4. Acido Plan Syrup

This syrup is composed of the herbs like patola(Trichosanthes dioica),Sajjikshar( Soda-bi-carb),Ghrit Kumari(Aloe barbadensis),Saunf(Foeniculum vulgare),Kokum(Garcinia indica),Pittapapada (Fumaria indica),Shatavari(Asparagus racemosus)etc which  pacifies the aggravated acid in  the gut and helps against dyspepsia, indigestion etc.

Dose: 2 teaspoons twice daily.

5. Digestion Support Capsules

These capsules consist of Amla( Emblica officinale), Haritali ( Terminalia chebula). Bibhitaki( Terminalia bellerica), Dhania (Coriander sativum), Saunf (Foeniculum vulgare) Jeera(Cyminum cuminum) and Pippali (Piper longum).This formulation maintains the natural pH of the stomach and aids in the digestion of all kinds of food.

Dose: 1 capsule twice daily.

6. Kanchnaar Guggul

Kanchnaar Guggul formulation is composed of the herbs such as Kachnar bark (Bauhinia variegata), Haritaki( Terminalia chebula), Bibhitaki( Terminalia bellerica) Amalki ( Emblica officinale),Shunthi (Zingiber officinale), Marich ( Piper nigrum), Pippali( Piper longum), Varun (Crateva religiosa) etc. This formulation very nicely detoxifies the body and clears off the pathological growths.

Dose: 2 tablets twice daily.

7. Graviola Capsules

This formulation is made up of Graviola ( Annona muricata) which is an anti pathogenic and an anti cancer herb.This herb increases energy , strengthens the immune system and also reduces the associated ;pain and inflammation.

Dose: 1 capsule twice daily.

CONCLUSION

Villous adenoma is a serious pathological condition which must not go without proper investigations and treatment. Ayurvedic management of this disease has proven its benefits to many people. These formulations are not only effective but also free of any kinds of side effects unlike steroidal medicines. In case of any query kindly visit www.PlanetAyurveda.com