The student should be able to discuss the following with regard to colonic and anorectal function and disease.

Physiology

1. The role of the colon in the intestinal transport of fluid and electrolytes.

2. The mechanism of defecation.

3. The different motility patterns in the right and left colon and how they
    determine colonic function.

4. The coordination of colonic motility with eating and the innervation of the
    colon and its relationship with the central nervous system.

5. The role of the colon in digestion.

Carcinoma of the Colon

1. The epidemiology of colonic carcinoma and the predisposing causes to colon
    cancer.

2. The use of CEA in diagnosis and follow-up of patients with colon cancer.

3. The Dukes’ classification of carcinoma of the colon and the percentage
    survival after five years for each group in the classification.

4. The role of diet in the etiology of colon cancer.

5. The role of chemotherapy and radiation therapy in carcinoma of the colon.

6. Classification of colonic polyps and how to determine their malignant
    potential.

7. How polyposis syndrome differs from other conditions associated with polyps.

Diverticular Disease

1. The pathophysiology of diverticular disease.

2. The complications and management of diverticular disease.

Colonic Obstruction

1. The symptoms and signs of colonic obstruction.

2. The causes of colonic obstruction in adults and children.

3. The diagnostic approach to a patient with presumed large bowel obstruction.

4. The x-ray findings of partial large bowel obstruction.

Irritable Bowel Syndrome

1. The Manning criteria and how to make a positive diagnosis of an irritable
    bowel.

2. The symptoms that are not associated with an irritable bowel.

3. When a patient with an irritable bowel should have further investigations to
    confirm the diagnosis and the appropriate screening tests to rule out other
    diseases.

4. The factors that influence patients with an irritable bowel seeking medical
    attention.

5. The treatment of irritable bowel and the approach to differential diagnosis.

Fecal Incontinence

1. The pathophysiology of fecal incontinence.

2. The mechanism by which the anal sphincter maintains continence.

3. The investigation and management of fecal incontinence.

Constipation

1. The etiological classification of constipation.

2. The investigation and differential diagnosis of constipation.

3. The management of constipation.

4. The identification of “laxative abuse.”

5. The causes of solitary rectal ulceration.

Colonic Ischemia

1. The colonic blood supply and the areas of the colon at greatest risk for
    ischemia.

2. The symptoms and signs of colonic ischemia.

3. The diagnosis and management of ischemia.

Infectious Diarrhea

1. The common causes of dysentery in the tropics.

2. The treatment of common bacterial infections of the colon and choice of the
    most appropriate antibiotic.

3. The infectious causes of persistent diarrhea.

4. The nematode infections that cause diarrhea and the presentation of
    nematode intestinal infections.

Perianal Disease

1. The proper techniques of examining the perineum and doing a complete rectal
    examination (students should be able to demonstrate these techniques).

2. The symptoms of hemorrhoids and their management.

3. The difference between internal and external hemorrhoids.

4. The symptoms and management of fissure in ano.