Descending Colon
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In the
anatomy Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having its ...
of humans and homologous primates, the descending colon is the part of the colon extending from the
left colic flexure In the anatomy of the human digestive tract, there are two colic flexures, or curvatures in the transverse colon. The right colic flexure is also known as the hepatic flexure, and the left colic flexure is also known as the splenic flexure. Note ...
to the level of the
iliac crest The crest of the ilium (or iliac crest) is the superior border of the wing of ilium and the superiolateral margin of the greater pelvis. Structure The iliac crest stretches posteriorly from the anterior superior iliac spine (ASIS) to the posterior ...
(whereupon it transitions into the
sigmoid colon The sigmoid colon (or pelvic colon) is the part of the large intestine that is closest to the rectum and anus. It forms a loop that averages about in length. The loop is typically shaped like a Greek letter sigma (ς) or Latin letter S (thus ''s ...
). The function of the descending colon in the
digestive system The human digestive system consists of the gastrointestinal tract plus the accessory organs of digestion (the tongue, salivary glands, pancreas, liver, and gallbladder). Digestion involves the breakdown of food into smaller and smaller compone ...
is to store the remains of digested food that will be emptied into the
rectum The rectum is the final straight portion of the large intestine in humans and some other mammals, and the Gastrointestinal tract, gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the s ...
. The descending colon is on the left side of the body (barring any malformations). The term left colon is hypernymous to ''descending colon'' in precise use; many casual mentions of the left colon chiefly concern the descending colon.


Structure

The descending colon extends from the
left colic flexure In the anatomy of the human digestive tract, there are two colic flexures, or curvatures in the transverse colon. The right colic flexure is also known as the hepatic flexure, and the left colic flexure is also known as the splenic flexure. Note ...
at the upper left part of the
abdomen The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. ...
inferior-ward through the left
hypochondrium In anatomy, the division of the abdomen into regions can employ a nine-region scheme. The hypochondrium refers to the two hypochondriac regions in the upper third of the abdomen; the left hypochondrium and right hypochondrium. They are located o ...
and lumbar regions, along the outer border of the left
kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...
, ending at the level of the
iliac crest The crest of the ilium (or iliac crest) is the superior border of the wing of ilium and the superiolateral margin of the greater pelvis. Structure The iliac crest stretches posteriorly from the anterior superior iliac spine (ASIS) to the posterior ...
at the lower left part of the abdomen, being contunued thenceforth as the
sigmoid colon The sigmoid colon (or pelvic colon) is the part of the large intestine that is closest to the rectum and anus. It forms a loop that averages about in length. The loop is typically shaped like a Greek letter sigma (ς) or Latin letter S (thus ''s ...
. It usually
retroperitoneal The retroperitoneal space (retroperitoneum) is the anatomical space (sometimes a potential space) behind (''retro'') the peritoneum. It has no specific delineating anatomical structures. Organs are retroperitoneal if they have peritoneum on their ...
(being lined by peritoneum on its anterior and lateral aspects), but may be suspended (usually short)
mesentery The mesentery is an organ that attaches the intestines to the posterior abdominal wall in humans and is formed by the double fold of peritoneum. It helps in storing fat and allowing blood vessels, lymphatics, and nerves to supply the intestines ...
in a minority of individuals. The arterial supply comes via the
left colic artery The left colic artery is a branch of the inferior mesenteric artery distributed to the descending colon, and left part of the transverse colon. It ends by dividing into an ascending branch and a descending branch; the terminal branches of the tw ...
.


Function

While the first part of the large intestine is responsible for the absorption of water and other substances from the
chyme Chyme or chymus (; from Greek χυμός ''khymos'', "juice") is the semi-fluid mass of partly digested food that is expelled by a person's stomach, through the pyloric valve, into the duodenumbowel movement Defecation (or defaecation) follows digestion, and is a necessary process by which organisms eliminate a solid, semisolid, or liquid waste material known as feces from the digestive tract via the anus. The act has a variety of names ranging fro ...
. The stools gradually solidify as they move along into the descending colon.The Function Of The Colon
Retrieved on 2010-01-21


Clinical significance

There are several diseases associated with the descending colon. Among the most common are the
inflammatory bowel disease Inflammatory bowel disease (IBD) is a group of inflammation, inflammatory conditions of the colon (anatomy), colon and small intestine, Crohn's disease and ulcerative colitis being the principal types. Crohn's disease affects the small intestine a ...
s (such as
ulcerative colitis Ulcerative colitis (UC) is a long-term condition that results in inflammation and ulcers of the colon and rectum. The primary symptoms of active disease are abdominal pain and diarrhea mixed with blood (hematochezia). Weight loss, fever, and a ...
or
Crohn’s disease Crohn's disease is a type of inflammatory bowel disease (IBD) that may affect any segment of the gastrointestinal tract. Symptoms often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, abdominal distensio ...
) and
colon cancer Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the large intestine). Signs and symptoms may include blood in the stool, a change in bowel mo ...
.


Ulcerative colitis

Ulcerative colitis can affect any part of the colon (and other
mucosa A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It is ...
, such as the mouth), but when it affects the descending colon, it is called ''left-sided colitis''.
Inflammation Inflammation (from la, wikt:en:inflammatio#Latin, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or Irritation, irritants, and is a protective response involving im ...
and
ulcers An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing o ...
on the lining of the intestine mark its presence. Symptoms of ulcerative colitis include
diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin wi ...
, bleeding, fever, abdominal pain, too much mucus in fecal material, and appetite and weight loss. Treatment methods can vary widely, ranging from changes in diet to drug therapy to corrective surgery, depending on the severity of the condition and the overall health of the patient.


Crohn’s disease

When a person has Crohn’s disease or Crohn’s colitis, they have lesions on the tissues of the intestine; this makes it hard for the intestine to absorb water and salt. The symptoms which may develop from this disease include abdominal pain, diarrhea or
constipation Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement ...
, nausea and vomiting, fever,
blood in the stool Blood in stool looks different depending on how early it enters the digestive tract—and thus how much digestive action it has been exposed to—and how much there is. The term can refer either to melena, with a black appearance, typically orig ...
, weight loss, abscesses and fatigue. There is no cure for Crohn’s disease although many treatments are available. Symptomatic treatment with antidiarrhoeals is common in low level cases where the inflammation is reasonably under control. Steroid and/or sulphasalazine treatment are usually the first line of drug based management, although newer drugs along the
TNF inhibitor A TNF inhibitor is a pharmaceutical drug that suppresses the physiologic response to tumor necrosis factor (TNF), which is part of the inflammatory response. TNF is involved in autoimmune and immune-mediated disorders such as rheumatoid arthritis, ...
line (such as
infliximab Infliximab, a chimeric monoclonal antibody, sold under the brand name Remicade among others, is a medication used to treat a number of autoimmune diseases. This includes Crohn's disease, ulcerative colitis, rheumatoid arthritis, ankylosing spon ...
and
adalimumab Adalimumab, sold under the brand name Humira, among others, is a monoclonal antibody used to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, plaque psoriasis, hidradenitis suppurati ...
) are becoming more widespread in the treatment of inflammatory colonic conditions. Diet and lifestyle changes can also be useful, as stress may exacerbate inflammatory processes.


Colon cancer

Cancer of the descending colon is a serious disease. A person can have colon cancer yet have no symptoms in the early stages. As such, regular colorectal examinations or fecal occult blood testing are necessary for catching the disease in its early stages. However, there are some signs that can indicate colon cancer; they include abrupt changes in bowel habits, bleeding from the rectum, black stools, frequent constipation, and mucus in the stools. Treatment options depend on the stage of the cancer and the overall health of the patient.


See also

*
Colonoscopy Colonoscopy () or coloscopy () is the endoscopic examination of the large bowel and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It can provide a visual diagnosis (''e. ...
* Ascending colon


References


External links


Lotti M. Anatomy in relation to left colectomy
* - "The large intestine." * {{Authority control Large intestine