Posts Tagged ‘colitis’

It is a very common thought and question every colitis sufferer will ask themselves and their doctor but the need for surgery for colitis is not inevitable. Only a small percentage of all those diagnosed with the disease have to ultimately undergo the surgical processes and they can be grouped into different categories depending on the extent of their colitis and how it affects their life.

The standard surgical procedure for colitis will involve the removal of the entire large colon and this will also include the complete removal of the rectum as well. It has to be understood and acknowledged that such an operation is the only permanent cure available for colitis. Whilst the sufferer may have come across many so called “cures”, they may reduce the symptoms but will never actually cure the disease.

So which people who have been diagnosed with colitis are most at risk of having to consider surgery? The first group will be those who suffer from fulminant colitis, where the extent of the inflammation affects over half of the entire colon. Whilst remission is possible with such extensive coverage, when a relapse happens the symptoms are severe and there are cases when they do not respond sufficiently to medications. At this point, the colitis can appear out of control and the only solution is surgery as there can be a further danger of perforation of the bowel occurring.

A second grouping of colitis sufferers who could face the prospect of surgery is those with long standing pancolitis or left-sided colitis, which describes the area of the bowel leading down to the rectum. Again, the symptoms may not be able to be brought under control or the sufferer has over a period of time be unable to attain a satisfactory amount of time in remission. Someone diagnosed with this extent of colitis will also face an increased risk of developing colon cancers. The removal of the entire large colon is important when precancerous changes are detected in the colon lining.

There is a third group that can also face the prospect of surgery for colitis. These are people who have not been able to gain much respite from colitis symptoms. Whilst the extent of the inflammation can be quite small, there are some who just cannot bring symptoms under control and live in such a state for several years. Lifestyle, diet and medications have all been trialled and tested but to no avail. In order to achieve a quality of life that resembles the norm, many chose the surgery option to rid themselves of colitis for good. Life does change when surgery happens, but at least these patients can look forward to a less painful and more normal and active life ahead.

It can either be a considered decision to opt to have surgery for colitis to bring some kind of normality back to a life for those that have moderate yet continuous symptoms or the decision to have surgery can be forced upon the patient due to symptoms being out of control and unresponsive the treatment. Whatever the reason for surgery for colitis, it is a life changing event that, whilst bringing its own challenges in the immediate aftermath and requiring the need to alter daily habits for the remaining lifetime, it can offer welcome respite from the painful grip that colitis has over so many sufferers.

As the use of the internet increases and that of the supporting technology, there are new methods of exchanging information and connecting to others. The use of video camers for real time conferencing is increasing and a brand new website has been created to target those diagnosed with certain diseases and medical conditions as a portal for people to contact others and discuss/chat in real time.

The website is called Healthcam and it was launched at the beginning of the month. It is very early days but once its existence is better known, this has the potential to be a more “live real time” discussion experience with fellow sufferers to compliment what is already available in various forums.

To use it, you will need a webcam and microphone. Don’t worry, these are very inexpensive and many people already use them when using such video/telephone services such as Skype.

Click on the link and take a look and see how it develops over the next few months. I certainly will keep my eye on it and will report back with news of its development.

When suffering from colitis symptoms, either from a relapse or from their continuous presence, it is only natural for the patient to, at some point in time, consider the merits of surgery for colitis. With so much discomfort being experienced, the prospect of perpetual relief can be attractive but any decision has to be carefully considered because the ramifications are major.

The process of surgery for colitis involves extraction of the large colon and this is irrespective of whether it is diseased in its entirety or only concentrated on a specific area. As the function of the large colon is simply a storage area for solid body waste to be held while water is reabsorbed into the body, if it is removed then the waste becomes a more liquid form. This is then eliminated through the anus or an opening that is formed on the side of the abdomen, called an ileostomy though this shall depend on the actual form of reconstruction of the waste system during surgery.

So do a few flare ups of colitis constitute a reason for a sufferer to consider the option of surgery? It is usually only considered for patients who have experienced it over a period of several years with a pattern of regular attacks and short periods of remission or for those who suffer virtually constant symptoms. There are other circumstances such as where the bowel is about to or has perforated, or has become toxic where the colon becomes extremely distended plus also the urgent situation known as fulminant colitis, where severe diarrhoea and bleeding is suffered and a course of intravenous steroids has been administered but not brought the symptoms under control.

For the average sufferer the principle factor that has to be taken into consideration is their quality of life and how the disease impacts on it. If the symptoms appear every couple of years for a few months then this can hardly suggest that the patient is severely restricted in life and only through surgery can some form of normality be achieved again. There can be feelings in the depths of a relapse that can create thoughts of “I never want to experience this again”, or “I wish they would just cut this thing out of me” yet when faced with the challenge of an attack against the life changing event of surgery for colitis, the sufferer will most likely conclude that they can endure what the disease does to them when it’s experienced on a periodic basis.

The general belief is that if a sufferer of colitis can cope with relapses whenever they happen and then make a good recovery and get back into a full life again, the subject of surgery should really not be considered. It is the case that there is no set pattern for relapses to occur so a period of several years where there have been several does not necessarily suggest that the next few years will follow the same pattern. They could in fact reduce in number due to several factors such as a change in lifestyle, understanding of how to manage the disease more effectively including the role of diet and reducing levels of stress.

Whilst it is a choice that ultimately the individual will make, it is important for detailed discussions with doctors and consultants plus also friends and family to be undertaken. It is advantageous for sufferers considering surgery to be fully informed of the procedures and consequences and to listen to opinion and advice from other former sufferers who have themselves faced the dilemma, experienced surgery for colitis and can advise of the outcomes and their thoughts on the very big decision that they took.

A great response for World IBD Day and a good level of press coverage.

Lets hope that colitis gets a higher profile in the minds of policy makers with a subsequent increase in funding for research and care.

For anyone diagnosed with colitis and their family and carers, they should be aware that the first world ibd day is happening on 19TH May.

This is where various ibd organisations around the world will talk with one voice to ensure that diseases like colitis get the media and press coverage they require to lift its status as a prevelant disease with ever increasing numbers particularly amongst younger people.

Go now to www.worldibdday.org to find out more.

There has been a stead stream of colitis news from studies and institutions which is all good news for keeping colitis in the public eye.

And with many more young people being diagnosed, there will be a greater weight to the colitis cause as often their preferred method of communication is via social media.

Therefore, we should all benefit from more information and knowledge of colitis and perhaps the powers that be will start to prioritise the disease more.

Here is hoping…

For the vast majority of people diagnosed with colitis, the prospect of surgery will never have to be addressed though that does not stop many from worrying about this unlikely scenario. For some though, it is something that has to be faced, often as a consequence of continuous symptoms. It is therefore important that there is an understanding of the procedure involved with surgery for colitis.

When it comes to the initial surgical treatment it is really straight forward. There are no choices to make of types of surgical procedure involved. There is only one and it is called a total colectomy where the entire large colon is removed. The result of such a procedure is that colitis is in fact removed and thus the sufferer is cured. But that is only part of the story as the challenge is now to ensure a comfortable system is put in place for the removal of body waste.

As the entire large colon is removed irrespective of how much of it is actually diseased, the process of eliminating waste obviously has to alter. The function of the large colon is that of a storage area for the waste to be held whilst the process of water being reabsorbed into the body is undertaken. Without the benefit of a large colon the waste that is eliminated will take on a more liquid form and is passed through an ileostomy and, after further available surgical procedure, the anus by way of a specially formed internal pouch.

An ileostomy is formed by creating a small opening in the abdominal wall and the end of the small intestine is brought out. Waste then drains automatically into a specially fitted bag that sticks against the abdomen and can easily be emptied when it fills. The bag can be very discrete under clothes and only those that are informed about it will know of its existence. A variation of this, though much less frequently created is when a continent ostomy is formed. This is where an internal pouch is formed under the abdominal wall for the purpose of waste collection and a valve is created on the abdominal wall through which a rigid tube is in order to drain the pouch.
These measures can either be permanent or for the majority of patients just temporary whilst the body recovers from the first operation before the creation of a permanent ileo-anal pouch. The procedure involves the end part of the small intestine being cut open and stitched back to form what is called a J pouch. This is then attached to where the rectum used to be to enable the holding of waste in the pouch until elimination is required through the anus.

There is a good track record of success for such a surgical procedure and the patient will, when used to the workings of the pouch and after having seen the capacity of it increase, have approximately six to eight movements per twenty four hours. With the aid of medication and attention to diet, this can be reduced to as low as three to four times per twenty four hour period. There are however some patients where the pouch does not function properly and bowel incontinence becomes a big problem or that the body rejects the surgery. In such cases, the operative procedure can be reversed and the patient will then have a permanent ileostomy.

Whilst surgery for colitis does have to be faced by a minority of sufferers, it does not mean a very restrictive life has to follow. In fact, most patients find that they can reclaim their life and enjoy one as close to normal as possible, a scenario that was often denied them during the period of their own colitis diagnosis.

A study of 79 children in China found an increasing diagnosis of inflammatory bowel disease in the recent decade compared with the 1980s and 1990s.

Study leader Dr. Tam YH of the Chinese University of Hong Kong reviewed a group of children who had their first colonoscopy within a six-year period.

The most common reasons for the procedure were blood in the stools and for the possibility of inflammatory bowel disease.

The study, published in the World Journal of Gastroenterology, found 23 children had colonic polyps and 13 had inflammatory bowel disease.

There were no complications by any of the study subjects, the study said.

It has recently been reported that there is increasing occurrence of childhood inflammatory bowel disease in Western countries.

The question that has to be asked is the western diet that is becoming more prevalent in urbanised China a potential reason for this occurrence? Will China start to experience the same health problem that are predominately found in the West?

Did you know that there is some evidence that ulcerative colitis has a genetic component?

Between 85 percent and 90 percent of people with ulcerative colitis have no relative with ulcerative colitis. But the 10 percent to 15 percent of people who have relatives with ulcerative colitis means that the risk is statistically higher in individuals who have a family member with inflammatory bowel disease .

Other evidence points to a genetic basis: Populations that bred closely within their communities for many generations, such as Eastern European Jews, have a higher incidence of inflammatory bowel disease than other groups.

A colonoscopy is so important for those sufferering from colitis

This is not just to ensure the inflamed area of the colon is behaving itself but also to keep on the look out for any sign of the development of bowel cancer.

Here is an extract from an interview by Dr Richard Billingham of the Swedish Cancer Institute in Seattle.
How many people develop colon cancer each year in the U.S.?

Dr. Billingham: More than 150,000; nearly HALF of those will die from their disease. The chance that an average person in the U.S. would develop colorectal cancer in their lifetime is 1 in 20.

Is there an age group that is at greatest risk?

Dr. Billingham: Those over 50 are at higher risk, so it is recommended that colonoscopy be done every 10 years, beginning at age 50, to look for POLYPS, which are benign growths in the lining of the colon. Currently it is believed that virtually ALL colon cancer develops from these polyps. Not every polyp becomes a colon cancer, but we can’t tell in advance which one WiLL or WILL NOT become colon cancer. Therefore, when polyps are discovered through colonoscopy, they are removed or destroyed so as to prevent any cancer from developing.

How can having a colonoscopy prevent this disease?

Dr. Billingham: If everybody had colonoscopy as indicated above, we would be able to prevent more than 95% of the colon cancers which we see today. The risks of a colonoscopy are perforation (3 in 10,000); and bleeding (7 in 10,000). The risk of development of cancer WITHOUT a colonoscopy is much larger (500 in 10,000). It seems to people who have never had a colonoscopy that it would be a really big deal; the prep is annoying, but people are completely asleep and pain-free during a colonoscopy, and wake up after the procedure without pain.

Can diet influence one’s risk?

Dr. Billingham: In theory, high consumption beef or animal fat can increase the chance of developing polyps, and subsequent colon cancer. However, with regular screening with colonoscopy, removing any polyps which are discovered, the risk of developing colon cancer is near zero.

What symptoms might be early warning signs to watch for?

Dr. Billingham: Most people have NO symptoms until a large colon cancer causes bleeding or obstruction. For this reason, it is recommended to have periodic colonoscopy to detect polyps, which are the PRE-cancerous lesions, and remove them before they can develop into cancer.

So the next time you have an appointment with your hospital consultant, ask about the opportunity of undergoing a colonoscopy…it is better to be in the know.