Posts Tagged ‘Hospitalization’

Laparoscopic Surgery For Crohns Disease

03.21.10

The rate of conversion from laparoscopic to open surgery was 11.2 percent. Laparoscopic procedures took longer to perform compared with open procedures, with a weighted mean difference of 25.54 minutes. Patients who underwent laparoscopic surgery had a more rapid recovery of bowel function, with a weighted mean difference of 0.75 days  and were able to tolerate oral intake earlier, with a weighted mean difference of 1.43 days .

The duration of hospitalization was shorter, with a weighted mean difference of 1.82 days. Morbidity was lower for laparoscopic procedures compared with open procedures (odds ratio, 0.57; 95 percent confidence interval, 0.37-0.87). The rate of disease recurrence was similar for both laparoscopic and open surgery.

Laparoscopic surgery for Crohns disease takes longer to perform, but there are significant short-term benefits to the patient. The morbidity also is lower, and the rate of disease recurrence is similar. Therefore, laparoscopic surgery for Crohns disease is both safe and feasible.

An effort was made to assess the feasibility, safety, and outcome of laparoscopic procedures performed in patients with Crohns disease. Methods: A prospectively maintained laparoscopic database was analyzed regarding operation time, intra- and postoperative complications, conversion to laparotomy, and length of hospitalization.

Fifty-one patients (23 males and 28 females) with a mean age of 36 (20-79) years underwent a laparoscopic or laparoscopic-assisted procedure for Crohns disease. The indications included terminal ileitis in 31 patients, colitis in 11, perianal disease in four, duodenal Crohns disease in three, and rectovaginal and rectourethral fistula in one patient each.

Thirty-two patients underwent an ileocolic resection; total abdominal colectomy with ileorectal anastomosis was performed in six patients with end ileostomy in one, take down of end ileostomy and ileorectal anastomosis in three, duodenal bypass gastrojejunostomy in three, and loop ileostomy in six patients.

Results: The mean operating time was 2.4 (0.6-4.5) h and the mean length of hospital stay was 5.1 (3-18) days. Eight complications were noted in seven patients (14%), which included enterotomy in two patients, bleeding in two, stoma obstruction in two, pelvic sepsis in one, and efferent limb obstruction in one. The procedure was converted to laparotomy in seven patients (14%) due to a large inflammatory mass in five and to bleeding in two patients; there was no mortality.

Conclusion: Laparoscopic surgery is a feasible, versatile, and safe modality in the surgical management of Crohns disease. Despite the often-malnourished state of these steroid-dependent patients with intraabdominal inflammatory conditions, morbidity, procedural length, and length-of-hospitalization data are all similar to results previously reported for less-challenging laparoscopic colorectal procedures.

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Crohns Disease Statistics

12.31.09

Crohn’s Disease is a chronic inflammation of the digestive track.

The digestive track covers the following:
•    Mouth
•    Esophagus
•    Stomach
•    Small Intestine
•    Large Intestine
•    Rectum
•    Anus

Crohn’s can affect any of those areas, but most commonly attacks the ileum or the lower small intestine. The swelling of the affected area will cause pain and diarrhea.

Statistics
Crohn’s can be found in both men and women. It may run in families, 20% of people diagnosed with the disease have a blood relative with some form of inflammatory bowel disease. It is usually diagnosed between the ages of 20 to 30, although people of all ages can suffer from Crohn’s. People of Jewish heritage have a greater risk of developing the disease while people of African American heritage have less of a risk.

Prevalance of Crohn’s disease: 500,000 Americans

Prevalance Rate: approx 1 in 544 or 0.18% or 500,000 people in

Hospitalization statistics for Crohn’s disease: The following are statistics from various sources about hospitalizations and Crohn’s disease:
•    0.17% (21,634) of hospital consultant episodes were for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    82% of hospital consultant episodes for crohn’s disease required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    42% of hospital consultant episodes for crohn’s disease were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    58% of hospital consultant episodes for crohn’s disease were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    35% of hospital consultant episodes for crohn’s disease required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    9.6 days was the mean length of stay in hospitals for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    6 days was the median length of stay in hospitals for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    39 was the mean age of patients hospitalised for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    78% of hospital consultant episodes for crohn’s disease occurred in 15-59 year olds in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    5% of hospital consultant episodes for crohn’s disease occurred in people over 75 in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    36% of hospital consultant episodes for crohn’s disease were single day episodes in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    0.18% (93,538) of hospital bed days were for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)

Can You Die From Crohns

05.24.09

Crohns disease is a condition where there is inflammation in the gut. The disease flares up from time to time. Symptoms vary, depending on the part of the gut affected. Medication can often ease symptoms when they flare-up. Surgery to remove sections of the gut is needed to treat some flare-ups. Medication taken each day may prevent symptoms from flaring-up.

IF YOU HAVE Crohns disease, you probably already know the bad news: The illness is incurable. If you’re a vegetarian with Crohn’s, the news is even more distressing: The standard medical solution often includes eating meat. Fortunately, though, there is hope. Natural medicine can help you control this potentially debilitating condition, in many cases without becoming a meat eater.

PATRICK DONOVAN, N.D., a naturopathic physician in private practice as well as a professor of gastroenterology at Bastyr University of Natural Health Sciences in Seattle, has seen several dozen cases of Crohns disease in the past 10 years. Donovan is quick to point out that allopathic medicine plays an important role in managing the disease. “There’s a place for prednisone and hospitalization when treating Crohn’s,” says Donovan. “A person can die from this disease, especially during a flare-up. Conventional treatments can save lives.”

In fact, Donovan will treat only those Crohn’s patients who are also seeing a physician with hospital privileges. He also stresses the need for a correct diagnosis. He recently saw a patient who had been treated unsuccessfully for Crohn’s for 10 years; he determined that she in fact had celiac disease, a condition in which gluten, a protein found in various grains, damages the intestinal lining. Crohns disease cannot be prevented but you can reduce your symptoms. We know living with Crohns disease or ulcerative colitis can be difficult, but the right resources and support can make day-to-day living easier.

Crohn’s Disease is not normally fatal, however complications from the disease could be fatal if not seen to. These could be due to infection. Such as a perforated bowel if medical attention to it is not sought out quickly enough. About 1 in 1500 people have Crohns disease. It can develop at any age but most commonly starts between the ages of 15 and 40. It affects women slightly more often than men. The myth was created by the medical system to allow them to profit from those who are chronically ill. The cause and cure remain perpetually just beyond reach.

All they need is more money to keep looking. The elusive search for the cause and cure for Crohns disease is as futile as the elusive search for the cause and cure for Multiple Sclerosis. There is no need to search any further than the word toxicity, the one place the medical profession never looks. That is the smoking gun.

Look where they are not looking and you’ll find it. I was struck down by Crohns disease in the summer of 1993 when I was 44. I nearly died in 1994. I believe the name of an illness should help the person who has it to understand what he or she has, not to disguise the nature of the illness, which is what disease names usually do. Crohn was the name of the doctor who observed and described the disease. He gave his name to it. But, unfortunately, the word Crohn explains absolutely nothing about the nature of the condition.

It merely tells us the name of the person who claimed it for his own and, like Alzheimer and Parkinson and Hodgkin and so many other disease names. Disease naming actually keeps us in the dark. In my opinion, Crohns disease is caused by toxicity. In my case the intestines were poisoned by mercury leaching into the digestive tract from my mercury fillings. The body eliminates mercury extremely slowly. Chelation is the only way to effectively remove mercury at a rate that will allow the body to recover from disease. 90% of the mercury that is excreted from the body is eliminated through the intestines. When it is not eliminated quickly via chelation it is allowed to accumulate in the intestines where it causes tissues to become diseased through mercury poisoning. Mercury destroys the tissues and attracts parasites, unfriendly bacteria and fungus which contribute to toxicity in the intestines.

In my opinion, it would be more helpful if Crohns disease were called Toxic Intestinal Disease (TID). It is not easy to understand “we don’t know the cause, we don’t have a cure”, so we’ll name it after Dr. Crohn. But it is very easy to understand the word toxicity. Toxicity means poisoning.

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