Posts Tagged ‘Rectum’

Ulcerated Colitis

06.05.10

Ulcerative colitis is a chronic disease in which the large intestine becomes inflamed and ulcerated (pitted or eroded), leading to flare-ups (bouts or attacks) of bloody diarrhea, abdominal cramps, and fever. The long-term risk of colon cancer is increased. Ulcerative colitis may start at any age but usually begins between the ages of 15 and 30.

A small group of people have their first attack between the ages of 50 and 70.Ulcerative colitis usually does not affect the full thickness of the wall of the large intestine and hardly ever affects the small intestine. The disease usually begins in the rectum or the rectum and the sigmoid colon (the lower end of the large intestine) but may eventually spread along part or all of the large intestine.

Ulcerative proctitis, which is confined to the rectum, is a very common and relatively benign form of ulcerative colitis. In some people, most of the large intestine is affected early on.

The cause of ulcerative colitis is not known for certain, but heredity and an overactive immune response in the intestine seem to be contributing factors. Cigarette smoking, which is detrimental in Crohns disease, seems to decrease the risk of ulcerative colitis.

However, smoking in order to reduce the risk of ulcerative colitis is ill-advised in light of the many health problems that smoking can cause. Ulcerative colitis (Colitis ulcerosa, UC) is a form of inflammatory bowel disease (IBD).

Ulcerative colitis is a form of colitis, a disease of the intestine, specifically the large intestine or colon, that includes characteristic ulcers, or open sores, in the colon. The main symptom of active disease is usually diarrhea mixed with blood, of gradual onset. Ulcerative colitis is, however, a systemic disease that affects many parts of the body outside the intestine.

Because of the name, IBD is often confused with irritable bowel syndrome (“IBS”), a troublesome, but much less serious condition. Ulcerative colitis has similarities to Crohns disease, another form of IBD. Ulcerative colitis is an intermittent disease, with periods of exacerbated symptoms, and periods that are relatively symptom-free. Although the symptoms of ulcerative colitis can sometimes diminish on their own, the disease usually requires treatment to go into remission.

Ulcerative colitis is a rare disease, with an incidence of about one person per 10,000 in North America. The disease tends to be more common in northern areas. Although ulcerative colitis has no known cause, there is a presumed genetic component to susceptibility.

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Crohns Disease Surgery

01.08.10

Two-thirds to three-quarters of patients with Crohn’s disease will require surgery at some point during their lives. Surgery becomes necessary in Crohn’s disease when medications can no longer control the symptoms. It may also be performed to repair a fistula or fissure.

Another indication for surgery is the presence of an intestinal obstruction or other complication, such as an intestinal abscess. In most cases, the diseased segment of bowel and any associated abscess is removed; this is called a resection. The two ends of healthy bowel are then joined together in a procedure called an anastomosis. While resection and anastomosis may allow many symptom-free years, this surgery is not considered a cure for Crohn’s disease, because the disease frequently recurs at or near the site of anastomosis.

An ileostomy also may be required when surgery is performed for Crohn’s disease of the colon. After the surgeon removes the colon, he brings the small bowel to the skin, so that waste products may be emptied into a pouch attached to the abdomen. This procedure is needed if the rectum is diseased and cannot be used for an anastomosis.

The overall goal of surgery in Crohn’s disease is to conserve bowel and return the individual to the best possible quality of life. Surgery does not cure Crohn’s disease, but corrects an immediate problem that cannot be resolved using medication. Four types of surgery are commonly performed on individuals with Crohn’s disease:
•    Partial bowel resection, to remove a diseased portion of intestine
•    Strictureplasty
•    Correction of fistulas
•    Draining of an abscess

It is estimated that about 75% of individuals who live with Crohn’s disease will require surgery at some point in their lives, and that 75% of those who have one surgery will need at least one subsequent surgery.

Partial Bowel Resection
Resection is usually performed when a portion of intestine has been so damaged by disease that a permanent partial obstruction has formed. The most common areas removed are the terminal ileum, the ileocecal valve, and a small portion of the large intestine. Usually, the surgeon will attach (anastomose) the healthy ends of intestine together during the procedure.

Sometimes, however, there is mild inflammation throughout the intestine, preventing such reattachment. In these cases, a temporary ostomy is created. The ostomy allows intestinal contents to drain directly out of the body into a collecting bag through the abdominal wall. The ostomy is usually closed and the bowel reattached six to eight weeks after the initial surgery.After surgery, disease tends to occur above

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Crohns Disease Prognosis

12.09.09

Crohn’s disease is a life-long illness. The severity of the disease can vary, and a patient can experience periods of time when the disease is not active and he or she is symptom free. However, the complications and risks of Crohn’s disease tend to increase over time. Well over 60% of all patients with Crohn’s disease will require surgery, and about half of these patients will require more than one operation over time. About 5-10% of all Crohn’s patients will die of their disease, primarily due to massive infection.

Endoscope
A medical instrument that can be passed into an area of the body (the bladder or intestine, for example) to allow examination of that area. The endoscope usually has a fiber-optic camera that allows a greatly magnified image to be shown on a television screen viewed by the operator. Many endoscopes also allow the operator to retrieve a small sample (biopsy) of the area being examined, to more closely view the tissue under a microscope.

Fistule
An abnormal channel that creates an open passageway between two structures that do not normally connect.

Gastrointestinal tract
The entire length of the digestive system, running from the stomach, through the small intestine, large intestine, and out the rectum and anus.

Immune system
The body system responsible for producing various cells and chemicals that fight infection by viruses, bacteria, fungi, and other foreign invaders. In autoimmune disease, these cells and chemicals turn against the body itself.

Inflammation
The result of the body’s attempts to fight off and wall off an area that is infected. Inflammation results in the classic signs of redness, heat, swelling, and loss of function.

Obstruction
A blockage.

Ulceration
A pitted area or break in the continuity of a surface such as skin or mucous membrane.

Some people have long periods of remission, sometimes years, when they are free of symptoms. However, the disease usually recurs at various times over a person’s lifetime. This changing pattern of the disease means one cannot always tell when a treatment has helped. Predicting when a remission may occur or when symptoms will return is not possible.)

People with Crohn’s disease may feel well and be free of symptoms for substantial spans of time when their disease is not active. Despite the need to take medication for long periods of time and occasional hospitalizations, most people with Crohn’s disease are able to hold jobs, raise families, and function successfully at home and in society

Crohns Disease Prognosis

08.05.09

Crohns disease is a life-long illness. The severity of the disease can vary, and a patient can experience periods of time when the disease is not active and he or she is symptom free. However, the complications and risks of Crohns disease tend to increase over time. Well over 60% of all patients with Crohns disease will require surgery, and about half of these patients will require more than one operation over time. About 5-10% of all Crohn’s patients will die of their disease, primarily due to massive infection.

Endoscope
A medical instrument that can be passed into an area of the body (the bladder or intestine, for example) to allow examination of that area. The endoscope usually has a fiber-optic camera that allows a greatly magnified image to be shown on a television screen viewed by the operator. Many endoscopes also allow the operator to retrieve a small sample (biopsy) of the area being examined, to more closely view the tissue under a microscope.

Fistule
An abnormal channel that creates an open passageway between two structures that do not normally connect.

Gastrointestinal tract
The entire length of the digestive system, running from the stomach, through the small intestine, large intestine, and out the rectum and anus.

Immune system
The body system responsible for producing various cells and chemicals that fight infection by viruses, bacteria, fungi, and other foreign invaders. In autoimmune disease, these cells and chemicals turn against the body itself.

Inflammation
The result of the body’s attempts to fight off and wall off an area that is infected. Inflammation results in the classic signs of redness, heat, swelling, and loss of function.

Obstruction
A blockage.

Ulceration
A pitted area or break in the continuity of a surface such as skin or mucous membrane.

Some people have long periods of remission, sometimes years, when they are free of symptoms. However, the disease usually recurs at various times over a person’s lifetime. This changing pattern of the disease means one cannot always tell when a treatment has helped. Predicting when a remission may occur or when symptoms will return is not possible.)

People with Crohns disease may feel well and be free of symptoms for substantial spans of time when their disease is not active. Despite the need to take medication for long periods of time and occasional hospitalizations, most people with Crohns disease are able to hold jobs, raise families, and function successfully at home and in society.

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Colitis and Crohns

06.07.09

Inflammatory bowel disease, or IBD, describes two similar yet distinct conditions called Crohns disease and ulcerative colitis. These diseases affect the digestive system and cause the intestinal tissue to become inflamed, form sores and bleed easily. Symptoms include abdominal pain, cramping, fatigue and diarrhea.Crohns disease can affect any part of the gastrointestinal tract, from the mouth to the anus. Patches of inflammation occur, with healthy tissue between the diseased areas.

The inflammation can extend through every layer of affected bowel tissue. Crohns disease can not be cured by drugs or surgery, although either or both can help relieve symptoms.Ulcerative colitis affects only the inner layer of the colon, or large bowel. It always starts in the rectum and may extend as a continuous inflammation from there into the rest of the colon. Usually ulcerative colitis can be controlled with medication. The disease can be completely eliminated by surgically removing the colon, but afterward, waste material may have to be stored and expelled through an external appliance.

While ulcerative colitis causes inflammation only in the colon (colitis) and/or the rectum (proctitis), Crohns disease may cause inflammation in the colon, rectum, small intestine (jejunum and ileum), and, occasionally, even the stomach, mouth, and esophagus.The patterns of inflammation in Crohns disease are different from ulcerative colitis. Except in the most severe cases, the inflammation of ulcerative colitis tends to involve the superficial layers of the inner lining of the bowel. The inflammation also tends to be diffuse and uniform. (All of the lining in the affected segment of the intestine is inflamed.) Unlike ulcerative colitis, the inflammation of Crohns disease is concentrated in some areas more than others and involves layers of the bowel that are deeper than the superficial inner layers. Therefore, the affected segment(s) of bowel in Crohns disease often is studded with deeper ulcers with normal lining between these ulcers.

The most common disease that mimics the symptoms of Crohns disease is ulcerative colitis, as both are inflammatory bowel diseases that can affect the colon with similar symptoms. It is important to differentiate these diseases, since the course of the diseases and treatments may be different. In some cases, however, it may not be possible to tell the difference, in which case the disease is classified as indeterminate colitis.

Currently there is no cure for Crohns disease and remission may not be possible or prolonged if achieved; in cases where remission is possible, relapse can be prevented and symptoms controlled with medication, lifestyle changes and in some cases, surgery. Adequately controlled, Crohns disease may not significantly restrict daily living. Treatment for Crohns disease is only when symptoms are active and involve first treating the acute problem, then maintaining remission.

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