| Rok's-Planet |
blogs updatedWe updated the blogs.forumer.com You can now see new features when you login. Thank you for choosing Forumer, Have you created a community yet? If not, give it a try http://www.forumer.com4:59 AM - Feb. 22, 2006 - comments {0} - post commentTechnorati Profile9:25 PM - Feb. 7, 2006 - comments {1} - post commentIleostomy, Colostomy, and Ileoanal Reservoir SurgerySometimes treatment for Crohn's disease, ulcerative colitis, and familial adenomatous polyposis involves removing all or part of the intestines. When the intestines are removed, the body needs a new way for stool to leave the body, so the surgeon creates an opening in the abdomen for stool to pass through. The surgery to create the new opening is called ostomy. The opening is called a stoma.
Different types of ostomy are performed depending on how much and what part of the intestines are removed. The surgeries are called ileostomy and colostomy. When the colon and rectum are removed, the surgeon performs an ileostomy to attach the bottom of the small intestine (ileum) to the stoma. When the rectum is removed, the surgeon performs a colostomy to attach the colon to the stoma. A temporary colostomy may be performed when part of the colon has been removed and the rest of it needs to heal.
Ileoanal reservoir surgery is an alternative to a permanent ileostomy. It is usually completed in two surgeries. In the first surgery, the colon and rectum are removed and a pouch or reservoir is constructed from the last 18 inches of the small intestine. This pouch is attached to the anus. In the second surgery, the ileostomy is closed. The muscles surrounding the anus and anal canal are left in place, so the stool in the pouch does not leak out of the anus. People who have this surgery are able to control their bowel movements.
If an ileoanal reservoir is not possible or feasible, a continent ileostomy may be an alternative to using an outside collecting bag. In continent ileostomy, an internal reservoir pouch is created from part of the small intestine. A valve is constructed and a stoma is placed through the abdominal wall. A tube is inserted through the stoma and valve to drain the pouch.
11:10 PM - Nov. 30, 2005 - comments {2} - post commentWhat I need to know about Diarrhea
Diarrhea means that you have a change in your bowel movements and pass unusually loose stools. Stool is what is left after your digestive system (stomach, small intestine, and colon) absorbs nutrients and fluids from what you eat and drink. Stool passes out of the body through the rectum. If fluids are not absorbed, or if your digestive system produces extra fluids, stools will be loose and watery. Loose stools are larger than usual. People with diarrhea often have frequent bowel movements and may pass more than a quart of watery stool a day.
What other symptoms accompany diarrhea? People who have diarrhea may also have
Also, people with diarrhea may feel sick to their stomach or be dehydrated.
What is dehydration? Dehydration means that your body does not have enough fluid to work properly. Every time you breathe out, sweat, urinate, or have a bowel movement, you lose fluid. Diarrhea increases the amount of fluid lost in bowel movements. Along with the fluid, you lose salts-chemicals that your body needs to work properly. The loss of fluids and salts can be serious, especially for babies and young children and for older people.
The signs of dehydration in adults are
In addition, the kidneys could stop working.
The signs of dehydration in babies and young children are
Also, when children have diarrhea, their skin seems to lose its elasticity. It does not flatten back to normal when pinched and released.
Who gets diarrhea? Anyone can get diarrhea. This common problem can last a day or two or for months or years, depending on the cause. Most people get better on their own, but diarrhea can be serious for babies and older people if lost fluids are not replaced. Many people throughout the world die from diarrhea because of the large volume of water lost and the accompanying loss of salts.
What causes diarrhea? Diarrhea can be caused by
Sometimes no cause for diarrhea can be found.
When should I talk to a doctor? Diarrhea often goes away by itself, but it can be a sign of a more serious problem. You should talk to your doctor if your diarrhea lasts for more than 3 days. You should also call your doctor if you have
Children younger than 12 become dehydrated much more easily than adults. If your child does not improve after 24 hours or has any of the following symptoms along with diarrhea, call the doctor. (This is especially important if your child is 6 months old or younger.)
What tests might be done? Your doctor may want to perform tests to find the cause of the diarrhea:
For a sigmoidoscopy or colonoscopy, the doctor uses a thin, flexible, lighted tube with a lens on the end.
How is diarrhea treated? In many cases of diarrhea, replacing lost fluid and salts is the only treatment needed.
Taking medicine to stop diarrhea can be helpful in some cases. Medicines that are available without a doctor's prescription include loperamide (Imodium) and bismuth subsalicylate (Pepto Bismol and Kaopectate). Stop taking these medicines if symptoms get worse or if diarrhea lasts more than 2 days.
If a particular food or medicine is the cause, you should avoid it.
Also, while you are waiting for the diarrhea to end, you should avoid foods that can make it worse:
As you feel better, begin eating soft, bland food, such as bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. Children can eat bananas, rice, applesauce, and toast (sometimes called the BRAT diet).
Traveler's Diarrhea People who are visiting other countries and eat food or drink water contaminated by bacteria, viruses, or parasites can develop traveler's diarrhea.
You can prevent it by being careful:
You can safely drink bottled water, carbonated soft drinks, and hot drinks like coffee or tea.
Points to Remember
10:57 PM - Nov. 30, 2005 - comments {0} - post commentDiarrheaWhat is diarrhea? Diarrhea—loose, watery stools occurring more than three times in one day—is a common problem that usually lasts a day or two and goes away on its own without any special treatment. However, prolonged diarrhea can be a sign of other problems. People with diarrhea may pass more than a quart of stool a day.
Diarrhea can cause dehydration, which means the body lacks enough fluid to function properly. Dehydration is particularly dangerous in children and the elderly, and it must be treated promptly to avoid serious health problems. (See "What is dehydration?")
People of all ages can get diarrhea. The average adult has a bout of diarrhea about four times a year. What causes diarrhea? Diarrhea may be caused by a temporary problem, like an infection, or a chronic problem, like an intestinal disease. A few of the more common causes of diarrhea are
In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes away on its own, an extensive search for the cause is not usually necessary.
People who visit foreign countries are at risk for traveler's diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or, sometimes, parasites. Traveler's diarrhea is a particular problem for people visiting developing countries. Visitors to the United States, Canada, most European countries, Japan, Australia, and New Zealand do not face much risk for traveler's diarrhea. (See "Preventing Traveler's Diarrhea.") What are the symptoms? Diarrhea may be accompanied by cramping abdominal pain, bloating, nausea, or an urgent need to use the bathroom. Depending on the cause, a person may have a fever or bloody stools. Diarrhea can be either acute (short-term) or chronic (long-term). The acute form, which lasts less than 4 weeks, is usually related to a bacterial, viral, or parasitic infection. Chronic diarrhea lasts more than 4 weeks and is usually related to functional disorders like irritable bowel syndrome or inflammatory bowel diseases like celiac disease. Diarrhea in Children Children can have acute or chronic forms of diarrhea. Causes include bacteria, viruses, parasites, medications, functional disorders, and food sensitivities. Infection with the rotavirus is the most common cause of acute childhood diarrhea. Rotavirus diarrhea usually resolves in 3 to 9 days.
Medications to treat diarrhea in adults can be dangerous to children and should be given only under a doctor's guidance.
Diarrhea can be dangerous in newborns and infants. In small children, severe diarrhea lasting just a day or two can lead to dehydration. Because a child can die from dehydration within a few days, the main treatment for diarrhea in children is rehydration. (See "Preventing Dehydration".)
Take your child to the doctor if any of the following symptoms appear:
What is dehydration? General signs of dehydration include
Signs of dehydration in children include
If you suspect that you or your child is dehydrated, call the doctor immediately. Severe dehydration may require hospitalization. Although usually not harmful, diarrhea can become dangerous or signal a more serious problem.
If your child has diarrhea, do not hesitate to call the doctor for advice. Diarrhea can be dangerous in children if too much fluid is lost and not replaced quickly. Diagnostic tests to find the cause of diarrhea include the following:
What is the treatment? In most cases, replacing lost fluid to prevent dehydration is the only treatment necessary. (See "Preventing Dehydration" below.) Medicines that stop diarrhea may be helpful in some cases, but they are not recommended for people whose diarrhea is caused by a bacterial infection or parasite—stopping the diarrhea traps the organism in the intestines, prolonging the problem. Instead, doctors usually prescribe antibiotics. Viral causes are either treated with medication or left to run their course, depending on the severity and type of the virus.
Preventing Dehydration Dehydration occurs when the body has lost too much fluid and electrolytes (the salts potassium and sodium). The fluid and electrolytes lost during diarrhea need to be replaced promptly—the body cannot function properly without them. Dehydration is particularly dangerous for children, who can die from it within a matter of days.
Although water is extremely important in preventing dehydration, it does not contain electrolytes. To maintain electrolyte levels, you could have broth or soups, which contain sodium, and fruit juices, soft fruits, or vegetables, which contain potassium.
For children, doctors often recommend a special rehydration solution that contains the nutrients they need. You can buy this solution in the grocery store without a prescription. Examples include Pedialyte, Ceralyte, and Infalyte.
Tips About Food Until diarrhea subsides, try to avoid milk products and foods that are greasy, high-fiber, or very sweet. These foods tend to aggravate diarrhea.
As you improve, you can add soft, bland foods to your diet, including bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. For children, the pediatrician may recommend what is called the BRAT diet: bananas, rice, applesauce, and toast. Traveler's diarrhea happens when you consume food or water contaminated with bacteria, viruses, or parasites. You can take the following precautions to prevent traveler's diarrhea when you go abroad:
You can safely drink bottled water (if you are the one to break the seal), carbonated soft drinks, and hot drinks like coffee or tea.
Depending on where you are going and how long you are staying, your doctor may recommend that you take antibiotics before leaving to protect you from possible infection. Hope Through Research NIDDK's Division of Digestive Diseases and Nutrition supports basic and clinical research into gastrointestinal conditions, including diarrhea. Among other areas, researchers are studying how the processes of absorption and secretion in the digestive tract affect the content and consistency of stool, the mechanisms by which E. coli infection causes diarrhea, and chemical compounds that may be useful in treating diarrhea.
10:47 PM - Nov. 30, 2005 - comments {1} - post commentUlcerative Colitis
Ulcerative colitis is an inflammatory bowel disease (IBD), the general name for diseases that cause inflammation in the small intestine and colon. Ulcerative colitis can be difficult to diagnose because its symptoms are similar to other intestinal disorders and to another type of IBD called Crohn's disease. Crohn's disease differs from ulcerative colitis because it causes inflammation deeper within the intestinal wall. Also, Crohn's disease usually occurs in the small intestine, although it can also occur in the mouth, esophagus, stomach, duodenum, large intestine, appendix, and anus.
Ulcerative colitis may occur in people of any age, but most often it starts between ages 15 and 30, or less frequently between ages 50 and 70. Children and adolescents sometimes develop the disease. Ulcerative colitis affects men and women equally and appears to run in some families. What causes ulcerative colitis? Theories about what causes ulcerative colitis abound, but none have been proven. The most popular theory is that the body's immune system reacts to a virus or a bacterium by causing ongoing inflammation in the intestinal wall.
People with ulcerative colitis have abnormalities of the immune system, but doctors do not know whether these abnormalities are a cause or a result of the disease. Ulcerative colitis is not caused by emotional distress or sensitivity to certain foods or food products, but these factors may trigger symptoms in some people. What are the symptoms of ulcerative colitis? The most common symptoms of ulcerative colitis are abdominal pain and bloody diarrhea. Patients also may experience
About half of patients have mild symptoms. Others suffer frequent fever, bloody diarrhea, nausea, and severe abdominal cramps. Ulcerative colitis may also cause problems such as arthritis, inflammation of the eye, liver disease (hepatitis, cirrhosis, and primary sclerosing cholangitis), osteoporosis, skin rashes, and anemia. No one knows for sure why problems occur outside the colon. Scientists think these complications may occur when the immune system triggers inflammation in other parts of the body. Some of these problems go away when the colitis is treated. How is ulcerative colitis diagnosed? A thorough physical exam and a series of tests may be required to diagnose ulcerative colitis. Blood tests may be done to check for anemia, which could indicate bleeding in the colon or rectum. Blood tests may also uncover a high white blood cell count, which is a sign of inflammation somewhere in the body. By testing a stool sample, the doctor can detect bleeding or infection in the colon or rectum.
The doctor may do a colonoscopy or sigmoidoscopy. For either test, the doctor inserts an endoscope—a long, flexible, lighted tube connected to a computer and TV monitor—into the anus to see the inside of the colon and rectum. The doctor will be able to see any inflammation, bleeding, or ulcers on the colon wall. During the exam, the doctor may do a biopsy, which involves taking a sample of tissue from the lining of the colon to view with a microscope. A barium enema x ray of the colon may also be required. This procedure involves filling the colon with barium, a chalky white solution. The barium shows up white on x ray film, allowing the doctor a clear view of the colon, including any ulcers or other abnormalities that might be there. What is the treatment for ulcerative colitis? Treatment for ulcerative colitis depends on the seriousness of the disease. Most people are treated with medication. In severe cases, a patient may need surgery to remove the diseased colon. Surgery is the only cure for ulcerative colitis.
Some people whose symptoms are triggered by certain foods are able to control the symptoms by avoiding foods that upset their intestines, like highly seasoned foods, raw fruits and vegetables, or milk sugar (lactose). Each person may experience ulcerative colitis differently, so treatment is adjusted for each individual. Emotional and psychological support is important.
Some people have remissions—periods when the symptoms go away—that last for months or even years. However, most patients' symptoms eventually return. This changing pattern of the disease means one cannot always tell when a treatment has helped.
Some people with ulcerative colitis may need medical care for some time, with regular doctor visits to monitor the condition. Drug Therapy The goal of therapy is to induce and maintain remission, and to improve the quality of life for people with ulcerative colitis. Several types of drugs are available.
Other drugs may be given to relax the patient or to relieve pain, diarrhea, or infection. Hospitalization Occasionally, symptoms are severe enough that the person must be hospitalized. For example, a person may have severe bleeding or severe diarrhea that causes dehydration. In such cases the doctor will try to stop diarrhea and loss of blood, fluids, and mineral salts. The patient may need a special diet, feeding through a vein, medications, or sometimes surgery. Surgery About 25 percent to 40 percent of ulcerative colitis patients must eventually have their colons removed because of massive bleeding, severe illness, rupture of the colon, or risk of cancer. Sometimes the doctor will recommend removing the colon if medical treatment fails or if the side effects of corticosteroids or other drugs threaten the patient's health.
Surgery to remove the colon and rectum, known as proctocolectomy, is followed by one of the following:
Not every operation is appropriate for every person. Which surgery to have depends on the severity of the disease and the patient's needs, expectations, and lifestyle. People faced with this decision should get as much information as possible by talking to their doctors, to nurses who work with colon surgery patients (enterostomal therapists), and to other colon surgery patients. Patient advocacy organizations can direct people to support groups and other information resources. (See For More Information for the names of such organizations.)
Most people with ulcerative colitis will never need to have surgery. If surgery does become necessary, however, some people find comfort in knowing that after the surgery, the colitis is cured and most people go on to live normal, active lives. Research Researchers are always looking for new treatments for ulcerative colitis. Therapies that are being tested for usefulness in treating the disease include
Is colon cancer a concern? About 5 percent of people with ulcerative colitis develop colon cancer. The risk of cancer increases with the duration and the extent of involvement of the colon. For example, if only the lower colon and rectum are involved, the risk of cancer is no higher than normal. However, if the entire colon is involved, the risk of cancer may be as much as 32 times the normal rate.
Sometimes precancerous changes occur in the cells lining the colon. These changes are called "dysplasia." People who have dysplasia are more likely to develop cancer than those who do not. Doctors look for signs of dysplasia when doing a colonoscopy or sigmoidoscopy and when examining tissue removed during the test.
According to the 2002 updated guidelines for colon cancer screening, people who have had IBD throughout their colon for at least 8 years and those who have had IBD in only the left colon for 12 to 15 years should have a colonoscopy with biopsies every 1 to 2 years to check for dysplasia. Such screening has not been proven to reduce the risk of colon cancer, but it may help identify cancer early should it develop. These guidelines were produced by an independent expert panel and endorsed by numerous organizations, including the American Cancer Society, the American College of Gastroenterology, the American Society of Colon and Rectal Surgeons, and the Crohn's & Colitis Foundation of America Inc., among others. Hope Through Research NIDDK, through the Division of Digestive Diseases and Nutrition, conducts and supports research into many kinds of digestive disorders, including ulcerative colitis. Researchers are studying how and why the immune system is activated, how it damages the colon, and the processes involved in healing. Through this increased understanding, new and more specific therapies can be developed.
10:09 PM - Nov. 30, 2005 - comments {0} - post commentDiverticulosis and Diverticulitis
Many people have small pouches in their colons that bulge outward through weak spots, like an inner tube that pokes through weak places in a tire. Each pouch is called a diverticulum. Pouches (plural) are called diverticula. The condition of having diverticula is called diverticulosis. About 10 percent of Americans over the age of 40 have diverticulosis. The condition becomes more common as people age. About half of all people over the age of 60 have diverticulosis. When the pouches become infected or inflamed, the condition is called diverticulitis. This happens in 10 to 25 percent of people with diverticulosis. Diverticulosis and diverticulitis are also called diverticular disease.
What are the symptoms? Diverticulosis Most people with diverticulosis do not have any discomfort or symptoms. However, symptoms may include mild cramps, bloating, and constipation. Other diseases such as irritable bowel syndrome (IBS) and stomach ulcers cause similar problems, so these symptoms do not always mean a person has diverticulosis. You should visit your doctor if you have these troubling symptoms. Diverticulitis The most common symptom of diverticulitis is abdominal pain. The most common sign is tenderness around the left side of the lower abdomen. If infection is the cause, fever, nausea, vomiting, chills, cramping, and constipation may occur as well. The severity of symptoms depends on the extent of the infection and complications.
Diverticulitis can lead to bleeding, infections, perforations or tears, or blockages. These complications always require treatment to prevent them from progressing and causing serious illness. Bleeding Bleeding from diverticula is a rare complication. When diverticula bleed, blood may appear in the toilet or in your stool. Bleeding can be severe, but it may stop by itself and not require treatment. Doctors believe bleeding diverticula are caused by a small blood vessel in a diverticulum that weakens and finally bursts. If you have bleeding from the rectum, you should see your doctor. If the bleeding does not stop, surgery may be necessary. Abscess, Perforation, and Peritonitis The infection causing diverticulitis often clears up after a few days of treatment with antibiotics. If the condition gets worse, an abscess may form in the colon.
An abscess is an infected area with pus that may cause swelling and destroy tissue. Sometimes the infected diverticula may develop small holes, called perforations. These perforations allow pus to leak out of the colon into the abdominal area. If the abscess is small and remains in the colon, it may clear up after treatment with antibiotics. If the abscess does not clear up with antibiotics, the doctor may need to drain it.
To drain the abscess, the doctor uses a needle and a small tube called a catheter. The doctor inserts the needle through the skin and drains the fluid through the catheter. This procedure is called percutaneous catheter drainage. Sometimes surgery is needed to clean the abscess and, if necessary, remove part of the colon.
A large abscess can become a serious problem if the infection leaks out and contaminates areas outside the colon. Infection that spreads into the abdominal cavity is called peritonitis. Peritonitis requires immediate surgery to clean the abdominal cavity and remove the damaged part of the colon. Without surgery, peritonitis can be fatal. Fistula A fistula is an abnormal connection of tissue between two organs or between an organ and the skin. When damaged tissues come into contact with each other during infection, they sometimes stick together. If they heal that way, a fistula forms. When diverticulitis-related infection spreads outside the colon, the colon's tissue may stick to nearby tissues. The organs usually involved are the bladder, small intestine, and skin.
The most common type of fistula occurs between the bladder and the colon. It affects men more than women. This type of fistula can result in a severe, long-lasting infection of the urinary tract. The problem can be corrected with surgery to remove the fistula and the affected part of the colon. Intestinal Obstruction The scarring caused by infection may cause partial or total blockage of the large intestine. When this happens, the colon is unable to move bowel contents normally. When the obstruction totally blocks the intestine, emergency surgery is necessary. Partial blockage is not an emergency, so the surgery to correct it can be planned.
Although not proven, the dominant theory is that a low-fiber diet is the main cause of diverticular disease. The disease was first noticed in the United States in the early 1900s. At about the same time, processed foods were introduced into the American diet. Many processed foods contain refined, low-fiber flour. Unlike whole-wheat flour, refined flour has no wheat bran.
Diverticular disease is common in developed or industrialized countries—particularly the United States, England, and Australia—where low-fiber diets are common. The disease is rare in countries of Asia and Africa, where people eat high-fiber vegetable diets.
Fiber is the part of fruits, vegetables, and grains that the body cannot digest. Some fiber dissolves easily in water (soluble fiber). It takes on a soft, jelly-like texture in the intestines. Some fiber passes almost unchanged through the intestines (insoluble fiber). Both kinds of fiber help make stools soft and easy to pass. Fiber also prevents constipation.
Constipation makes the muscles strain to move stool that is too hard. It is the main cause of increased pressure in the colon. This excess pressure might cause the weak spots in the colon to bulge out and become diverticula.
Diverticulitis occurs when diverticula become infected or inflamed. Doctors are not certain what causes the infection. It may begin when stool or bacteria are caught in the diverticula. An attack of diverticulitis can develop suddenly and without warning.
How does the doctor diagnose diverticular disease? To diagnose diverticular disease, the doctor asks about medical history, does a physical exam, and may perform one or more diagnostic tests. Because most people do not have symptoms, diverticulosis is often found through tests ordered for another ailment.
When taking a medical history, the doctor may ask about bowel habits, symptoms, pain, diet, and medications. The physical exam usually involves a digital rectal exam. To perform this test, the doctor inserts a gloved, lubricated finger into the rectum to detect tenderness, blockage, or blood. The doctor may check stool for signs of bleeding and test blood for signs of infection. The doctor may also order x rays or other tests.
A high-fiber diet and, occasionally, mild pain medications will help relieve symptoms in most cases. Sometimes an attack of diverticulitis is serious enough to require a hospital stay and possibly surgery. Diverticulosis Increasing the amount of fiber in the diet may reduce symptoms of diverticulosis and prevent complications such as diverticulitis. Fiber keeps stool soft and lowers pressure inside the colon so that bowel contents can move through easily. The American Dietetic Association recommends 20 to 35 grams of fiber each day. The table below shows the amount of fiber in some foods that you can easily add to your diet.
The doctor may also recommend taking a fiber product such as Citrucel or Metamucil once a day. These products are mixed with water and provide about 2 to 3.5 grams of fiber per tablespoon, mixed with 8 ounces of water.
Until recently, many doctors suggested avoiding foods with small seeds such as tomatoes or strawberries because they believed that particles could lodge in the diverticula and cause inflammation. However, it is now generally accepted that only foods that may irritate or get caught in the diverticula cause problems. Foods such as nuts, popcorn hulls, and sunflower, pumpkin, caraway, and sesame seeds should be avoided. The seeds in tomatoes, zucchini, cucumbers, strawberries, and raspberries, as well as poppy seeds, are generally considered harmless. People differ in the amounts and types of foods they can eat. Decisions about diet should be made based on what works best for each person. Keeping a food diary may help identify individual items in one's diet.
If cramps, bloating, and constipation are problems, the doctor may prescribe a short course of pain medication. However, many medications affect emptying of the colon, an undesirable side effect for people with diverticulosis.
Diverticulitis Treatment for diverticulitis focuses on clearing up the infection and inflammation, resting the colon, and preventing or minimizing complications. An attack of diverticulitis without complications may respond to antibiotics within a few days if treated early.
To help the colon rest, the doctor may recommend bed rest and a liquid diet, along with a pain reliever.
An acute attack with severe pain or severe infection may require a hospital stay. Most acute cases of diverticulitis are treated with antibiotics and a liquid diet. The antibiotics are given by injection into a vein. In some cases, however, surgery may be necessary.
When is surgery necessary? If attacks are severe or frequent, the doctor may advise surgery. The surgeon removes the affected part of the colon and joins the remaining sections. This type of surgery, called colon resection, aims to keep attacks from coming back and to prevent complications. The doctor may also recommend surgery for complications of a fistula or intestinal obstruction.
If antibiotics do not correct an attack, emergency surgery may be required. Other reasons for emergency surgery include a large abscess, perforation, peritonitis, or continued bleeding.
Emergency surgery usually involves two operations. The first surgery will clear the infected abdominal cavity and remove part of the colon. Because of infection and sometimes obstruction, it is not safe to rejoin the colon during the first operation. Instead, the surgeon creates a temporary hole, or stoma, in the abdomen. The end of the colon is connected to the hole, a procedure called a colostomy, to allow normal eating and bowel movements. The stool goes into a bag attached to the opening in the abdomen. In the second operation, the surgeon rejoins the ends of the colon.
Points to Remember
9:57 PM - Nov. 30, 2005 - comments {0} - post commentColonoscopy
For the procedure, you will lie on your left side on the examining table. You will probably be given pain medication and a mild sedative to keep you comfortable and to help you relax during the exam. The physician will insert a long, flexible, lighted tube into your rectum and slowly guide it into your colon. The tube is called a colonoscope (koh-LON-oh-skope). The scope transmits an image of the inside of the colon, so the physician can carefully examine the lining of the colon. The scope bends, so the physician can move it around the curves of your colon. You may be asked to change position occasionally to help the physician move the scope. The scope also blows air into your colon, which inflates the colon and helps the physician see better.
If anything abnormal is seen in your colon, like a polyp or inflamed tissue, the physician can remove all or part of it using tiny instruments passed through the scope. That tissue (biopsy) is then sent to a lab for testing. If there is bleeding in the colon, the physician can pass a laser, heater probe, or electrical probe, or can inject special medicines through the scope and use it to stop the bleeding.
Bleeding and puncture of the colon are possible complications of colonoscopy. However, such complications are uncommon.
Colonoscopy takes 30 to 60 minutes. The sedative and pain medicine should keep you from feeling much discomfort during the exam. You will need to remain at the colonoscopy facility for 1 to 2 hours until the sedative wears off. Preparation Your colon must be completely empty for the colonoscopy to be thorough and safe. To prepare for the procedure you may have to follow a liquid diet for 1 to 3 days beforehand. A liquid diet means fat-free bouillon or broth, strained fruit juice, water, plain coffee, plain tea, or diet soda. Gelatin or popsicles in any color but red may also be eaten. You will also take one of several types of laxatives the night before the procedure. Also, you must arrange for someone to take you home afterward—you will not be allowed to drive because of the sedatives. Your physician may give you other special instructions. Inform your physician of any medical conditions or medications that you take before the colonscopy.
9:45 PM - Nov. 30, 2005 - comments {1} - post commentCollagenous Colitis and Lymphocytic ColitisInflammatory bowel disease is a general name for diseases that cause inflammation in the intestines. Collagenous colitis and lymphocytic colitis are two types of bowel inflammation that affect the colon (large intestine). They are not related to Crohn's disease or ulcerative colitis, which are more severe forms of inflammatory bowel disease (IBD).
Collagenous colitis and lymphocytic colitis are referred to as microscopic colitis because colonoscopy usually shows no signs of inflammation on the surface of the colon. Instead, tissue samples from the colon must be examined under a microscope to make the diagnosis.
No precise cause has been found for collagenous colitis or lymphocytic colitis. Possible causes of damage to the lining of the colon are bacteria and their toxins, viruses, or nonsteroidal anti-inflammatory drugs (NSAIDs). Some researchers have suggested that collagenous colitis and lymphocytic colitis result from an autoimmune response, which means that the body's immune system destroys cells for no known reason.
Symptoms The symptoms of collagenous colitis and lymphocytic colitis are similar—chronic watery, nonbloody diarrhea. The diarrhea may be continuous or episodic. Abdominal pain or cramps may also be present.
Diagnosis The diagnosis of collagenous colitis or lymphocytic colitis is made after tissue samples taken during colonoscopy or flexible sigmoidoscopy are examined under a microscope. Collagenous colitis is characterized by a larger-than-normal band of protein called collagen inside the lining of the colon. The thickness of the band varies, so multiple tissue samples from different areas of the colon may need to be examined. In lymphocytic colitis, tissue samples show inflammation with white blood cells known as lymphocytes between the cells that line the colon, and in contrast to collagenous colitis, there is no abnormality of the collagen.
People with collagenous colitis are most often diagnosed in their 50s, although some cases have been reported in adults younger than 45 years and in children aged 5 to 12. It is diagnosed more frequently in women than men.
People with lymphocytic colitis are also generally diagnosed in their 50s. Both men and women are equally affected.
Treatment Treatment for collagenous colitis and lymphocytic colitis varies depending on the symptoms and severity of the cases. The diseases have been known to resolve spontaneously, but most patients have recurrent symptoms.
Lifestyle changes aimed at improving diarrhea are usually tried first. Recommended changes include reducing the amount of fat in the diet, eliminating foods that contain caffeine or lactose, and not using NSAIDs.
If lifestyle changes alone are not enough, medications are often used to control the symptoms of collagenous colitis and lymphocytic colitis.
For very extreme cases of collagenous colitis and lymphocytic colitis, bypass of the colon or surgery to remove all or part of the colon has been done in a few patients. This is rarely recommended.
Collagenous colitis and lymphocytic colitis do not increase the risk of colon cancer.
9:35 PM - Nov. 30, 2005 - comments {0} - post commentColon PolypsWhat I need to know about Colon Polyps
A polyp* is extra tissue that grows inside your body. Colon polyps grow in the large intestine. The large intestine, also called the colon, is part of your digestive system. It's a long, hollow tube at the end of your digestive tract where your body makes and stores stool. *Medical terms are defined in the glossary.
Most polyps are not dangerous. Most are benign, which means they are not cancer. But over time, some types of polyps can turn into cancer. Usually, polyps that are smaller than a pea aren't harmful. But larger polyps could someday become cancer or may already be cancer. To be safe, doctors remove all polyps and test them.
Who gets polyps? Anyone can get polyps, but certain people are more likely than others. You may have a greater chance of getting polyps if
You may also be more likely to get polyps if you
What are the symptoms? Most small polyps don't cause symptoms. Often, people don't know they have one until the doctor finds it during a regular checkup or while testing them for something else. But some people do have symptoms like these:
How does the doctor test for polyps? The doctor can use four tests to check for polyps:
Who should get tested for polyps? Talk to your doctor about getting tested for polyps if
The doctor will remove the polyp. Sometimes, the doctor takes it out during sigmoidoscopy or colonoscopy. Or the doctor may decide to operate through the abdomen. The polyp is then tested for cancer. If you've had polyps, the doctor may want you to get tested regularly in the future.
How can I prevent polyps? Doctors don't know of any one sure way to prevent polyps. But you might be able to lower your risk of getting them if you
Eating more calcium and folate can also lower your risk of getting polyps. Some foods that are rich in calcium are milk, cheese, and broccoli. Some foods that are rich in folate are chickpeas, kidney beans, and spinach. Some doctors think that aspirin might help prevent polyps. Studies are under way.
Points to Remember
Glossary Abdomen (AB-duh-men): The area between the chest and the hips. It contains the stomach, small intestine, large intestine, liver, gallbladder, pancreas, and spleen. Anus (AY-nus): The opening through which stool leaves the body. Benign (buh-NINE): Not cancerous. Colonoscopy (koh-luh-NAW-skuh-pee): A test to look inside the entire large intestine. The doctor uses a flexible tube that contains a light and a tiny video camera. This device is called a colonoscope. Large intestine: A long, hollow tube in your body that makes and stores stool. Also called the colon. Polyp (PAH-lip): An extra piece of tissue that grows inside the body. Rectum (REK-tum): The last section of the large intestine, leading to the anus. Sigmoidoscopy (SIG-moy-DAW-skuh-pee): A test to look inside the lower section of the large intestine. The doctor uses a flexible tube that contains a light and a tiny video camera. The device is called a sigmoidoscope. Stool: The solid waste that passes through the rectum as a bowel movement.
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What is diarrhea?
Ulcerative colitis is a disease that causes inflammation and sores, called ulcers, in the lining of the large intestine. The inflammation usually occurs in the rectum and lower part of the colon, but it may affect the entire colon. Ulcerative colitis rarely affects the small intestine except for the end section, called the terminal ileum. Ulcerative colitis may also be called colitis or proctitis.
What are diverticulosis and diverticulitis?
Colonoscopy (koh-luh-NAH-skuh-pee) lets the physician look inside your entire large intestine, from the lowest part, the rectum, all the way up through the colon to the lower end of the small intestine. The procedure is used to look for early signs of cancer in the colon and rectum. It is also used to diagnose the causes of unexplained changes in bowel habits. Colonoscopy enables the physician to see inflamed tissue, abnormal growths, ulcers, and bleeding.
What are colon polyps?
Are polyps dangerous?
Colonoscopy. This test is like sigmoidoscopy, but the doctor looks at all of the large intestine. It usually requires sedation.
How are polyps treated?