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CHRON’S DISEASE

UNDERSTANDING THE PROBLEM

Crohn's disease is a chronic, or long lasting, disease that causes inflammation, irritation or swelling in the gastrointestinal (GI) tract. Most commonly, Crohn's affects the small intestine and the beginning of the large intestine. However, the disease can affect any part of the GI tract, from the mouth to the anus. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus, a 1-inch-long opening through which stool leaves the body. The body digests food using the movement of muscles in the GI tract, along with the release of hormones and enzymes. Organs that make up the GI tract are the mouth, esophagus, stomach, small intestine, large intestine which includes the appendix, cecum, colon, and rectum and anus. The last part of the GI tract called the lower GI tract consists of the large intestine and anus. The intestines are sometimes called the bowel.

UNDERSTANDING WHO SUFFERS

The highest annual incidence of Crohn's disease was 12.7 per 100,000 person-years in Europe, 5.0 person-years in Asia and the Middle East, and 20.2 per 100,000 person-years in North America.

Crohn's disease can occur in people of any age. However, it is more likely to develop in people

  • between the ages of 20 and 29
  • who have a family member, most often a sibling or parent, with IBD
  • who smoke cigarettes

The exact cause of Crohn's disease is unknown. Researchers believe the following factors may play a role in causing Crohn's disease:

  • Autoimmune reaction (when a person's immune system attacks healthy cells in the body by mistake)
  • Genes (Crohn's disease sometimes runs in families)
  • Environmental factors (some studies suggest that certain things in the environment may increase the chance of a person getting Crohn's disease, although the overall chance is low)
POTENTIAL SIGNS AND SYMPTOMS

Any part of the GI tract can be affected by Crohn’s disease and symptoms could vary from patient to patient. Some of the symptoms may also be more common than others. The symptoms of Crohn’s disease include the following:

  • Inflammation of the GI tract
  • Diarrhoea (which can be bloody if inflammation is severe)
  • Abdominal cramping and pain
  • Sensation of incomplete evacuation.
  • Constipation leading to bowel obstruction
  • Weight loss
  • Fever

Complications may often occur outside the gastrointestinal tract and could include:

  • Feeling tired
  • Nausea or loss of appetite
  • Anaemia

Signs and symptoms of inflammation outside of the intestines include

  • Joint pain or soreness
  • Inflammation of the eyes
  • Skin changes that involve red, tender bumps under the skin

The symptoms a person experiences can vary depending on the severity of the inflammation and where it occurs.

Crohn's is classified as a chronic disease and patients will likely experience periods when the disease flare up, causes symptoms, and followed by periods of remission.

EXAMINATIONS USUALLY REQUIRED

Crohn's disease may be diagnosed with the some of the following:

  • Medical and family history (family history, symptoms, current and past medical conditions, current medications)
  • Physical exam (check for abdominal distension or swelling, listen to sounds within the abdomen using a stethoscope, taps on the abdomen to check for tenderness and pain and establish if the liver or spleen is abnormal or enlarged)
  • Lab tests (Blood tests, Stool tests)
  • Upper GI series (An upper GI series, also called a barium swallow, uses x-rays and fluoroscopy to help diagnose problems of the upper GI tract. )
  • Computerized tomography (CT) scan (Computerized tomography scans use a combination of x-rays and computer technology to create images)
  • Intestinal endoscopy (Intestinal endoscopies are the most accurate methods for diagnosing Crohn's disease and ruling out other possible conditions, such as ulcerative colitis, diverticular disease, or cancer. Intestinal endoscopies include: upper GI endoscopy and enteroscopy, capsule endoscopy, colonoscopy)

The health care provider may perform a series of medical tests to rule out other bowel diseases, such as irritable bowel syndrome, ulcerative colitis, or celiac disease, that cause symptoms similar to those of Crohn's disease.

PROPOSING TREATMENT AND WHY AIMIS

Even with medication treatments, up to 20 percent of people will need surgery to treat their Crohn's disease. There are various types of surgery dependent on the areas affected.

The definition of a colectomy is a surgical procedure during which all or part of the large intestine is resected. The large intestine is a portion of the alimentary tract consisting of the following:

  • Cecum.
  • Ascending colon.
  • Transverse colon.
  • Descending colon.
  • Sigmoid colon.
  • Rectum.

A total colectomy involves removing the entire colon. Subtotal colectomy is a term to describe a procedure removing part of the colon. Segmental colectomy is a term describing the removal of a segment of the colon and could also be labelled a hemicolectomy to differentiate between the right or left halves of the large intestine. When using the prefix “procto” it indicates a procedure that involves the removal of the rectum as well as the colon. Rectum removal is called proctectomy. Other terms such as low anterior resection, indicating the removal of the sigmoid colon as well as the upper part of the rectum. Although the rectum is distinct from the colon it is a fact that many pathologic conditions and procedures normally related to the colon will involve the rectum.

If a surgeon recommends surgery to treat Crohn’s, these are potential surgery types for minimally invasive da Vinci Surgery.

AIMIS is an expert in all da Vinci Robotic surgeries related to Crohn’s and provides advanced techniques offering many advantages over standard laparoscopy such as

  • Greater precision
  • Lower blood loss
  • Quicker return of bowel function
  • Lower rate of complications
  • Shorter hospital stay
  • Small incisions for minimal scarring

To see the procedures we undertake with Robotic Xi Surgery, please click here

GETTING MORE INFORMATION BEFORE MOVING FORWARD
YOU MAY HAVE QUESTIONS LIKE:
  • Can I get more information before I commit to this?
  • Can I get a second opinion from you before I commit to this?
  • How can I find out the cost before I have any obligation?
WHAT AIMIS CAN DO:

AIMIS will provide a full review, diagnosis and potential surgical options for your condition, after receiving the relevant examinations and information from you. They will also provide an estimate for your surgical procedure before you decide.

AIMIS’ mission is to the provision of “true” healthcare for those who require it. It provides world leading surgeons using state of the art procedures to optimize potential surgical outcomes, whilst taking care of all arrangements so as to allow concentration on recovery.

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AFFORDABILITY

AIMIS provide competitive prices for state of the art procedures. We also work with a large range of Insurance companies where your policy allows you to have surgery abroad.

 

FURTHER INFORMATION ON THE PROBLEM:

Complications of Crohn's disease can include:

  • Bowel obstruction. Crohn's disease can thicken the wall of the intestine. Over time, the thickened areas of the intestine can narrow, which can block the intestine. A partial or complete obstruction, also called a bowel blockage, can block the movement of food or stool through the intestines. A complete bowel obstruction can be life threatening and requires immediate medical attention and often surgery.
  • Fistulas—abnormal passages, or tunnels, between two organs, or between an organ and the outside of the body. How a health care provider treats fistulas depends on their type and severity. For some people, fistulas heal with medication and diet changes, while other people will need to have surgery.
  • Anal fissures—small tears in the anus that may cause itching, pain, or bleeding. Most anal fissures heal with medical treatment; including ointments, warm baths, and dietary changes.
  • Ulcers. Inflammation anywhere along the GI tract can lead to ulcers or open sores in a person's mouth, intestines, anus, and perineum (the area between the anus and the sex organs). In most cases, the treatment a health care provider prescribes for Crohn's disease will also treat the ulcers.
  • Malnutrition—a condition that develops when the body does not get the right amount of vitamins, minerals, and nutrients it needs to maintain healthy tissues and organ function. Some people may need IV fluids or feeding tubes to replace lost nutrients and fluids.
  • Inflammation in other areas of the body. The immune system can trigger inflammation in the joints, eyes and also the skin. Health care providers can treat inflammation by adjusting medications or prescribing new medications.
FURTHER INFORMATION ON INCREASED RISK GROUPS

Other factors in increased risk groups:

  • Good nutrition is important in the management of Crohn's disease. A high-fat diet may also slightly increase the chance of getting Crohn's disease. A health care provider may recommend that a person make dietary changes.
  • People with Crohn's disease should talk with their health care provider about how often they should get screened for colon cancer.
  • Research has shown that people who have a parent or sibling with Crohn's disease may be more likely to develop the disease. Researchers continue to study the link between genes and Crohn's disease.
  • Some studies suggest that certain things in the environment may increase the chance of a person getting Crohn's disease, although the overall chance is low. Nonsteroidal anti-inflammatory drugs, antibiotics and oral contraceptives may slightly increase the chance of developing Crohn's disease.
FURTHER EXAMINATION THAT MAYBE REQUIRED OR REQUESTED

Intestinal endoscopies are the most accurate methods for diagnosing Crohn's disease and ruling out other possible conditions, such as ulcerative colitis, diverticular disease, or cancer. Intestinal endoscopies include:

  • Upper GI endoscopy and enteroscopy ( An upper GI endoscopy is a procedure that uses an endoscope—a small, flexible tube with a light—to directly visualize the lining of the upper GI tract)
  • Capsule endoscopy (Although this procedure can examine the entire digestive tract, health care providers use it mostly to examine the small intestine)
  • Colonoscopy (Colonoscopy is a test that uses a long, flexible, narrow tube with a light and tiny camera on one end, called a colonoscope or scope, to look inside a patient's rectum and entire colon.
WHY AIMIS FOR THIS SURGERY

AIMIS is an expert in Robotic Surgery for Lower Gastrointestinal Problems including:

Right & Left Hemicolectomy, Subtotal Colectomy, Total Colectomy, Total Proctocolectomy with pouch, Anterior Resection of the Rectum, Total Mesorectal Excision, Abdominoperineal Excision and other minimal invasive procedures involving the best American and International surgeons who are experts in the field

Da Vinci Surgery uses state-of-the-art technology to assist doctors in performing a range of delicate operations for Lower Gastrointestinal problem and offers several potential benefits over traditional open and laparoscopic surgery, including:

  • Low rate of major complications
  • Lower blood loss
  • Greater precision
  • Few small incisions - Minimal Scarring
  • Better margins with potential less disruption to surrounding tissue
  • Shorter hospital stays
  • Return to normal activities quicker.

Over the past few years this innovative system has given millions of patients worldwide the benefit of minimal invasive surgery. The da Vinci Xi system has changed technology and the experience of surgery to patients around the world.

OTHER SERVICES PROVIDED BY AIMIS

In addition to its Innovative Healthcare, AIMIS provides seamless service along the way. From the start of your journey you'll know the best flights to take, where you'll be staying, what paperwork you will need. You will have a personal assistant assigned; from your pick up at the airport, to your accommodation, continuous assistance at your pre-consultation, through surgery and in your postsurgical care. Our Patients have said that they feel they have become "part of our family" and some even asked to stay a little longer! AIMIS is here to assist you in an all you requirements, allowing you to focus on your health and recovery.

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