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ULCERATIVE COLITIS

UNDERSTANDING THE PROBLEM

Ulcerative colitis is best described as the result of an abnormal response by the immune system of the human body. Under normal conditions the cells and proteins, making up the immune system, protect the body from infection. In patients suffering from IBD, the immune system mistakes food, bacteria, and other materials in the intestine for substances that is either foreign or invading. This results in the body sending white blood cells to the lining of the intestines, and they start producing chronic inflammation and ulcerations.

The difference between ulcerative colitis and Crohn's disease should be clearly understood to get the right treatment and care. Crohn’s disease is able to affect any part of the gastrointestinal tract, whereas ulcerative colitis will affect only the colon. Crohn’s disease can also affect all layers of the bowel wall but ulcerative colitis will only affect the lining of the colon.

Ulcerative colitis is defined as a chronic inflammatory disease affecting the gastrointestinal (GI) tract, known in medical terms as inflammatory bowel disease (IBD). The other common IBD’S are Crohn's disease and microscopic colitis.

The onset of Ulcerative colitis is mostly gradually becoming worse over time. The symptoms could be mild or severe and most patients will experience periods of remission when symptoms disappear for weeks or years.

UNDERSTANDING WHO SUFFERS

Ulcerative colitis is the most common type of inflammatory disease of the bowel and has an incidence rate of around 10 per 100,000 people annually. It also has a prevalence of approximately 240 per 100,000 people.

The disease can occur at any age and older men are more likely to be diagnosed than older women.

Ulcerative colitis can occur in people of any age. However, it is more likely to develop in people

  • between the ages of 15 and 30 (peak incidence rate at age 15)
  • older than 55 (also another incidence rate between 55 and 65)
  • who have a family member with IBD
  • of Jewish descent

The exact cause of ulcerative colitis is unknown. Researchers believe the following factors may play a role in causing ulcerative colitis:

  • overactive intestinal immune system (Scientists believe one cause of ulcerative colitis may be an abnormal immune reaction in the intestine)
  • genes (Ulcerative colitis sometimes runs in families)
  • environment (Some studies suggest that certain things in the environment may increase the chance of a person getting ulcerative colitis, although the overall chance is low)
POTENTIAL SIGNS AND SYMPTOMS

The most common signs and symptoms of ulcerative colitis are diarrhoea with blood or pus and abdominal discomfort. Other signs and symptoms include:

  • an urgent need to have a bowel movement
  • feeling tired
  • nausea or loss of appetite
  • weight loss
  • fever
  • anaemia

Less common symptoms can include:

  • joint pain or soreness
  • eye irritation
  • certain rashes

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

When symptoms first appear:

  • most people with ulcerative colitis have mild to moderate symptoms
  • about 10 % of people can have severe symptoms, such as frequent, bloody bowel movements; fevers; and severe abdominal cramping
EXAMINATIONS USUALLY REQUIRED

Diagnosis of ulcerative colitis will include some of the following:

  • Medical and family history
  • Physical exam (checks for abdominal distension or swelling, listens to sounds within the abdomen using a stethoscope, taps on the abdomen to check for tenderness and pain)
  • Lab tests (Blood tests, Stool tests)
  • Endoscopies of the large intestine (the most accurate methods for diagnosing ulcerative colitis and ruling out other possible conditions, such as Crohn's disease, diverticular disease, or cancer. Endoscopies of the large intestine include colonoscopy and flexible sigmoidoscopy)
  • The health care provider may perform a series of medical tests to rule out other bowel disorders, such as irritable bowel syndrome, Crohn's disease, or celiac disease, that may cause symptoms similar to those of ulcerative colitis
PROPOSING TREATMENT AND WHY AIMIS

If medication treatments are little help of symptoms proceed, eventually surgery may be needed to treat Ulcerative Colitis. There are various types of surgery dependent on the areas affected:

  • colon cancer
  • dysplasia, or precancerous cells in the colon
  • complications that are life threatening, such as megacolon or bleeding
  • no improvement in symptoms or condition despite treatment
  • continued dependency on steroids
  • side effects from medications that threaten their health

Removal of the entire colon, including the rectum, ""cures"" ulcerative colitis. A surgeon performs the procedure at a hospital. Two different types of surgery to remove a patient's colon and treat ulcerative colitis can be performed:

  • proctocolectomy and ileostomy (A proctocolectomy is surgery to remove a patient's entire colon and rectum. An ileostomy is a stoma, or opening in the abdomen, that a surgeon creates from a part of the ileum—the last section of the small intestine)
  • proctocolectomy and ileoanal reservoir (An ileoanal reservior is an internal pouch made from the patient's ileum. This surgery is a common alternative to an ileostomy and does not have a permanent stoma. Ileoanal reservoir is also known as a J-pouch, a pelvic pouch, or an ileoanal pouch anastamosis)

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 Ulcerative Colitis, these are potential surgery types for minimally invasive da Vinci Surgery.

AIMIS is an expert in all da Vinci Robotic surgeries related to Ulcerative Colitis 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 ulcerative colitis can include:

  • Rectal bleeding—when ulcers in the intestinal lining open and bleed. Rectal bleeding can cause anaemia, which health care providers can treat with diet changes and iron supplements. People who have a large amount of bleeding in the intestine over a short period of time may require surgery to stop the bleeding. Severe bleeding is a rare complication of ulcerative colitis.
  • Dehydration and malabsorption, which occur when the large intestine is unable to absorb fluids and nutrients because of diarrhoea and inflammation. Some people may need IV fluids to replace lost nutrients and fluids.
  • Changes in bones. Some corticosteroid medications taken to treat ulcerative colitis symptoms can cause:
    • osteoporosis—the loss of bone
    • osteopenia—low bone density
  • Health care providers will monitor people for bone loss and can recommend calcium and vitamin D supplements and medications to help prevent or slow bone loss.
  • Inflammation in other areas of the body. The immune system can trigger inflammation in the:
    • joints
    • eyes
    • skin
    • liver
  • Health care providers can treat inflammation by adjusting medications or prescribing new medications.
  • Mega colon—a serious complication that occurs when inflammation spreads to the deep tissue layers of the large intestine. The large intestine swells and stops working. Mega colon can be a life-threatening complication and most often requires immediate surgery. Megacolon is a rare complication of ulcerative colitis.
FURTHER INFORMATION ON INCREASED RISK GROUPS

While ulcerative colitis tends to run in families, researchers have been unable to establish a clear pattern of inheritance. Studies show that up to 20 % of people with ulcerative colitis will also have a close relative with the disease. The disease is more common among white people of European origin and among people of Jewish heritage.

Researchers have not found that eating, diet, and nutrition play a role in causing ulcerative colitis symptoms. Good nutrition is important in the management of ulcerative colitis, however. Dietary changes can help reduce symptoms. A health care provider may recommend dietary changes such as:

  • avoiding carbonated drinks
  • avoiding popcorn, vegetable skins, nuts, and other high-fiber foods while a person has symptoms
  • drinking more liquids
  • eating smaller meals more often
  • keeping a food diary to help identify troublesome foods

Health care providers may recommend nutritional supplements and vitamins for people who do not absorb enough nutrients.

FURTHER EXAMINATION THAT MAYBE REQUIRED OR REQUESTED

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

  • Colonoscopy (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 the rectum and entire colon.
  • Flexible sigmoidoscopy (a test that uses a flexible, narrow tube with a light and tiny camera on one end, called a sigmoidoscope or scope, to look inside the rectum, the sigmoid colon, and sometimes the descending 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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