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Ulcerative Colitis - Tips To Tackle It!

Diplomate of National Board , DM in Gastroenterology , MD in General medicine, MBBS
Gastroenterologist, Faridabad
Ulcerative Colitis - Tips To Tackle It!
Living with ulcerative colitis can be very challenging. Patients of this disease will have to deal with pain in the abdomen and several digestion related issues in their daily lives. It is known to adversely impact the digestive tract. There can be extreme discomfort at the time of flare-ups. A patient can find life extremely difficult while dealing with symptoms like abdominal pain, fever, weight loss, and chronic diarrhea.

What is Ulcerative colitis (UC)?
It is a serious inflammatory disease. It is caused due to inflammatory bowel movements in the digestive tract. It can affect your daily life adversely. The worst part about this disease is that it relapses in the individual. It is characterized by flare-ups. You need to know fist what is an UC flare-up. Well, it is a term to refer to an exaggerated condition in the disease. It refers to a state when things turn worse. These flare-ups can be caused due to a number of factors. Some of these include:

Side-effect of certain medicines
Hormonal imbalance, especially during pregnancy
Sudden withdrawal from medication
Any infection or other medical condition
How to deal with the UC flare-ups?

Doctors often prescribe corticosteroids to deal with the flare-ups. Some of the most common drugs are Prednisone and budesonide.
Doctors prescribe the intake of steroids, 5-Aminosalicylates, antibiotics, and biologics.
Lifestyle changes are helpful in treating this disease. You can work towards detoxification and de-stressing yourself to get rid of the flare-ups. Take up some exercises, meditation and Yoga for best results.
You can also control chronic diarrhea by keeping a check on what you eat. You should avoid eating fibrous diet. Fibres are tough to digest for patients with UC. You must maintain proper hygiene as well to stay away from diarrhea.
Surgical Management of Ulcerative Colitis

Ulcerative colitis (UC) is an inflammatory disease of the colon and rectum limited to the mucosa, and may vary in severity from a mild intermittent disease to an acute fulminant and potentially fatal disease requiring urgent surgery. Management of ulcerative colitis depends on severity, extent, and duration of the disease, response and tolerance to medication, patient age and comorbidity as well as patient preference.

Surgery plays an important role in the management of UC both because of the premalignant nature of the disease, and because of the periodic failure of medical management. The underlying rationale for surgical treatment of the disease is that the disease is confined to the colon and rectum, and therefore proctocolectomy is curative. The goal of surgical therapy for ulcerative colitis is to remove the disease with as little alteration of normal physiological functions and lifestyle as possible.

Four surgical options exist for patients with ulcerative colitis and each has its own advantages and disadvantages.

The surgical choices are:

Proctocolectomy and Brooke ileostomy.
Abdominal colectomy and ilcorectal anastomosis.
Proctocolectomy and Kock pouch.
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA).
The choice of operation requires consideration of the advantages and disadvantages of each option and must be tailored to an individual patient's needs and circumstances. Important factors to be considered in the choice of operation include the indication for surgery, age, associated medical conditions, body habitues, and quality of the anal sphincter. Extensive preoperative education is required which should include discussion with a specialized Gastroenterologist.
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Chronic Inflammatory Disorder - How To Diagnose It?

MBBS, MS - General Surgery
General Surgeon, Bhopal
Chronic Inflammatory Disorder - How To Diagnose It?
Crohn s disease is a chronic inflammatory disorder of GI or digestive tract. Crohn s disease is most commonly affects the mucosal lining due to ulcerations of small and large intestines, but it can affect the entire digestive system. Crohn s disease is usually related to another chronic inflammatory condition namely ulcerative colitis, which involves mainly colon. Crohn s disease and ulcerative colitis are together referred to as inflammatory bowel disease. The symptoms include vomiting, abdominal pain, diarrhea, bloody diarrhea, fever, weight loss, anal fistulae, and perirectal abscesses. But, the symptoms are mostly dependent on the location, extent and severity of the inflammation.

Subtypes of Crohn s disease are:

Crohn s colitis Inflammation of the colon. The common symptoms are abdominal pain and bloody diarrhea. However, anal fistulae and perirectal abscesses can also occur.
Crohn s enteritis Inflammation of small intestines. Mainly jejunum (second part) or ileum (third part). The common symptoms are abdominal pain and diarrhea. In this obstruction of small intestines can also occur.
Crohn s terminal ileitis Inflammation of the part of the small intestine which is closest to the colon, i.e. ileum (third or terminal part of small intestine). Similar to colitis and enteritis, the common symptoms are abdominal pain and diarrhea.
Crohn s entero-colitis and ileocolitis Inflammation involving both small intestine and colon. The symptoms include abdominal pain and bloody diarrhea. Obstruction of the small intestine can also occur.
Causes of Crohn s Disease
The cause of the disease is still not known. However, the researchers report that it is due to the abnormal response of the immune system. The uncontrolled inflammation which is associated with Crohn s disease may be caused by food or bacterial intestines or due to the lining of the bowel.

Diagnosis
There are various diagnostic procedures and laboratory tests by which Crohn s disease can be distinguished from other GI tract disease such as ulcerative colitis. A gastroenterologist can perform a sigmoidoscopy or colonoscopy to get bowel tissue for analysis or upper endoscopy can be done to study esophagus, stomach,and duodenum (first part of the small intestine). To study in detail of small intestine, capsule endoscopy can be done, which is done by using a small, pill-sized camera which is swallowed. Other tests that can be suggested by your doctor are:

Blood tests can be done. High white blood cell indicates inflammation and low red blood cells indicates a sign of anemia due to blood loss.
Stool examination can be done to rule out any infection that can occur due to diarrhea.
Special x-rays, namely CT scan or MRI can be performed of both upper and lower GI tract in order to confirm the location of the inflammation.
Treatment
Although there is no cure for Crohn s disease, however, one can lead normal lives. Crohn s disease is normally treated with medications. These include:

Anti-inflammatory drugs, namely, salicylates. Side effects of these drugs are gastrointestinal upset, nausea, rash, headache, or diarrhea.
Corticosteroids, again type of anti-inflammatory drugs, but this is more powerful. The side effects are seen if these drugs are consumed for long periods of time, mainly, thinning of bone, muscle loss, skin problems, and increased risk of infections.
Antibiotics can be given such as ciprofloxacin, metronidazole and others. The side effects include nausea, tingling or numbness of feet and hands.
Antidiarrheal drugs
Risks
Along with Crohn s disease, you are likely to develop other health problems such as colon cancer, lymphoma, deep vein thrombosis or pulmonary embolism, or psoriatic arthritis.
Thus, with this information, you can with the help of your doctor can work out your plan to avoid problems and possible complications.

I am having urge to defecate again and again after certain interval of time like every 2 hrs or 3 hrs and I can't control.

BHMS
Homeopathy Doctor, Noida
I am having urge to defecate again and again after certain interval of time like every 2 hrs or 3 hrs and I can't con...
Its because of stomach infection. 1.Take home cooked, fresh light food. 2. Drink boiled water. 3. Take ORS. 4. Avoid fast foods, spicy and fried foods 5. curd is good for you. For details you can consult me.
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Ulcerative Colitis Surgery - Know Types Of it!

MS - General Surgery, MBBS
General Surgeon, Thane
Ulcerative Colitis Surgery - Know Types Of it!
Ulcerative colitis is a chronic inflammatory condition whereby tiny abscesses and ulcers are formed on the inner lining of the large intestine, or on the colon or rectum. These ulcers may burst frequently resulting in diarrhea and bloody stools. This disease may also be responsible for causing anemia as well as harsh abdominal pain.

Ulcerative colitis normally alternates periodically from flaring up to receding quickly. These periods of remission can either last for weeks or maybe, even for years at a stretch. They are however, not permanent and although the disease may seem to have disappeared completely, it can soon show up again in no time. Usually beginning in the rectum, it can, by and by, spread rapidly to other parts of the colon. If it is, however, limited only to the rectum, then it is more commonly referred to as ulcerative proctitis.

Surgery is generally obligatory and mandatory when it comes to treating ulcerative colitis. If surgery is not performed, you may suffer long-lasting side effects, including cancer and colon rupture. Here are the different types of surgery that you may undergo:

1. Colectomy: This is done when the entire colon needs to be removed and is usually performed to eliminate the perils of acquiring colon cancer.
2. Proctocolectomy: This concerns the total removal of both colon and rectum, and is usually the standard procedure when dealing with ulcerative colitis.
3. Ileal Pouch Anal Anastomosis: If the treatment does not require a permanent stoma, and if you can still manage to let out stool from your anus, then this surgery, also called restorative proctolectomy, would be most appropriate. Here, both colon and rectum are removed but at the same time, the small intestine is utilized to form an internal reservoir, called a J-pouch, which is linked to the anus and can hereafter serve as your new rectum.
1463 people found this helpful

Ulcerative Colitis - How To Manage It?

MBBS, DNB ( General Surgery ), DNB - Gastroenterology
Gastroenterologist, Pune
Ulcerative Colitis - How To Manage It?
Living with ulcerative colitis can be very challenging. Patients of this disease will have to deal with pain in the abdomen and several digestive related issues in their daily lives. It is known to adversely impact the digestive tract. There can be extreme discomfort at the time of flare-ups. A patient can find life extremely difficult while dealing with symptoms like abdominal pain, fever, weight loss, and chronic diarrhea.

What is Ulcerative colitis (UC)?
It is a serious inflammatory disease. It is caused due to inflammatory bowel movements in the digestive tract. It can affect your daily life adversely. The worst part about this disease is that it relapses in the individual. It is characterized by flare-ups. You need to know fist what is an UC flare-up. Well, it is a term to refer to an exaggerated condition in the disease. It refers to a state when things turn worse. These flare-ups can be caused due to a number of factors. Some of these include:

Side-effect of certain medicines
Hormonal imbalance, especially during pregnancy
Sudden withdrawal from medication
Any infection or other medical condition
How to deal with the UC flare-ups?

Doctors often prescribe corticosteroids to deal with the flare-ups. Some of the most common drugs are Prednisone and budesonide.
Doctors prescribe the intake of steroids, 5-Aminosalicylates, antibiotics, and biologics.
Lifestyle changes are helpful in treating this disease. You can work towards detoxification and de-stressing yourself to get rid of the flare-ups. Take up some exercises, meditation and Yoga for best results.
You can also control chronic diarrhea by keeping a check on what you eat. You should avoid eating fibrous diet. Fibres are tough to digest for patients with UC. You must maintain proper hygiene as well to stay away from diarrhea.
Surgical Management of Ulcerative Colitis

Ulcerative colitis (UC) is an inflammatory disease of the colon and rectum limited to the mucosa and may vary in severity from a mild intermittent disease to an acute fulminant and potentially fatal disease requiring urgent surgery. Management of ulcerative colitis depends on severity, extent, and duration of the disease, response and tolerance to medication, patient age and comorbidity as well as patient preference.

Surgery plays an important role in the management of UC both because of the premalignant nature of the disease, and because of the periodic failure of medical management. The underlying rationale for surgical treatment of the disease is that the disease is confined to the colon and rectum, and therefore proctocolectomy is curative. The goal of surgical therapy for ulcerative colitis is to remove the disease with as little alteration of normal physiological functions and lifestyle as possible.

Four surgical options exist for patients with ulcerative colitis and each has its own advantages and disadvantages.

The surgical choices are:

Proctocolectomy and Brooke ileostomy.
Abdominal colectomy and ilcorectal anastomosis.
Proctocolectomy and Kock pouch.
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA).
The choice of operation requires consideration of the advantages and disadvantages of each option and must be tailored to an individual patient's needs and circumstances. Important factors to be considered in the choice of operation include the indication for surgery, age, associated medical conditions, body habitus, and quality of the anal sphincter. Extensive preoperative education is required which should include a discussion with a specialized Gastroenterologist.
1221 people found this helpful

Ulcerative Colitis Surgery - Know Forms Of It!

MS - General Surgery
General Surgeon, Alwar
Ulcerative Colitis Surgery - Know Forms Of It!
Ulcerative colitis is a chronic inflammatory condition whereby tiny abscesses and ulcers are formed on the inner lining of the large intestine, or on the colon or rectum. These ulcers may burst frequently resulting in diarrhea and bloody stools. This disease may also be responsible for causing anemia as well as harsh abdominal pain.
Ulcerative colitis normally alternates periodically from flaring up to receding quickly. These periods of remission can either last for weeks or maybe, even for years at a stretch. They are, however, not permanent and although the disease may seem to have disappeared completely, it can soon show up again in no time. Usually beginning in the rectum, it can by and by, spread rapidly to other parts of the colon. If it is, however, limited only to the rectum, then it is more commonly referred to as ulcerative proctitis.

Surgery is generally obligatory and mandatory when it comes to treating ulcerative colitis. If surgery is not performed, you may suffer long-lasting side effects, including cancer and colon rupture.

Here are the different types of surgery that you may undergo:

1. Colectomy: This is done when the entire colon needs to be removed and is usually performed to eliminate the perils of acquiring colon cancer.
2. Proctocolectomy: This concerns the total removal of both colon and rectum, and is usually the standard procedure when dealing with ulcerative colitis.
3. Ileal Pouch Anal Anastomosis: If the treatment does not require a permanent stoma, and if you can still manage to let out stool from your anus, then this surgery, also called restorative proctolectomy, would be most appropriate. Here, both colon and rectum are removed but at the same time, the small intestine is utilized to form an internal reservoir, called a J-pouch, which is linked to the anus and can hereafter serve as your new rectum.
951 people found this helpful

Hi Sir, I have ulcerative colitis from 2 years and taking dxn product from one year but I am not felling well I have the following problem too much gastric problem sometimes it stools felling come and only just like mucus, blood clotting come.

BAMS
Ayurveda, Ahmedabad
With the age of 24 this much gastritis is not good it has some perfect reasons for having it its the perfect problem of gi tract deformity so consult good ayurvedic physician it will cured for lifetime with out any side effects.
2 people found this helpful
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I am 44 years old I have currently suffering for last 10 months I am suffering for crohn's disease {ibd}. I am under medication but not getting relief, so what should I do? Can you prescribe me some diet.

C.S.C, D.C.H, M.B.B.S
General Physician, Alappuzha
I am 44 years old I have currently suffering for last 10 months I am suffering for crohn's disease {ibd}. I am under ...
Try avoiding butter, margarine, cream sauces and fried foods. Limit fiber, if it's a problem food. If you have inflammatory bowel disease, high-fiber foods, such as fresh fruits and vegetables and whole grains, may make your symptoms worse. If raw fruits and vegetables bother you, try steaming, baking or stewing them
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Perianal Crohn Disease (PCD)

MBBS, MS - General Surgery, Fellowship In Advanced Laparoscopic colo-rectal & Robotic Surgery, FICS - General Surgery, Fellowship in Minimal Access Surgery(FMAS) & Reproductive Medicine, Fellowship in Laser Varicose Vein Surgery
General Surgeon, Mumbai
Play video
Hello friends,

I am Dr. Dilip S Rajpal. I am a general and colorectal surgeon. Today I am going to discuss about perianal diseases. Most common symptoms of perianal diseases is usually painful defecation, bleeding PR and pus discharge from around the motion area. First of all before going anywhere I would like to highlight that not all bleeding PR are because of piles at the same time not all bleeding PR are because of cancer. Now the most important pathophysiology, any etiology of any disease related to motion area is constipation, straining at the time of motion and hard motion, three common disease what we usually see in this particular area one is fissure, one is piles and one is fistula, coming to fissure. Fissure, one of the commonest of the disease which is usually seen in very young age and common presentation is usually pain and also bleeding, basically it is a small crack in the motion area, any person who has hard motion, when he strains he finds a small cut in that particular area and because there is a cut, the muscles in that particular area they contract causing severe pain and because the muscles are contracting this wound or amal cut also fails to heal.

Now the treatment for this is medical treatment, very good appointments are available in today's date but the most important is taking care of constipation, because till the time of patient constipation is not cured or patient is having hard motion this small wound is never going to heal. The most important treatment would be laxatives and we practically stopped operating with these patients because what we do is bedside dilatation and once dilatation is done the patient is immediately pain-free and he is better applying ointments and taking medical treatment, otherwise if patient has recurrent diseases than we offer surgical treatment in the form of internal sphincterotomy. Coming to next disease called piles, now pilles is one of the most common diagnoses which patient assumes that each and every bleeding because of piles, now piles is nothing but it's mucosal prolapse so any person who strains at the time of motion some part of the anal mucosa that comes out and that is called piles, depending on the severity how much it comes out, how much its prolapses, severity are there. Now if it prolapses inside inside then something like pops then it will be a grade I or grade II, if it comes out of the motion area the patient complaint that he can feel something, but it comes and goes inside then it's usually grade III and if something comes out, but does not go inside it's usually grade IV.

As I already said the main reason is straining at the time of motion, hard motion so till the time all these things are not taken care of patient is bound to have this disease and it is never going to get cured. Treatment wise, in today s world treatment is medical treatment in the form of laxatives, sitting in warm water because once you sit in warm water there is soothing effect, patient is better compliant, pain reduces and also the bleeding also reduces. Surgically we usually offer MIPS that is minimally invasive procedure for piles, which is done with the PPH03 stapler, with the help of the staplers complete surgery is done about the motion area, so it is definitely a pain-free surgery. Today we also do suture rectopexy, many times this staplers are quite expensive when this type of patient can not afford then we offer them suture rectopexy, surgery done completely above the motion area so hence it is painless surgery.

Other treatment options like laser treatment option nowadays is coming up in a very big way that can also be offered. All these and whatever form of treatment is offered is just to decrease the morbidity of the surgery, for recurrence patient has to take care of this, What I always tell all my patient is irrespective whether they get operated or not, whether they take Ayurvedic, homeopathic or allopathic you have to take care of your motions that till the time patients doesn't take dietary advice he is bound to have recurrence and third form of disease is fistula. Fistula is a small tunnel is formed within the motion area and outside skin which keeps on discharging pus so typical this pus discharges every 3 weekly, patient will have some pus discharge and because there is a pus discharge patient have lot of pain and he will have inflammation, he may have fever also very rarely but we need to operate that pus also, so for fistula treatment is 100% surgery.

So for all these perianal diseases the most important reason is constipation till the time patient does not take care of his diet, because these all are lifestyle diseases, diet in the form of patient should drink a lot of liquids, liquids like any form water, coconut water, Dal, soup, juice whatever you want you have fruits, vegetables, salad, all these leafy vegetables. All these leafy vegetables and salads are fibre and the more fibre you take more it will absorb the water and once it absorbs the water the motion become more and more softer this problem will decrease on its own. The non-vegetarian food, extra spicy food, cheese, chocolate should be reduced as much as possible because they all alludes more and more constipation and also patient should not strain at the time of motion, patient should pass motion as and when he feels right, don't try to control and patient motions should always be soft, if we follow this advice then patient s motion will be soft, any motion related problem will never ever recur in his life. For any such more videos you should definitely go to lybrate page.

Thank you
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