Re: Ulcerative colitis

Posted By HFHSM.D.-ym on November 08, 1998 at 22:22:40:

In Reply to: Ulcerative colitis posted by Anela on November 05, 1998 at 11:50:02:






Please give me your opinion on the UC case, I will appreciate, as I can't find similar tragedy on my internet search on this illness. My mother,living in Croatia, 65 y old and otherwise healthy, had UC for 25 y (50 cm above anus) and 4 times treated in hospital with the medicines used throughout the world. Last hospital treatment lasted for 5o days with high doeses of glutenocorticoides, sulfasalamines, enemas, intravenos, etc, but her health deteriorated, she lost l5 kg and doctors couldn't stop the worsening. They declined giving her the dietary food, and with extremely high corticoide doses, her colon ruptured along 30 cm. It took 16 hours to get the surgeon to operate (for colostomy), eventhough she was already in hospital, due to bad organisation, poor hospital situation, lengthy tests, etc. She developed stercoral peritonitis, accompanied with aspergilosa difusa-pneumonia. Mother died after 3 days on breathing machines, mostly unconcious. Latin exp: Peritonitis diffusa, Perforatio colonis sigmodei, Colitis ulcerosa, Shock septicus, DIK. Th: Laparotomia explorativa, Hemicoloctomia lat. sin. Op. sec. Hartmann. Anus praeternalis transfersalis, Exitus letalis.
Please, help with info: Could her life have been saved if the operation had been done urgently after perforation? Would you sugest her the surgery before the rupture if you see that she is failing to respond to medicaments? Can it be seen that the colon will rupture before it happens? Is it true what doctors told me that the new world research shows it is not neccessary to have dietary food? They also told me her liver was in such bad cond. that she would die anyway. I dont't feel they did their best and will appreciate your opinion even the general one as you haven't seen the patient.
Dear Anela,
Im sorry to hear about your mothers death. In the United States, in patients with ulcerative colitis who do not respond to standard medical therapy, the standard treatment is to perform a total colectomy with ileostomy. This prevents the development of colon cancer and essentially cures the colitis. It is difficult to predict when a perforation or rupture will occur, however, if toxic megacolon is present the risk of perforation is higher. It is much easier to operate on a colon that is not perforated. After colonic perforation occurs leakage of fecal material into the peritoneal cavity increases the risk of infection (peritonitis) and the risk of surgery. There is no current dietary regimen proven to induce remission in ulcerative colitis. There are studies that support utilizing nutritional supplementation in addition to steroids. Im not sure why your mothers liver was in such bad condition, however, a condition called primary sclerosing cholangitis (scarring and inflammation of bile ducts) is sometimes associated with ulcerative colitis. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: ulcerative colitis, colectomy