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Treatment options for chronic constipation and Chron's disease - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Digestion and Bowels
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Doctor :   Hi
Doctor :   Dr XXX here
Doctor :   How may i help you?
User :   AAAAAAA my mam has cronic constipation and crohn's disiese and it has spread into her back and her gastrentoligist has sent her to see a surgan and he wants to take her small and large bowel out but she has mental problems and she cant go through with a operation and she is wondering if there is something that will get rid of the constipation because she is allready taking laxatives and there is no one to tell the doctors that my mam cant go through with a operation because she has no other family apart from me and the doctors wont listen to me because i am only 1 and she is desperate,what can she do???
Doctor :   Let me read your query
User :   *13 sorry
Doctor :   Ok
Doctor :   Let me breif you
Doctor :   She requires only surgical correction
User :   ok
Doctor :   Crohn's disease is a chronic inflammatory disease of the intestines. It primarily causes ulcerations (breaks in the lining) of the small and large intestines, but can affect the digestive system anywhere from the mouth to the anus
User :   that is what the gastro said but she is wondering if there is something that she can do apart from surgery
Doctor :   The first mode of treatment is with antiinflammtory medicines
User :   she was on 6mp but it made her sick so she had to stop it
Doctor :   The second line is Sulfasalazine (Azulfidine)
Doctor :   Ok
Doctor :   Thirdly we give them Corticosteroids
Doctor :   Then atlast when symptoms dont regress we have to opt for surgery
User :   she has had 10 courses of steroids in a year
Doctor :   Its a simple surgery where in affected length of colon is ressexcted
Doctor :   Ok
Doctor :   Thats why the surgeon has suggested for an operation
User :   but they want to take the colon out because of the constipation and everyone thinks its a bit radical
Doctor :   Its not due to constipation
Doctor :   The inflamatory changes in the colon will then lead to ulcerative growth which left unattended will start intestinal obstruction
User :   she only has crohn's in the small bowel not the large and they want to take the large bowel out aswel and she has cronic anxiety and she is terrified
Doctor :   And produce severe peritoniotis which will then become a surgical emergency
Doctor :   Its only the affected length and they always spare the healthier ones
Doctor :   A part is removed not whole
Doctor :   Did you follow me?
User :   yes
Doctor :   So ask her not to worry , give her moral support to face the procedure
Doctor :   She will get well soon
Doctor :   Wishing her a speedy recovery
User :   she is also wondering what are the chances of surviving the operation?
Doctor :   95%
Doctor :   There are very few risks invovled in the procedure
Doctor :   Thanks for consulting me
Doctor :   Bye for now
Doctor :   Hi
Doctor :   You were asking about survival rates
Doctor :   As mentioned they are 95%
User :   hello my mam is also wondering gow
User :   *wondering how far they will cut her
Doctor :   Depending on the length of intestine affected
Doctor :   Was an scan taken , It would be mentioned about the extent of involvement
User :   okay,is it a common operation?
Doctor :   Yes
User :   a ct scan was taken and a enima and a bariium followthrough
Doctor :   Its neither a major surgery
Doctor :   Ok
Doctor :   I think the region and extent of invlovement will be mentioned in it
User :   and she is wondering how come she will have to be in hospital for 10 days
Doctor :   You have to till the surgical woung heals and sutures are removed
User :   the sergen said he was going to leave her rectum and it would take 2 hours
Doctor :   Just to avoid chances of infection the full recovery is awited in hospital
Doctor :   Any surgery involving the abdomen will atleast take two hours
User :   okay and she would like to know if she will be able to take her medication after the operation and will she be able to eat
Doctor :   Yes there will be a good improvement after operation
Doctor :   Her medications will be reduced
User :   and she is on pantoprazole and ranitadine
Doctor :   Those are just antacids
Doctor :   They will be tapered and stopped follwing the procedure
User :   would she be able to were normal clothes
Doctor :   Yes after a week
User :   okayy how often does she need to change the bag she will have
Doctor :   Twice a day
Doctor :   And slowly after full recovery the bag will also be removed and reconstructive surgery will be done
User :   okahh,thankyou you are a great help,she has calmed down alot since i have spoken to you about her questions and it is a perminent bag
Doctor :   Just give her more moral support she can easily go through the surgery
Doctor :   All she needs is uuport
Doctor :   * support'
User :   will she be 'out of it' when she wakes up after the operation
Doctor :   Yes, for a while she might be anxious
User :   and i am her only family and i have school so it is hard for me to support her as much as she needs but im trying,i am only 13
Doctor :   Ok
Doctor :   Dont give up she will be fine
Doctor :   Wishing her all the best
Doctor :   Bye for now
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