Male1: We got through an era where we see kids that get bloody diarrhea and we use this term colitis and the gastro people like to use a lot of medicine, but a lot of people are worried if you leave a bowel with ulcerated colitis in, there could be problems down the road. What kind of problems could you get from a bowel that is inflamed for years and years? Is there a chance of maybe something like cancer or something like that?
Male2: Yes, so now you are talking about one of the big forms of inflammatory bowel disease, ulcerative colitis. People get a little colitis sometimes from a virus, a bacteria and they get that. You are talking about a disease that does not go away. It is lifelong.
Male1: And it involves the big or the little--?
Male2: It involves strictly the colon, the big bowel and it is called ulcerative colitis. Ulcerative colitis is a very severe bloody diarrhea with tremendous cramping and the gastroenterologist and pediatrics are very familiar with this condition and diagnosed and they manage it and they treat it. The reason you are asking me about it is partly because lifelong, left alone there is a significant risk of colon cancer which can be very hard to treat in ulcerative colitis. But also sometimes, the medicines just do not work. They cause toxic side effects and they fail to cure the problem and in those cases, those children can be very well served by reconstructive surgery.
Male1: So basically, if you see an area that is where the inflammation is, it is going to get rid of it, is that correct?
Male2: Well, again, you do not jump to operate on this. It is disease managed, but if you operate which you have to take out the colon, traditionally, if you take out the colon, how would a person pass stool so it meant sentencing these young people to a lifelong appliance or stoma. That was fine, they got off their toxic medicines. They got rid of their cancer risk, but they had to deal with the self image of living with an appliance. The modern era, the last 30 years, as colorectal surgeons and a few pediatric surgeons have become expert in reconstructive surgery, so you are able to remove the whole colon and do a pull through operation, restore rectal function and live without any stoma.
Male1: And the success rate is pretty high?
Male2: The success rate is 90%.
Male1: Is there such a thing where we can only have a small area involved, not the whole area?
Male2: Ulcerative colitis is a disease of the whole colon. Sometimes, it largely affects the left side, meaning the end, the sigmoid and rectum, but the operation is going to require removal of the whole colon because the whole colon is at risk.
Male1: And once you remove it that risk of cancer is no more.
Male2: Essentially eliminated.
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