Colectomy Reversal

[Colliewobs]

Hi, I've had a sub total colectomy 18 months ago and I am keen to get it reversed. My problem is that the remaining part from the anus up (roughly 10cm) is still slightly inflamed and the surgeon won't do the op. I am taking 1g Pentasa suppository twice daily, and although this has helped (it was severely inflamed)  I feel I still need to do more.

Has anybody else had this problem? And is there anything anybody can recommend doing myself, or anything I can mention to my doctor on the next visit?

Regards

[Christopher R Watters, MD]

Don't want to be pessimistic but if the inflammation is still that bad it sounds more consistent with Crohn's disease. If that is the case reconnecting things probably won't be feasible. There is a subset of Crohn's where only the colon is involved. Frequently these present in the teen years with perforation and undergo procedures that spare the rectum. It is extremely common that the rectum must ultimately be removed and unfortunately, the time spent waiting for it to calm down resulted in so much scar around the area that muscle flaps must be swung in to fill the space.

[Colliewobs]

Thanks for your reply.
The surgeon has told me the it is reverseable but that the inflammation is too bad at present (18 months after the initial surgeory) and they would be concerned that the pouch wouldn't take. I'm just concerned that the doctors are running out of ideas to get the inflammation down, so I'm looking for ideas that they might not have thought of or tried to get it sorted.

[Christopher R Watters, MD]

If this was UC I assume that this was done emergently for toxic megacolon. UC is usually worse near the anus with less involvement the furyher up you go. Thev option for "reversal" is to remove the lining of the rectum and pull a pouch made from the end of the small intestine through the muscle tube remaining from the rectum. This would not be a good idea if it was Crohn's disease. In Crohn's disease, it is a little unusual to be able to reconnect the rectum. It is more common that it is eventually removed due to ongoing inflammation. A qualified colorectal surgeon should be able to sort this out. What have your doctors told you about being reconnected?

[Colliewobs]

It has never been 100% confirmed from biopsy but they said they were fairly positive it was UC.

[Christopher R Watters, MD]

What is your diagnosis? Is this Crohn's disease or ulcerative colitis?