Inflammatory Bowel Disease: Intestinal Problems (cont.)
What should be done about polyps in IBD?
Not all polyps that are found in IBD patients are pre-cancerous or cancerous.
Some polyps form as a result of the inflammatory and healing processes. These
polyps are called inflammatory polyps or pseudopolyps, and they do not turn into
cancer. The only way to make sure that polyps do not have pre-cancerous or
cancerous cells, however, is to remove (biopsy) and examine them under the
microscope.
What is toxic megacolon and what are its causes?
Toxic megacolon is a widened (dilated) segment of the colon in a patient with
severe inflammation of the colon (colitis). The megacolon develops when the
lining of the colon is so inflamed that the colon loses its ability to contract
properly. When this happens, the propelling (peristaltic) contractions are
unable to move the intestinal gas along through the colon. The colon, therefore,
accumulates excessive amounts of gas. The gas then increases the pressure on the
bowel wall, which causes the colon to dilate.
Patients with toxic megacolon
usually are very ill, with abdominal pain, bloating (distention), and fever. The
dilated colon can allow bacteria to leak through the bowel wall into the blood
stream (septicemia). With continuing dilation, the inflamed colonic wall becomes
at high risk for bursting (perforating) and causing inflammation of the
abdominal cavity (peritonitis). Both septicemia and peritonitis are serious
infections, which, in some cases, can even lead to death.
Toxic megacolon
typically occurs when inflammation of the colon is severe. This complication,
however, does not occur exclusively in patients with ulcerative colitis or
Crohn's disease. Thus, a toxic
megacolon can develop in other types of colitis, such as amebiasis or bacillary
dysentery (shigella). Narcotics, codeine, or anti-diarrheal medications such as
diphenoxylate (Lomotil) or loperamide (Imodium) can decrease the contractions of
the colon and allow excessive gas to accumulate. These medications, therefore,
predispose to the development of toxic megacolon and should be avoided during
severe episodes (flares) of colitis.
Next: What kind of malabsorption occurs in IBD? »
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