Ulcerative Colitis and Crohn's Disease

Ulcerative colitis (UC) and Crohn's disease (CD) are inflammatory bowel diseases. In UC the lining of the colon and rectum can be involved whereas in CD any part of the gut from the lips to the back passage can be affected, with the full thickness of the bowel tube being inflamed. When CD affects the colon it can be very difficult to distinguish from UC. If only the back passage is affected, either by UC or CD then the disease is referred to as proctitis.

In assessing new patients with symptoms of diarrhoea, rectal bleeding and abdominal pain the Institute frequently identifies new cases of inflammatory bowel disease at colonoscopy. These patients are then managed jointly with medical gut specialists (gastroenterologists).

For those patients with severe UC or CD the Institute's surgeons frequently operate on emergency patients who are extremely unwell and not responding to drug therapy; and in a planned, elective fashion for chronic disease, to prevent cancer forming in at-risk UC and CD patients, and to surgically treat narrowings of the gut tube caused by CD (strictures) and for bowel leaks (fistulas) from diseased bowel into neighbouring organs such as skin, vagina or bladder.

Complex surgical procedures such as removal of the colon and rectum with formation of a permanent ileostomy (panproctocolectmy) is routinely performed for CD and for those UC patients who are suitable, ileoanal pouch formation with construction of a "new rectum" from remaining small intestine is regularly carried out.