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Bowel Perforation

Can You Plug Up a Hole in the Bowel?

To appreciate the significance of a bowel perforation, one needs to recall the attention normally given to the discovery of a leak in the household plumbing. You realize any failure to repair the leak will likely result in the loss of a good deal of water. Such realization clearly points out why even a small leak can provoke a certain amount of hesitation.

Causes of a Perforated Bowel

A bowel perforation is analogous to a “leaky bowel.” At the present, the exact cause for a perforation remains in doubt. It’s been hypothesized an irritating substance (most likely a microbe, a parasite, a toxic chemical, or some other environmental agent) eats through the cells of the intestine’s thin inner lining and passes on through the outer wall.

The cells in the outer wall inevitably initiate an immune response to the irritating substance. This immune response leads to the subsequent pain and swelling physicians expect from an internal perforation. Such swelling frequently damages the intestinal cells, and that serves to enlarge and inflame the perforation even further.

A person with a bowel perforation is said to have a form of colitis. Such a patient would typically present with the following symptoms: pain, diarrhea, and weight loss. This patient might also complain about rashes, eye inflammation, or arthritis. Those latter conditions would call attention to the body’s initiation of an immunological response to the irritation initially causing the perforation.

Types of Bowel Perforations

Various types of Colitis exist, with the classification stemming from this simple criterion-at which point along the intestinal tract is the bowel perforation leaking intestinal fluids. Distal colitis has the distinction of being bothersome only to a limited extent because it can be treated with an old-fashioned enema.

A Proctosigmoiditis involves the Rectosigmoid colon (the section nearest the rectum). In many cases, Proctosigmoiditis can also be treated with an enema. An Extensive Colitis, however, presents physicians with a condition that will not respond to this treatment. Patients with Extensive Colitis normally require surgery, possibly involving removal of the bowel perforation.

A diagnosis indicating the discovery of a bowl perforation doesn’t mean the patient should expect to have surgery always. Certain drugs can often treat the inflammation resulting from such a perforation. Physicians have garnered success treating the early stages of bowel perforation with steroids and antibiotics.

Colitis precipitates the need for surgery in other cases as well. If the colitis involves the section of the intestine beyond the splenic flexure (the turn of the colon in proximity to the spleen), it can increase a patient’s risk of developing colon cancer. Ulcerative colitis is one of the three main causes of colon cancer, contributing to the occurrence in the Unites States of 60,000 cases annually of colon cancer that fail to respond to treatment. Futile treatment leads to a loss of life, particularly in patients just over 50 years of age.

Avoiding Bowel Perforation

A definite relationship exists between family history and risk for colon cancer. Hence, a patient with genes predisposing them to colon cancer should exercise extra care if he or she develops any form of colitis. A person with intestinal polyps (a third risk factor) should also take precautions if he or she is diagnosed with colitis.

Various tests for colon cancer can help a patient with a bowel perforation to monitor themselves for symptoms of this disease. For example, a simple test costing less than $10 can be used to detect blood in the stool. Scientists in the Congressional Office of Technology have estimated this test could prevent the onset of 23,000 cases of colon cancers per annum if performed on patients over the age of 65.

The digital rectal exam is another screening test for cancer. Every person over the age of 50 should receive a digital rectal exam each year. For someone with a family history of colon cancer, or for someone who has developed intestinal polyps at any time, the start date should be moved up. For such an individual, health screenings including a rectal exam should begin no later than age 40. Whenever a diagnosis of colitis indicates a higher risk of colon cancer a person should not rely solely on those results. He or she should watch carefully for any telltale signs of colon cancer including blood in the stool, direct bleeding from the rectum, or a sudden change in bowel habits.

When those signs get your prompt attention, the selected treatment usually offers a greater chance for yielding the desired outcome e.g. successful reduction or elimination of the disorder. Treatment for colon cancer improves steadily with each passing year. Perhaps one day, such treatment will be as customary as treating bowel perforation or any other minor health concern.

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