Counseling Crohn's.
Good morning Mr. Smith, I am Dr. Munagapati senior house officer in the department of medicine, I would like to talk to you about your condition. In view of your symptoms, diarrhoea, weight loss, bleeding, abdominal pain, etc., we have do some investigations. I am afraid we have diagnosed a condition called Crohn's disease. It is also called inflammatory bowel disease.
I am going to explain it to you. This means that the lining of the bowel is inflamed and that is why you are experiencing those symptoms. The cause for the inflammation is not known. Unfortunately there is no cure for this condition, but we can definitely offer you treatment to relieve your symptoms.
We are going to start you on some medication. One of them is prednisolone, which will keep the inflammation under control. The other medicines are called sulphasalazine and azathioprine. We will also give you a course of antibiotics called metronidazole, to get rid of any gut infection.
In addition to these drugs you need to be careful with your diet. The dietitian will talk to you as well.
Crohn's control: We will monitor your progress regularly by clinic appointments and blood tests. In some chronic and resistant cases, we sometimes advice surgery. This will involve removing the diseased part of the bowel.
Ulcerative Colitis: (similar counseling)
Surgery: this would involve removing the diseased end of the bowel and performing an ileostomy. This is when the healthy part of the bowel is brought to the outside through a hole in the abdominal wall. This is called a stoma. You will be opening your bowels through the stoma into a bag attached to it. This stoma stays permanently. I can imagine that it sounds horrible, but we have quite a few patients who have a stoma. The stoma nurse will talk to you about it in detail. There wont be any smell and you carry on your daily activities normally. I will give you some leaflets about stoma care that you can go through. You can meet and talk to other patients with stomas.
There is a stoma care helpline as well.