Mr Muti Abulafi

Mr Muti Abulafi
Colorectal surgery
South London


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Mr Muti Abulafi

Colorectal surgeon in
London
Caterham &
Sutton

MB BCh MS (Lond), FRCS (Eng)

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Mr Muti Abulafi areas of expertise:

Professional statement

Mr Muti Abulafi is a highly skilled consultant surgeon with over 30 years' experience in both colorectal and general surgery. He has a special interest in colorectal cancer care and currently acts as lead for the colorectal cancer multidisciplinary team at Croydon University Hospital. His other specialist interests include colorectal and keyhole surgery, colonoscopy, inflammatory bowel disease, pelvic floor dysfunction, and hernia operations. Mr Abulafi takes a keen interest in research, and has published extensively on colorectal cancer and cancer genetics. He is actively involved in training and education, having helped found and establish the annual M25 colorectal course, which teaches trainee surgeons and educates them on all aspects of colorectal surgery. Mr Abulafi is a member of several specialist surgical associations in the UK and Europe and is the current Chair of the Colorectal Cancer Pathway Group at the Royal Marsden Partners Cancer Vanguard.

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Can bowel cancer be prevented?

 Credentials

GMC: ‍3381353

 Professional experience

• More than 30 years of experience
• Consultant General and Colorectal Surgeon, BMI Shirley Oaks Hospital (present)
• Consultant General and Colorectal Surgeon, Spire St Anthony's (present)
• Consultant General and Colorectal Surgeon, Croydon Day Hospital (present)
• Consultant General and Colorectal Surgeon, North Downs Hospital, Surrey (present)
• Consultant General and Colorectal Surgeon & Colorectal Cancer Team Lead, Croydon University Hospital (present)

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 Sub-specialties

• Colorectal cancer
• Inflammatory bowel disease
• Pelvic floor dysfunction
• Colonoscopy
• Laparoscopy (keyhole surgery)
• Hernia operations

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 Positions in public associations

• Chair, Colorectal Cancer Pathway Group, Royal Marsden Partners CancerVanguard
• Past Chair, Colorectal Cancer Pathway Group, London Cancer Alliance (LCA)
• Past Director of Cancer, Croydon University Hospital (2005 – 2012)
• Past Chair of the SWL Colorectal Tumour Working Group
• Past member, Specialised Colorectal Clinical Reference Group, NHS England (2010 – 2015)
• Past Member, research and audit committee, Association of Coloproctology of Great Britain and Northern Ireland
• Past Member, London Zone Cancer Peer Review reference group
• Member, London Cancer Project Expert Panel for Common Cancers and General Care (2011)

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 Education

• MS, University of London, UK (1993)
• FRCS, Royal College of Surgeons, London, UK (1988)
• FRCS, Royal College of Physicians and Surgeons, Glasgow, UK (1988)
• MBBCh, University of Cairo, Egypt (1980)

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 Prizes and awards

• BJS (British Journal of Surgery) prize for best SRS (Surgical Research Society) published research paper (1995)
• Honours, University of Cairo (1980)

 Professional membership

• Fellow of the Royal College of Surgeons of England
• Association of Surgeons of Great Britain and Ireland
• Association of Coloproctology of Great Britain and Ireland
• Association of Laparoscopic Surgeons of Great Britain and Ireland
• European Association of Endoscopic Surgeons
• Royal Society of Medicine

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Languages spoken

  • English
  • Arabic

Patient reviews for Dr. Muti Abulafi

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All reviews are from verified patients booked through Top Doctors.

Patient reviews

Verified Patient
17/01/2018

Would you recommend this doctor?

  • Bedside manner
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Verified Patient
05/12/2017

Would you recommend this doctor?

  • Bedside manner
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  • Wait time
  • Facilities conditions

Patients comments

Sensitive, compassionate, informative and a listener. highly recommended.

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Diseases, Medical Tests and Treatments

Colonoscopy

What is a colonoscopy? A colonoscopy is a type of endoscopy that is used to examine the colon and small intestine in order to detect any abnormalit ...

Colorectal cancer

Colorectal cancer begins with a polyp that develops in the colon or rectum. When this polyp is covered with adipose tissue it can change into an adeno ...

Hernia

A hernia appears as a lump, most commonly in the abdominal or groin area. The occur when an organ, often the bowel, protrudes through the cavity which ...

Inflammatory bowel disease (IBD)

Inflammatory bowel disease (IBD) is used to refer to chronic diseases affecting the intestine. the most common are Crohn’s disease (CD) and ulcerative ...

Laparoscopy

Laparoscopy is a surgical technique used to inspect the abdominal cavity, allowing the surgeon not to make large incisions. During the procedure, a laparoscope,  which is a tube containing an optical system coupled with a light source, is inserted into the abdomen. The camera allows the doctor to inspect the pelvic organs from a monitor and, if necessary, to introduce other instruments through the same laparoscope to correct a problem. The advantages of laparoscopy are many, such as the patient requiring shorter hospitalisation and recovery time, fewer chances of infectious complications, less postoperative pain and no visible scars. Laparoscopy is used primarily in processes such as prostate cancer or some kidney diseases. ...

Rectal prolapse

What is rectal prolapse? A rectal prolapse is when part of the rectum protrudes through the anus. The rectum is at the end of the large bowel and is where the faeces collect before passing through the anus as a bowel movement. The rectal is made up of three layers, the rectal wall lining (mucosa), a layer of muscle (muscularis propria) and a fatty tissue that surrounds the rectum (mesorectum). If the wall of the rectum sticks out through the anus, it is a rectal prolapse. What are the types of rectal prolapse? The three types of rectal prolapse are: Full-thickness rectal prolapse – which is the most common type and is when the wall of the rectum sticks out through the anus. Mucosal prolapse – when the lining of the rectums protrudes through the anus. Internal rectal prolapse – the rectum folds in on itself but does not stick out of the anus. What are the symptoms of rectal prolapse? A lump or swelling coming out of the anus may be noticeable when having a bowel movement. If the prolapse gets worse, it could also protrude when coughing, sneezing or standing up. If the prolapse is an internal rectal prolapse, it may not feel like the bowels are fully emptying. Other symptoms of a rectal prolapse include: Difficulty in controlling bowel movements Blood Discomfort An ulcer What causes rectal prolapse? A rectal prolapse is often associated with weak muscles in the pelvis. These are triggered by pregnancy, constipation, diarrhoea and a lot of coughing due to conditions such as cystic fibrosis or whooping cough. As women age, a rectal prolapse can happen at the same time as a prolapsed uterus or bladder. The pelvic floor muscles weaken over time or weaken after having given birth. How to diagnose rectal prolapse A rectal prolapse is diagnosed following a rectal examination. Further tests may be needed, which may include a proctography, colonoscopy or endoanal ultrasound.   How is rectal prolapse treated? In children, rectal prolapse usually gets better without any treatment. Adults are recommended to treat constipation by eating high-fibre foods or taking laxatives. Surgery may be offered with the type of surgery depending on the type of prolapse, the patient’s age and a history of medical problems. There are two types of surgery.   Abdominal surgery – involves making a cut into the abdomen and is only used for full-thickness prolapse. Perineal surgery – involves cutting the prolapse itself and is generally performed on older people. ...

Anal abscess

Anal abscess is an infection of perianal cavities that causes inflammation of the anal canal. The main symptom is an intense and sharp pain in the anus when sitting, defecating and even coughing or sneezing. If the timeline of the infection is extended, the patient may develop fever and other symptoms of sickness. There are several causes such as diarrhoea, trauma, anal fissures or skin wounds from sexual intercourse.   ...

Anal fissure

What is an anal fissure? An anal fissure (fissures) is a tear or crack in the lining of the anal canal (anus), which causes extreme pain during bowel movements. Anal fissures affect everyone, from men and women to young and old people. It is the most common cause of rectal bleeding in infancy. A fissure tends to occur when passing hard or large stools during a bowel movement. There may also be spasms in the ring of muscle at the end of the anus. What is the cause of an anal fissure? Common causes of an anal fissure include passing large stools, constipation and straining during bowel movements, chronic diarrhoea, inflammation of the anorectal area and childbirth. The less common causes of anal fissures include anal cancer, HIV, tuberculosis, syphilis and herpes. What are the symptoms of an anal fissure? The symptoms of an anal fissure include: Pain, which can sometimes be severe during bowel movements Pain after bowel movements Blood on the stool or toilet paper Itching or irritation around the anus A visible crack in the skin around the anus A small lump on the skin near the anal fissure How is an anal fissure treated? An anal fissure will often heal within a few weeks if the stool is kept soft through increasing the intake of fibre and fluids. Soaking in a warm bath for 10 to 20 minutes daily, especially after toilet use, helps to relax the sphincter and helps it to heal. A doctor may recommend topical anaesthetic creams for pain relief. A Botox (Botulinum toxic type A) injection can paralyse the anal sphincter muscle and aids in relaxing spasms. Blood pressure medications can also help relax the sphincter. How to prevent an anal fissure? By preventing constipation it may help in preventing an anal fissure. Constipation can be prevented when eating high-fibre foods, drinking water and regularly exercising to stop from straining during bowel movements. Risk factors for developing an anal fissure Infancy – experts are not sure why but many infants experience an anal fissure during the first year of their life. Aging – as an adult ages there is a decrease in circulation and blood flow to the rectal area. Constipation – straining when trying to pass hard stool can increase the risk of tearing. Childbirth – anal fissures become common in women after they give birth. Crohn’s disease – the inflammatory bowel disease causes chronic inflammation of the intestinal tract and this makes the lining of the rectum vulnerable to tearing. Anal intercourse.  ...

Anal fistula

What is an anal fistula? An anal fistula is small channel or tunnel that develops between the end of the bowel and the skin near the anus (i.e. where stool leaves the body). These can result in bleeding when passing stool and cause pain and discomfort. Often anal fistulas won’t get better on their own and will usually require treatment. Surgery is a common recommendation for treating anal fistulas. What are the symptoms of an anal fistula? The most common symptoms of an anal fistula are: pain where the fistula is, which can be made worse when sitting down or passing stool passing pus or blood  skin irritation around the anus fever What causes an anal fistula? Anal fistulas are usually a result of an anal abscess that has not healed properly. When an anal abscess has not healed properly, the pus has drained away, but leaves a channel or tunnel behind. It is common for an anal abscess to result in anal fistula. Other causes of anal fistulas include: surgical complication near the anus Crohn’s disease diverticulitis What is the treatment for an anal fistula? As anal fistulas usually do not heal on their own, surgery is often required. There are numerous types of surgery, including: Fistulotomy – the length of the fistula is cut open so that the contents can be removed. Once healed, a flat scar is left behind. Seton procedures – surgical thread (a seton) is placed into the fistula and left there for a few weeks. This helps it to heal before another procedure is performed to treat it fully. Fibrin glue – a non-surgical treatment option that involves glue being injected into the fistula to seal the channel, with the opening stitched shut. However, long-term results with this procedure are not as successful with further surgery being required in many cases. Flap procedures – often used in more complex cases, a piece or flap of tissue from skin around the anus is removed. The fistula tract is also removed and the flap if reattached where the fistula opening was. ...

Anal fistula surgery

What is anal fistula surgery? An anal fistula is a tunnel or channel that develops between the skin near the anus and the bowel. This can have a number of unpleasant symptoms, and surgery, known as anal fistula surgery, is often undertaken to correct this. It is performed under general anaesthetic. Why would you do it? Anal fistula surgery is usually needed to treat anyone suffering from an anal fistula as they are unlikely to heal on their own. Anal fistulas are normally the result of an abscess around the anus, which when drained of the pus, leaves a small channel behind it. Anal fistulas can be extremely unpleasant, and often cause discomfort. Surgery is nearly always required. What does it involve? Anal fistula surgery is carried out under general anaesthetic. There is more than one possible procedure and the most suitable will depend on individual cases. Fistulotomy: A fistulotomy involves cutting the fistula open and allowing it to heal as a flat scar. This is the most common form of surgery. This is the best choice of treatment for fistulas that don’t pass through the sphincter. If the anal fistula does pass through the sphincter, then there is an increased risk of incontinence with a fistulotomy and other procedures might be preferred. Seton techniques: A seton is a piece of surgical thread that can be inserted into the fistula to keep it open. This can be deployed to keep the fistula open for several weeks, allowing it time to drain and heal thus avoiding the need to make an incision. Although this allows the fistula to heal, it does not cure it. To cure the fistula, it may be necessary to have numerous, tighter setons inserted to gradually cut through the fistula. Advancement flap procedure: This involves covering the entrance of the fistula to the bowel with a flap of tissue from the rectum. This procedure means that the muscles around the anal sphincter do not need to be cut. How to prepare for it Leading up to the surgery, it might be necessary to stop taking certain medications. It is also likely that you will need to empty your colon with either a laxative or an enema before surgery. You will also need to stop eating and drinking a certain period prior to surgery. It is recommended that you have someone to drive you home after surgery. Post-operative care It is to be expected that there will be some bleeding and pain with your first bowel movement after surgery. It can help to make this less painful by adopting a high-fibre diet and taking stool-softeners the first few days after surgery. Most patients will return to normal activities 1 to 2 weeks after surgery, but it will taken several weeks or a few months for the fistula to fully heal, depending on the individual case. Here are some key post-operative care things to do after having anal fistula surgery: Keep active – try to walk a little each day. Diet – eat a high-fibre diet daily. Stay hydrated Painkillers may be prescribed for the first couple of weeks. Keep the area operated on clean – warm baths are recommended. ...

Bowel incontinence

What is bowel incontinence? Bowel incontinence describes a loss of control over bowel movements, leading to the patient unintentionally soiling themself. It is thought that as many as one in ten people will experience some degree of bowel incontinence in their lifetime, and is nothing to be ashamed of. It is usually symptomatic of another problem or underlying condition, and is not a normal part of ageing. It usually won’t just go away on its own, but it can be treated effectively, and often cured, so it is always best to consult your GP or a specialist.   What are the symptoms of bowel incontinence? Bowel incontinence itself is usually a symptom, not a diagnosis. It may occur as a sudden need to go to the toilet, but the patient may not make it in time (urge bowel incontinence). However, other patients have no warning before they soil themselves, feeling no sensation as the stool passes (passive incontinence/passive soiling). Passing wind may also cause slight soiling.   What causes bowel incontinence? Most cases of bowel incontinence are brought on by bouts of diarrhoea, or conversely, constipation. Another common cause is weakening of the anal sphincter (the ring of muscle that opens and closes the anus). Long-term causes, such as diabetes, multiple sclerosis, spina bifida, and even dementia can also cause bowel incontinence.   How can it be prevented? Maintaining a healthy diet and lifestyle can help to reduce the chances of getting diarrhoea or constipation, which are the leading causes of bowel incontinence. This can also stave off type 2 diabetes. However, there is no guarantee of preventing these problems, and there is nothing that can be done to prevent causes such as MS or dementia.     What is the treatment? Luckily, bowel incontinence is highly treatable, enabling most patients to maintain normal bowel function for the rest of their lives. Different treatments include: Exercises to strengthen the bowel muscles and anal sphincter. Dietary and lifestyle changes – a healthier diet and lifestyle can prevent diarrhoea and constipation. Medication can also treat diarrhoea and constipation, depending on the cause. There are various surgical options. Incontinence products, e.g. anal plugs, incontinence pads, etc. can help to manage the symptoms until you regain some control In many cases, incontinence can be cured, but even if not it is usually possible to improve bowel control to some degree, and significantly improve the symptoms. ...

Colitis

What is colitis? Colitis refers to the inner lining of the colon becoming inflamed. Colitis can be a symptom of a disease that affects other parts of the body, which causes fevers, chills, fatigue and dehydration. There are many types of colitis that are usually classified by the cause of each one. The two most common types include ulcerative colitis and Crohn’s disease, which are types of inflammatory bowel disease (IBD). Ulcerative colitis causes other manifestations in the body, which include mouth ulcers, swelling of the joints and skin inflammation. What are the different types of colitis? The types of colitis are categorised by what causes them. Some of the different types include:   • Ulcerative colitis and Crohn’s disease – these two types of colitis are classified as inflammatory bowel disease. Ulcerative colitis occurs when the immune system overreacts to bacteria in the digestive tract. It begins in the rectum and spreads to the colon. • Pseudomembranous colitis – this type of colitis occurs from the overgrowth of a bacteria known as Clostridium difficile. Normally found living in the intestine, this bacteria does not usually cause problems because of the balance with the good bacteria. Clostridium difficile takes over when medications such as antibiotics destroy the good bacteria. The toxins that are released cause inflammation. • Ischemic colitis – this occurs when the blood flow to the colon is cut off or restricted. What causes colitis? The most common causes of colitis include:   • Infections or viruses • Loss of blood supply • Chronic diseases • Allergic reactions What are the signs of colitis?   The symptoms of ulcerative colitis may include: • Diarrhoea • Abdominal pain and cramps • Rectal pain • Rectal bleeding – experiencing a small amount of blood in the stool • Desperate to use the toilet • Inability to defecate even though there is a feeling of urgency • Weight loss • Fatigue • Fever How is colitis diagnosed? A physical examination by a specialist helps to determine the cause of a patient’s symptoms. The doctor will take the patient’s blood pressure and check their temperature for fever. There is an examination of the abdomen to check if there is a feeling of tenderness. Bowel sounds are listened to through the use of a stethoscope. A blood test can measure haemoglobin and haematocrit levels to check for anaemia. Stool samples may also be collected to search for bacterial and parasitic infections as the cause of colitis. The stool may be tested for blood too. How is colitis treated? The treatment of colitis depends on how bad the disease is within the individual patient. Treatment usually involves a change in diet, nutritional supplements and medication being prescribed. In severe cases, surgery may be required. Mild colitis responds to medicines such as steroids and anti-inflammatories. More severe symptoms will require stronger medication such as immunomodulator medicines, which suppress the immune system to prevent inflammation. Surgery may be required to remove the large intestine, however this can cause other problems in different areas of the body. Foods to avoid: • Alcohol and fizzy drinks • Caffeine • Dairy products • Raw fruits and vegetables • Legumes Foods to incorporate into the diet: • Omega-3 fatty acids (found in salmon) • Probiotics (kefir) • Iron-rich foods (green vegetables) • Turmeric • Folate-rich foods ...

Colon cancer

Colon cancer is the proliferation of malignant cells in the colon, which, along with the rectum, is in charge of storing faeces which are then expelled through the anus. Its causes are determined by genetics, sedentary lifestyle and previous illnesses such as polyps, ulcerative colitis and other cancers. The most obvious symptoms of the disease become visible when the disease is advanced: alternating between diarrhoea and constipation, blood in the stool, abdominal pain, loss of appetite, weight loss and fatigue. If detected early there is a good chance of cure, with the most common treatments being radiotherapy, chemotherapy, immunotherapy to strengthen the body's defences, and surgery. ...

Colorectal cancer surgery

What is colorectal cancer surgery? Colorectal cancer, also known as bowel cancer, is the cancer of the large intestine (colon). The large intestine makes up the end of the digestive tract, and cancer usually starts as a cluster of cells called polyps. Not all polyps are cancerous, and therefore it is important to closely monitor them and have them removed before they become cancerous. Colorectal cancer surgery involves the removal of the cancerous part of the colon, which is known as a colectomy. Depending on what stage the cancer is at, surgery can range from minimally-invasive polyp removal, to the removal of both the colon and rectum. Depending on the type of surgery, local or general anaesthetic will be used. If colorectal cancer is identified early on, surgical treatment can often cure the cancer and prevent it from returning, however, this is not always possible. Surgery is often combined with other treatments such as chemotherapy and radiotherapy. What causes colorectal cancer? Exact causes of colorectal cancer are unknown, however, there are associated risk factors that can increase the likelihood of developing it. These include: Age – people over the age of 60 are more likely to be diagnosed with colorectal cancer. Family history – if a direct relative has had colorectal cancer, chances of developing colorectal cancer are increased. Smoking & alcohol Diet – evidence has suggested that diets containing large portions of red meat have an increased chance of colorectal cancer developing. Obesity Digestive disorders – people suffering chronically from disorders such as Crohn’s disease are more likely to suffer from colorectal cancer. Genetic conditions – there are genetic syndromes that increase the number of polyps formed, increasing the chance of these polyps becoming cancerous over time. These syndromes are called familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC). What does surgery involve? Surgery for early-stage colorectal cancer usually involves the removal of a small section of the colon lining. This is called a local excision. However, if the cancer has spread into the surrounding muscle, a whole section of the colon will need to be removed. This is called a colectomy. Colectomies can be carried out in the following ways: Laparoscopically – a special instrument is guided by cameras through small incisions in the abdomen. Robotically – keyhole surgery carried out by a special robotic instrument. Open surgery – a large incision is made in the abdomen so that part of the colon can be removed. Whilst surgery is carried out, it is common for nearby lymph nodes to be removed as well and will be tested for cancer. During a colectomy, the surgeon will reconnect the healthy parts of the colon. If these cannot be reconnected, then the surgeon will have to carry out stoma surgery. This diverts the faeces away from the colon towards an opening in the abdomen and into a stool bag that is fitted to the opening. The stoma will either be temporary or permanent, depending on how well the colon heals after surgery. How to prepare for surgery Depending on the type of surgery, you might be required to a follow a special diet before surgery, or to empty your bowels. On the day of surgery, you won’t be able to eat or drink. It is common that prior to surgery you will be given a dose of antibiotics to prevent the possibility of infection. If you are going to have a stoma, then you will have met a stoma specialist to explain how they work. Post-operative care Immediately after surgery, the care team will try to get you moving to prevent blood clotting. It is common to expect some pain and nausea. Patients can generally return home in around three to seven days after surgery, and a check-up appointment would be booked in to discuss recovery and any further treatment required. ...

Crohn's disease

What is Crohn’s disease? Crohn’s disease is a type of chronic inflammatory bowel disease (IBD) that can affect any part of the digestive tract from mouth to anus, but is most commonly found at the end of the small intestine, where this meets the colon (large intestine). It is characterised by inflammation, which is often severe and can be debilitating, and may extend through the whole width of the bowel wall.   Prognosis of Crohn’s disease Crohn’s is a chronic condition, meaning long-term. There is currently no known cure for Crohn’s disease, although existing therapies make it manageable and can cause the disease to go into remission for years at a time. Flare-ups still occur periodically, however, and can make life difficult.   Symptoms of Crohn’s disease When Crohn’s disease is active, typical symptoms include: Diarrhoea Abdominal pain (stomach aches, etc.) Blood in the stool Fatigue Weight loss Reduced appetite Mouth sores Fever Symptoms can range from mild to severe, and usually develop gradually, but may come on in sudden attacks. In severe cases, Crohn’s can also affect other parts of the body, including inflammation in the joints, the liver, the skin, and the eyes. Crohn’s can start at any age, but symptoms usually first manifest in late childhood and early adulthood, with the majority of cases being diagnosed before the age of 30. It often occurs in flare-ups, which may go into remission with treatment, but will flare up again weeks, months, or even years later.   What are the causes of Crohn’s disease? The causes of Crohn’s disease are currently poorly understood, but a great deal of research into the illness is being carried across the world and experts are continuing to learn a lot about its mechanisms and possible causes. The leading theories are that it is caused by a combination of some of the following factors: Genetics – it is thought that some people are born with genes that predispose them to the development of Crohn’s Autoimmune – many experts believe that Crohn’s is an autoimmune disease; that is, the immune system mistakenly attacks cells in the digestive system as if they were invading bacteria or viruses. Gut bacteria and antigens – it is possible that certain bacteria or the antigens they produce may trigger the autoimmune response. Another theory is that an imbalance in gut bacteria may have a more direct effect on the development of Crohn’s. Current research indicates that, whatever the mechanism, bacteria seem to be relevant. Other risk factors that may contribute include: Smoking Previous stomach bugs Living in an urban environment Family history, i.e. relatives that also have Crohn’s   Treatments for Crohn’s disease While Crohn’s disease cannot be cured, there are treatments to reduce and control the symptoms. Sometimes, these treatments can be enough to send the disease into periods of remission. Typical treatment options include: Various anti-inflammatory medication, including certain steroids. The type prescribed will depend on the patient and on the severity and location of the inflammation in the digestive system. Immune system suppressors may be prescribed to reduce inflammation by targeting the immune system, which makes the substances that cause inflammation. Surgery may be the best option – by removing part of the tissue in the digestive tract, and reconnecting the healthy sections, the inflammation can be removed. However, this does not eliminate the chances of recurrence; surgery usually offers a temporary solution in severe cases of the disease.   Which type of specialist treats Crohn’s disease? Gastroenterologists treat all kinds of inflammatory bowel disease, including Crohn’s disease and ulcerative colitis. Colorectal surgeons are usually responsible for performing operations to treat IBD. ...

Diverticular disease

  Diverticular disease is characterized by the presence of diverticula in the colon wall, due to an increase in intraluminal pressure. Diverticula are pockets that usually form on the left side of the colon walls, although it can occupy the entire colon. When an increase in intraluminal pressure produces a pulse of the muscosa occurs through colonic muscle layers in their weak points, which correspond to the points where the neurovascular bundles penetrate. In most cases, diverticular disease have no symptoms, and only when there is bleeding or complications may appear diverticulitis. Diverticulitis (that is infection of the diverticula) in turn can cause abdominal pain, fever and chills. More serious complications can even cause an ruputura or fistulae that require surgery. The treatment of diverticular disease is essential and based on regular consumption of dietary fiber. In the case of diverticulitis, treatment should be done by antibiotics (oral or intravenous), restrictions on food and stool softeners. ...

Diverticulitis

  What is diverticulitis? Diverticulitis is a condition affecting the large intestine, or bowel. It is closely related to another condition affecting the bowel, called diverticular disease. Diverticulitis is more likely to occur in those who do not get enough fibre through their diet.   What causes diverticulitis? As we get older, small pockets or bulges called diverticula may develop in the lining of the intestine. These do not often cause symptoms and can go entirely unnoticed, but when they do cause symptoms, this is referred to as diverticular disease. Once symptoms become more severe, and the diverticula become infected, or inflamed, this is referred to as diverticulitis. What are the symptoms of diverticulitis? Diverticulitis symptoms include: Severe, constant tummy pain Feeling sick/vomiting Fatigue (feeling tired) Blood in your stool Rectal bleeding A high temperature (over 38 degrees Celsius) If you experience symptoms of diverticulitis, without any previous diagnosis of diverticular disease, you should contact your GP as soon as possible. If you have a previous diagnosis of diverticular disease the symptoms can be managed and treated from home. However, if you notice bleeding, or are experiencing severe pain, it is best to seek medical attention. How is diverticulitis diagnosed? Your doctor will take your medical history and make an assessment of your symptoms. This is because they will want to rule out other conditions which can display similar symptoms, such as IBS (irritable bowel syndrome), or bowel cancer. The doctor may also take blood tests and refer you for a colonoscopy or CT scan. What is the treatment for diverticulitis? Diverticulitis is most commonly treated at home using medication to relieve symptoms of pain, and antibiotics. In more severe cases, diverticulitis can be treated at the hospital so the doctor can monitor your progress and symptoms. Treatment in hospital may involve antibiotics administered through injections, and an intravenous drip to provide hydration and nourishment. If you have already been diagnosed with diverticular disease, a high-fibre diet may help to ease any symptoms you experience with the condition. The ideal amount of fibre for an adult is 30g per day, and your doctor will discuss targets and ways to include fibre in your diet. In more extreme cases, diverticulitis can be treated with surgery. This type of treatment is rare, and it involves removing the affected section of intestine. However, before any type of surgery, your surgeon will discuss the benefits and risks implied. ...

Fistula

A fistula is when a connection forms between an organ and another structure, and usually develop when an organ becomes inflamed or injured. Fistulas are very common in people who suffer with Crohn’s disease, an inflammatory bowel disease, with around 35% of people with Crohn’s disease having at least one fistula.   What are the different types of fistula?   Fistulas can appear in numerous places in the body, but they are most commonly found around the anus. These kind of fistulas are called perianal fistulas. Another common form of fistula is the kind that develops between loops of intestine. Fistulas can also form between the rectum and vagina, between the intestine and the skin, between the intestine and the bladder, between the trachea and the oesophagus, and in other places.   What causes a fistula?   Fistulas can form in a number of different ways, depending on the type of fistula and the position. With anal fistulas, they most commonly form because of an anal abscess. If the abscess hasn’t healed properly, it can lead to the development of a fistula. It is estimated that up to 50% of people with an anal abscess can then go on to develop a fistula. Fistulas that form in the digestive tract can do so following surgery, radiation therapy for cancer, or due to a traumatic injury. Some diseases can also cause fistulas such as STIs and diverticulosis. Some fistulas such as tracheoesophageal fistula (TOF) can form in the baby during pregnancy.   How are fistulas treated?   Fistulas can often be repaired with surgery. The appropriate medical professional will diagnose the fistula and decide on the best course of action, depending on the kind of fistula and the position. Another way of treating a fistula is with a catheter used to drain the fistula. These are usually used on small fistulas to control infection. Fistulas may also be repaired with a kind of glue called fibrin glue, which can be adopted to seal the fistula where appropriate. A plug can also be used to fill a fistula. The symptoms of a fistula may be managed with medication in some cases, and to treat infection caused by a fistula. Treatment for most kinds of fistula is fairly successful. ...

Haemorrhoid surgery

Hemorrhoid surgery (piles) is surgery that is done to treat the veins that have been swollen or expanded around the anus. Hemorrhoid surgery is indicated when the patient has itching in the anus, anal bleeding, pain or gore. Piles operation can be carried out using different techniques, the most common is the hemorrhoidectomy, which involves removing hemorrhoids and leave the area sterile gauze to slow the bleeding. Another method is stapled hemorrhoidopexy (also called PTT or Longo method) which involves inserting a mechanical seaming anal rectal excising the excess tissue and, simultaneously, the mucosa with metallic suture points and hemorrhoids are repositioned in his natural position. There is also a surgical procedure to cure hemorrhoids that does not involve the removal of tissue: dearterialization guided transanal hemorrhoidal doppler (THD method), a minimally invasive and virtually painless technique that involves locating, with a Doppler probe and suture the hemorrhoidal artery that carries blood to hemorrhoids. In the same operation, mucosal prolapse has been placed on your site. ...

Inguinal hernia

What is an inguinal hernia? A hernia occurs when part of the internal organs or tissue pushes through a weakness in the muscle wall. An inguinal hernia is said to occur when part of the bowel or fatty tissue pushes into the groin at the top of the thigh. It is also the most common type of hernia, particularly in a male. Inguinal hernias are rare in females. What are the symptoms of an inguinal hernia? Symptoms of an inguinal hernia are a swelling or a lump in the groin or an enlarged scrotum. There may also be associated pain or discomfort, pain when coughing or lifting, or a dragging sensation in the groin. A bulge either side of the pubic bone could also be a sign of an inguinal hernia. The hernia may be pushed back in when lying down, however complications can occur whereby the hernia gets stuck or trapped and obstructs the bowel, or the hernia becomes strangulated, whereby the blood supply gets cut off. This is potentially very serious, even life-threatening and requires immediate attention. Symptoms of a strangulated hernia include vomiting and nausea, fever, sudden pain, a bulge that turns red or purple, or an inability to pass stools or gas. What causes an inguinal hernia? In males the testicles descend during development via a small opening in the groin. This process leads to a weakness in the abdominal wall and is the cause for inguinal hernias. In a boy there is usually a sac which accompanies the testis. Generally it is supposed to close but occasionally the sac remains, leading to a hernia. In adults, undue straining such as heavy lifting, violent coughing or prolonged straining on the toilet may cause the hernia to develop due to the underlying weakness in the groin. Loss of elastic tissue due to the ageing process also leads to inguinal hernias. It is not unusual for hernias to occur in both groins.  How can an inguinal hernia be prevented? Avoiding undue pressure in the abdomen by straining when passing stool or urinating or carrying and moving heavy loads can reduce the risk of an inguinal hernia, however many hernias may be unavoidable as they have no apparent cause. Strain on the abdominal muscles can be reduced by maintaining a healthy weight, eating a high-fibre diet and stopping smoking. What is the treatment for an inguinal hernia? Surgery is the usual treatment for inguinal hernias. In some patients a non-surgical option, such as a hernia truss, may be appropriate. Occasionally it may be appropriate to wait and watch and monitor the hernia. Surgery becomes an emergency for hernias that cause severe pain or that have developed complications. Strangulation, where the bowel has become trapped, is one such complication and it requires immediate treatment to restore the blood supply via surgery.  ...

Itchy bottom

Pruritus ani is a symptom characterized by anal and perianal itching, initially found in the area around the anus, but it can spread to the scrotum and vagina. It may be asymptomatic for a period of time. Anal itching usually occurs at night when the perineal temperature increases, increasing sensitivity to itching. Anal itching can be severe and can lead to injury from scratching. In extreme cases it can cause insomnia and thus, anxiety and depression. Causes of pruritus ani include poor hygiene or excessive cleaning of the area of ​​the anus, and diseases and conditions of the anus (fissures, fistulas, haemorrhoids.), infection of certain bacteria or viruses in the gut, anxiety, dermatological and systemic diseases and reaction to certain foods or antibiotics. ...

Pelvic Floor

The pelvic floor is the set of muscles and ligaments surrounding the abdominal cavity at its bottom. Holding all the pelvic organs (bladder and urethra, uterus and vagina, and rectum) and ensure their normal operation.   The pelvic floor is dynamic, adapting to our movement while still maintaining adequate voltage to hold the organs inside the pelvis. When the pelvic floor is weakened, as problems that can affect urine leakage, discomfort, pain and even the fall of the abdominal organs arise. The pelvic floor is the set of muscles and ligaments that surround all the pelvic organs (bladder and urethra, uterus and vagina, and rectum) and ensure their normal operation. When the pelvic floor is weakened, it can cause problems such as urine leakage, discomfort, pain and even the collapse of abdominal organs. The pelvic floor is the set of muscles and ligaments that surround all the pelvic organs (bladder and urethra, uterus and vagina, and rectum) and ensure their normal operation. When the pelvic floor is weakened, it can cause problems such as urine leakage, discomfort, pain and even the collapse of abdominal organs. ...

Pelvic floor reconstructive surgery

What is pelvic floor reconstruction? Pelvic floor reconstruction is a surgical procedure involving the repositioning of the internal organs of the female pelvis.   Why is it done? The goal of pelvic floor reconstruction is to position pelvic structures in a manner that corrects urinary and/or faecal incontinence, pelvic disease and pelvic symptoms while preserving sexual function. What does it involve? Pelvic floor reconstruction is performed to achieve correct positioning of the internal organs of the female pelvis: uterus, bladder and rectum. The procedure involves placement of a polypropylene mesh. There are different ways to perform it: vaginal route, abdominal route, laparoscopically (minimally invasive) or a combination of these. The vaginal route is the most common. How to prepare for it Before undergoing pelvic floor surgery, it is advisable to undergo a course of vaginal physiotherapy to strengthen the musculature of the area for the intervention. Post-operative care When performed as minimally invasive surgery, the surgical procedure is shorter and recovery is faster. You can resume your normal routine one week after the operation. If the surgery is performed through the vaginal or abdominal route, your surgeon will advise what type of post-operative care is necessary and how long you will need to rest. ...

Piles (haemorrhoids)

Haemorrhoids, also known commonly as piles, are the dilation of a vein in the rectum or anus. This is a very common and painful condition that is usually caused by constipation, genetic predisposition, being too long standing, or associated with pregnancy. There are two variations of this pathology:external and internal hemorrhoids. The first generate protrusions on the ring on the outside of the anus, so they are easier to diagnose and cause pain when sitting, as well as traces of blood in stool. Treatment consists in applying creams and warm water in the affected area and in cases of severe pain, taking painkillers. On the other hand, internal hemorrhoids occur inside the anus, causing bleeding in the stool and itching in the anal region. If they grow, a surgical intervention may be necessary to remove. ...

Rectal surgery

What is rectal surgery? Rectal surgery covers a large number of procedures used to treat conditions that affect the rectal area and colon. The disorders that rectal surgery addresses include: Haemorrhoids Anal fissures Fistulas Rectal prolapse Colorectal cancer Types of Inflammatory Bowel Disease (IBD) such as Crohn’s disease and ulcerative colitis Procedures that are a type of rectal surgery include: Colectomy Colostomy Endoscopy Colonoscopy Haemorrhoidectomy IBD surgery Resection Internal sphincterotomy Rectopexy Why would you need rectal surgery? Surgery might be recommended for any of the above conditions if other means of treatment have failed, or if the condition is severe enough to require surgical intervention. What does it involve? Colectomy: The removal of some or all of the colon. Segmental colectomy – the diseased section of the colon is removed, and the ends of the bowel are then joined together. Polypectomy – cancerous polyps are removed using a colonscope which is inserted into the rectum, and a loop is passed through the colonscope to remove the polyp. Total colectomy – the whole colon is removed and a new pouch is formed and joined to the anus. Colostomy: Also known as a stoma, a colostomy is an opening connecting the colon to the surface of the abdomen where a stoma is attached to allow the removal of waste from the body. These can either be temporary or permanent. Endoscopy: A tube with a camera at the end is inserted through a small incision in the abdomen, allowing the surgeon access to the abdomen and to perform certain procedures. Often an endoscopy is carried out to remove tumours or to make a diagnosis. Colonoscopy: A tube with a camera at the end is inserted through the rectum, and allows the surgeon to see a camera image of the colon. This procedure is usually carried out for diagnostic purposes. Haemorrhoidectomy: Initial treatments for haemorrhoids are usually non-surgical, however, if these do not provide sufficient relief, then surgery will be recommended. Local anaesthesia is given, and incisions are made around the anus to remove the haemorrhoids. IBD surgery: If the IBD has caused extreme intestinal pain that has resulted in hospitalisation, then surgery may be recommended. Surgery to remove the colon (colectomy) can cure ulcerative colitis, and can provide relief for those suffering from Crohn’s disease. Resection: Broadly, a resection is a procedure that removes diseased sections of tissue or organ. Different resections can treat colorectal cancer and various intestinal issues. Internal sphincterotomy: Used to treat anal fissures, local anaesthetic is applied to the area and where small incisions are made to the sphincter to relieve pressure caused by the anal fissure. Sometimes general anaesthetic is required. This procedure does not cure anal fissures, but allows the muscles to relax, aiding the healing of the anal fissure. Rectopexy: Used to treat rectal prolapse, the procedure repositions the internal structures of the rectum. How to prepare for it Depending on which type of procedure and disorder you have, preparation for surgery will differ. For more intensive surgery, health will need to be monitored and improved before surgery, and often a period of fasting the day before surgery will be required. Post-operative care Recovery from rectal surgery differs depending on the type. Those carried out laparoscopically (keyhole surgery) will often allow same or next day discharge from hospital. Other, more intense surgeries may require a stay in hospital for up to two weeks.  ...

Rectocele

What is rectocele? Rectocele, also known as posterior vaginal prolapse, is a condition in which the tissue wall between the rectum and vagina weakens. This allows the vaginal wall to bulge. Childbirth and processes that put pressure on pelvic tissues can lead to rectocele. Self-care measures are often very effective but severe rectocele may require surgical repair. What are the symptoms of rectocele? A woman may notice pressure within the vagina, or that her bowels do not feel empty after having used the bathroom. In moderate cases, when trying to push the stool out through the anus may push it into the rectocele instead. This can cause pain and discomfort and creates a higher chance of having constipation. It could also lead to pain during sexual intercourse. More severe cases include vaginal bleeding and sometimes the rectocele bulge may prolapse through the vagina mouth or through the anus. Most of the time, many women have a rectocele but do not notice all of the symptoms. What causes rectocele? The commonest cause of rectocele is childbirth, especially if the baby is heavy, or if the birth happens quickly. The muscles, ligaments and tissues in the vagina become stretched and weakened during pregnancy, labour and delivery. If a woman has had more than one vaginal birth she is at a higher risk of developing rectocele. Women who have never given birth can also develop a posterior vaginal prolapse. Rectocele occurs as a result from pressure on the pelvic floor. Increased pelvic floor pressure can be caused by constipation or straining with bowel movements, chronic coughing, repeated heavy lifting or obesity. What are the risk factors of rectocele? The following factors may increase the risk of rectocele: Genetics – some women are born with weaker connective tissues in the pelvic area. Childbirth – delivering more than one child creates a higher risk of having rectocele. Ageing – growing older means naturally losing muscle mass and elasticity. Being overweight – carrying extra body weight causes stress on the pelvic floor tissues. How can you prevent rectocele? To reduce the risk of worsening rectocele, a woman can: Follow Kegel exercises on a regular basis – these movements can help to strengthen pelvic floor muscles. Treat constipation – by eating high-fibre foods and drinking plenty of water. Avoid heavy lifting. Treat chronic coughing. Maintain a healthy weight. When should you see a doctor? Rectocele is a common condition in both women who have had children and those who have not. It is recommended to see a specialist if suffering from chronic constipation and if there is a bulge of tissue that protrudes through the vaginal opening.  ...

Ulcerative colitis

What is ulcerative colitis? Ulcerative colitis is a condition where the large intestine and rectum become inflamed and eventually produce ulcers. It is a type of inflammatory bowel disease, along with Crohn’s disease. Inflammatory bowel disease affects more than 620,000 people in the UK . Can it be cured? Ulcerative colitis is a long-term condition, which means it can’t be cured. Instead, treatment focusses on managing the symptoms, and achieving “remission”, where no symptoms occur. This doesn’t mean that symptoms can’t come back – ulcerative colitis is a fluctuating condition involving “flare-ups” (see below). Symptoms of ulcerative colitis The main symptoms of ulcerative colitis include: diarrhoea, often containing blood stomach pain and rectal pain fequently needing to go to the toilet weight loss fatigue Ulcerative colitis is characterised by “flare-ups”, where symptoms worsen for a period of time, and you can experience symptoms in other parts of the body. These can include: mouth ulcers a high temperature painful and swollen joints irritated eyes Everyone experiences ulcerative colitis differently. With the right treatment and self-management, some people can experience long periods of “remission” where you only experience mild symptoms, or even none at all. Diagnosis Diagnosis will usually involve a combination of: taking a stools sample to rule out other conditions such as an infection or colon blood tests to rule out anaemia or inflammation sigmoidoscopy or colonoscopy to see inside your large intestine Sometimes the doctor might need to do an X-ray to check if there are serious complications, but this is much less common. What causes ulcerative colitis? It’s not clear exactly what causes ulcerative colitis. Many health professionals now think that it could be an autoimmune condition, involving the immune system mistakenly attacking healthy cells. This may be triggered by an infection in the large intestine. However, other factors appear to play a role: you’re more likely to have the condition if a family member has had it having certain genes makes you more likely to have the condition the condition is more common in places with better sanitation Ulcerative colitis therefore seems to be caused by a combination of genetic and environmental factors. Treatment Treatment for ulcerative colitis includes lifestyle and diet changes, medication, and in very rare cases, surgery. Lifestyle changes For some people, making changes to their diet can help control the symptoms and reduce the frequency of “flare-ups”. Some helpful changes can include: Making sure you stay hydrated by drinking plenty of liquids through the day Making sure you have a well-balanced diet with all the vitamins and minerals you need, possibly with the aid of supplements Avoiding foods you have any intolerance to (e.g. avoiding dairy products if you’re lactose intolerant) Eating smaller, more frequent meals, rather than a few large meals Medication Your doctor may prescribe a combination of drugs to achieve different goals, including: Anti-inflammatory drugs such as aminosalicylates and corticosteroids Immunosuppressants usually used to treat flare-ups, or to treat patients who haven’t responded to anti-inflammatory drugs Surgery Surgery is generally only recommended when a patient hasn’t responded to medication, or are experiencing severe flare-ups that significantly affect their day to day life. Surgery will involve removing the colon, and replacing its function with an ileostomoy or ileo-anal pouch. This results in a complete cure of the condition. ...

Umbilical hernia

What is an umbilical hernia? An umbilical hernia is a type of hernia, which refers to when part of the internal organs protrude through a weakness in the surrounding cavity. In the case of an umbilical hernia, abdominal fat or part of the bowel passes through an area around the navel. What are the symptoms of an umbilical hernia? Umbilical hernias are very common, particularly in babies and are characterised by a bulge around the navel that might get bigger when laughing or coughing. They are usually painless in infants and children, however, in adults who develop an umbilical hernia, the swelling may also be accompanied by pain and discomfort. What causes an umbilical hernia? An umbilical hernia develops as a result of a weakness in the abdominal wall at the navel. If the hole through which the umbilical cord passes through during pregnancy doesn’t close properly after birth, it can cause a hernia either at birth or later on in life. In adults, too much pressure in the abdominal cavity can increase the possibility of an umbilical hernia. How can an umbilical hernia be prevented? There is little that can be done to prevent umbilical hernias at birth, however, there are certain risk factors for adults. Anything that increases pressure in the abdominal cavity, such as obesity, straining while moving or lifting heavy objects, a persistent heavy cough, ascites (fluid in the abdomen, and having multiple pregnancies (i.e. twins, triplets, etc.), can increase the risk of an umbilical hernia. What is the treatment for an umbilical hernia? In infants, an umbilical hernia very often clears up on its own – the hernia goes back in and the muscle reseals over it. In adults, an umbilical hernia will generally get worse over time. In most cases, it is advised to wait until a child has reached four of five years of age to see if the hernia disappears before considering surgery, except in cases where the hernia is very large or there are other complications. In most adults, umbilical hernias are treated with surgery to push the abdominal tissue back into place and seal the abdominal wall. Complications can include obstruction where a section of bowel gets stuck outside the abdomen and can cause nausea, vomiting and pain and discomfort. Strangulation, whereby the blood supply to the section of bowel forming the hernia is cut off, is a potentially serious complication and needs emergency treatment to prevent the trapped tissue from dying.  ...

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