Colon transplant surgery..

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You-See
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Date Joined Jan 2013
Total Posts : 419
   Posted 2/1/2013 2:26 PM (GMT -7)   
Question, they can remove your heart, replace your arm, give you a new transplant on almost any organ.. But how come in 2013 the best surgery involving removing the diseased colon (ulcerative colitis) involves leaving a person with a bag on there belly, having to expose of waste in an extremely inhuman way.. Obviously the reason is beyond my knowledge, but my question is, how come they can't remove a diseased colon and replace it with a healthy colon from an organ donar like they would do for other surgeries, anyone know this reasoning?
22 year old male, diagnosed with severe ulcerative colitis on Jan 7th 2013, still remain in flare.. Currently taking Asacol Hd (800mg, 6 pills a day) and Prednisone (20mg, 3 times a day)

MaxMilian
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   Posted 2/1/2013 2:39 PM (GMT -7)   
I think they have tried before (not sure if it was successful or not). Moreover, transplanting a colon may not necessarily prevent UC from coming back (as UC, for many, may be an over-reactive immune system so it'd just attack the transplanted colon as well).

Lastly, if you transplant an organ, you have to keep taking immune supressing drugs (like Imuran). This is one of the maintstream treatments for UC anyway and in lower dosages than someone who has an organ transplant.
2010: DX proctitis, IBS, cecum inflammation
2012: DX Crohns? (mild ulcers on terminal ileum), fructose + sorbitol malabsorption, non-toxigenic c.diff
Things I've Tried: Pentasa (Oral and rectal), Salofalk (Oral), FMTs (5 infusions)
STATUS: Mild ulcers on TI, everything else clear
CURRENT MEDS: Pentasa supps 1g per 2 days, Oral Pentasa 3g per day

iPoop
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Date Joined Aug 2012
Total Posts : 11046
   Posted 2/1/2013 2:39 PM (GMT -7)   
Well, the problem isn't the organ rather it is the immune system. If you put a healthy colon in one of us, our immune system would still attack the new colon, and probably more fiercely than it would our original one. Any people, after receiving an organ transplant, has to be on immunosurpressants to stop the body from attacking a donor organ as it is identified as a foreign object.
34; Flaring since 1/1/2013 w/6 daily bms
Rx: Daily 40mg Prednisone, 50mg 6MP, Lialda, and Rowasa w/ no supplements or diet mods.
Dx: 2-2012 ulcerative proctosigmoiditis

notsosicklygirl
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Date Joined Dec 2008
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   Posted 2/1/2013 2:39 PM (GMT -7)   
You can have your colon removed and not have a bag. Look up j-pouch. It's not like living with a colon though, you will go more times daily than a person with a colon but it gives you the ability to remove the UC without having an external appliance.
Co-moderator: Ulcerative Colitis
Diagnosed with Pancolitis, Laryngopharyngeal Reflux & Migraines. Battling Extreme Exhaustion.
Currently: 6mp (25mg) + Lialda (2400mg) + Canasa (1g PM)

You-See
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Date Joined Jan 2013
Total Posts : 419
   Posted 2/1/2013 2:42 PM (GMT -7)   
Ahhhh, I see, the immune system part of it makes sense.. I figured the surgery had to of been attempted before without a good outcome, just wasn't sure the depth of it all
22 year old male, diagnosed with severe ulcerative colitis on Jan 7th 2013, still remain in flare.. Currently taking Asacol Hd (800mg, 6 pills a day) and Prednisone (20mg, 3 times a day)

You-See
Regular Member


Date Joined Jan 2013
Total Posts : 419
   Posted 2/1/2013 2:43 PM (GMT -7)   
Yeah I've heard about the j pouch, but it seems the go-to surgery is the bag, and both still have its complications
22 year old male, diagnosed with severe ulcerative colitis on Jan 7th 2013, still remain in flare.. Currently taking Asacol Hd (800mg, 6 pills a day) and Prednisone (20mg, 3 times a day)

uc-logic
Regular Member


Date Joined Oct 2010
Total Posts : 160
   Posted 2/1/2013 3:13 PM (GMT -7)   
iPoop is completely right, this is the whole reason they don't do it, they can but it doesn't make much sense does it.
Diagnosed Feb 2010
Started Remicade March 5th 2012
Multi Vitamins

Been on: Asacol, Sulfasalazine, Prednisone, Imuran

SouthernGirl6
Regular Member


Date Joined Dec 2012
Total Posts : 399
   Posted 2/1/2013 3:18 PM (GMT -7)   
I googled this myself just a few weeks ago. Makes sense about the immune system though
Centrum Chewable Multivitamin, Pomegranates & Pomegranate Juice
28 years old and have had UC 13 years

garylouisville
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Date Joined Aug 2012
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   Posted 2/1/2013 3:50 PM (GMT -7)   
That's why it is an autoimmune disease and just healing the colon doesn't work. That's why when on meds that suppress the immune system the colon can heal but when you get off the meds you start flaring again.
Asacol 400mgs 2 pillsX3; VSL#3 112.5mgs 1 pillX3; Vitamin D3 5000 ius 1 pillX2; B6 1/day; Bentyl & Swanson DAO with meals; Slippery Elm at bedtime

Discontinued: Robinul; Natural - peppermint oil, Inflaguard (Boswellia), Pepto Bismol, Omega 3 fish oil, Imodium, Beano, Zymactive, Renew Life Probiotic 80 billion, Florastor, DGL, Monolaurin

Christine1946
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Date Joined Aug 2008
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   Posted 2/1/2013 6:03 PM (GMT -7)   
     Well, I was on immunosuppressant drugs and they didn't stop me from flaring one iota.  Odd thing, this topic....when I had my operation, the only disease I had was ulcerations in the rectum.  For the entire twelve years I suffered with UP...it never traveled further into my colon!  The only problem in my colon was just minor diverticulosis and I was 63 at the time of my operation.  It was kinda sad the idea of taking out a relatively good colon, but when the rectum goes due to UP, so must the colon sad .  So, I just bid adiou to it and live with my "bag"...just as happy as a lark to be free of that diseased rectum tongue , and off all those powerful meds.

You-See
Regular Member


Date Joined Jan 2013
Total Posts : 419
   Posted 2/1/2013 6:13 PM (GMT -7)   
Makes plenty of sense
22 year old male, diagnosed with severe ulcerative colitis on Jan 7th 2013, still remain in flare.. Currently taking Asacol Hd (800mg, 6 pills a day) and Prednisone (20mg, 3 times a day)

Probiotic
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Date Joined Mar 2007
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   Posted 2/1/2013 6:47 PM (GMT -7)   
I suspect eventually- eg a few decades or a bit more (guessing timelines fior such things is a fool's errand but it will happen eventually,one can safely say) they will be able to clone body parts using the recipients own stem cells, so a transplant of ones own fresh, unused colon without the need for anti-rejection meds would be possible... That would in theory dovetail with advanced future treatments to switch off the immune attack while replacing the damaged part. But that is going to be way too late for most of us.
"In order to save the village organ, we had to destroy remove it" -- Doctor's Prescriber's proverb.

summerstorm
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Date Joined Aug 2006
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   Posted 2/2/2013 8:41 AM (GMT -7)   
It's also an extremely big organ. And when a person can live a perfectly normal life without one, with a jpouch or a bag, which there is nothing extrmemely inhuman about, there's not a huge need to keep trying for it.

C_G_K
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Date Joined Dec 2006
Total Posts : 914
   Posted 2/2/2013 9:15 AM (GMT -7)   
The colon is extremely vascular so it wouldn't be practical.

Besides no one knows what causes U.C. in the first place, so it would be presumptuous, not to mention risky.
DX Pancolitis 2003. Subsequent flares limited to left side
Flare every 2-3 years.
Salofalk 12 tabs daily,
Probiotics: VSL#3DS. Fiber: Psyllium.
Allergic to Imuran


Flaring again and starting a round of Pred :-( Currently down to 25mg

Pluot
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Date Joined May 2012
Total Posts : 2500
   Posted 2/2/2013 12:57 PM (GMT -7)   
"having to expose of waste in an extremely inhuman way"

There's nothing inhuman about having an ostomy and you'd do well to educate yourself and change your mind about that. I hope you find an easy remission and never need surgery yourself, but there are no guarantees in life and you'll find you're happier if you don't look down on your fellow human beings as "inhuman" because their bodies are different from yours.

Seconding all the responses above about rejection/recurrence of colitis... My brother is a Type 1 diabetic (autoimmune disease that attacks the pancreas) and they don't do pancreas transplants for Type 1 diabetics for the same reason, it's a difficult transplant and the body would most likely just attack the new organ.
Liz, 26
http://itslikethisuc.blogspot.com

dx'ed UC pancolitis 5/12 w/ moderate-severe inflammation

past meds: asacol hd, VSL#3, apriso, rowasa, xifaxan, 6mp, cortifoam, pentasa, cimzia, canasa, butyrate, flagyl, cipro, prednisone, remicade, methotrexate, cholestyramine, cortenema

current meds: tapering 10 mg/5 mg prednisone

step one: colectomy w/ end ileostomy, 1/16/13
so much happier already!

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 2/2/2013 1:02 PM (GMT -7)   
It was done for crohn's in the small intestine and the patient became sick with CD again a few yrs later, proving it's the immune system attacking our intestines.
bee propolis caps 500mg one cap twice/day
omegas 369 caps one cap twice/day
probiotics 10 billion cfu once/day
vitamins C-calcium ascorbate (easy on the gut) and vitamin A each once/day
Prodiem fibre supplement one cap before bed
I've also altered my diet (no junky stuff at all, processed, fast-foods, refined sugars, ect) and exercise regularly.
I went from 30+ bloody BM's/day with lots of lower back pain to an average of 5/day no bleeding no back pain and completely formed stools, still have severe urgency issues.
~~~~~~~~My bum is broken....there's a big crack down the middle of it! LOL :)~~~~~~~~

Canada Mark
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Date Joined Jan 2013
Total Posts : 3481
   Posted 1/23/2014 5:56 PM (GMT -7)   
Awesome post.

I don't buy into the into the Autoimmune thing - so I'd actually like to dig up some results that show the "disease" came back and attacked the transplanted small intestine or colon... and that it was Crohn's or Colitis again and NOT transplant rejection.

I'd like to dig out the literature on this actually if anyone has any. My money is on it not coming back lol... Unless someone can show different or post a study where the entire Colon or Small Bowel was replaced and Crohn's or Colitis struck again.

Here's an article on someone that had this done in the UK for Crohn's.. http://www.theguardian.com/lifeandstyle/2012/jul/01/bowel-transplant-let-me-live-again

My bet is GI's don't consider it cause you can get along fine without your colon, put a new one in and you risk rejection and further surgery - not return of the disease itself.

ByeByeUC
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Date Joined Feb 2011
Total Posts : 4530
   Posted 1/23/2014 6:08 PM (GMT -7)   
This thread is from last year but anyway, I couldn't imagine how hard of a procedure that would be even if it were done. And people are afraid of a j pouch? The risk of infection plus the anti rejection drugs you'd be on the rest of your life. And they are not pleasant drugs. It's crazy since you can live your life and be drug free without your colon.
Marianne

DX Pancolitis in 2005. Family history of UC.
Tried every drug-even Remicade & Cyclosporine (nasty!)-Tried diets-nothing worked-wanted my life back!
Step 1: J-pouch surgery (Laparoscopic restorative proctocolectomy w/ temporary diverting loop ileostomy) 6-25-10
Step 2: Take down surgery (Ileostomy reversal) 10/8/10
No more UC and no more drugs!! Very happy j-poucher!! :)

Canada Mark
Veteran Member


Date Joined Jan 2013
Total Posts : 3481
   Posted 1/23/2014 6:28 PM (GMT -7)   
Here is a link to someone who has had this done for Crohn's... (complete small bowel replacement) www.crohnsforum.com/showthread.php?t=31907

In regards to the whole Autoimmune thing - No one knows... Everyone just assumes it's all autoimmune and says it's just going to come back. But that hasn't been proven yet that I am aware of. Also people just tend to assume the cause is "autoimmune" because that is what we are told... even though that may not be the case at all.

NiceCupOfTea
Elite Member


Date Joined Jan 2010
Total Posts : 10095
   Posted 1/23/2014 6:34 PM (GMT -7)   
I kind of feel the same way as woofwoof, to be honest.

I just want my colon back. I don't like having an ileostomy.
~
Dx Crohn's in summer of 2000.
Tried and failed: 5-ASAs, Azathioprine, 6MP, Remicade, Methotrexate, Humira.
Diet didn't make any difference either.
The only med which worked was Prednisolone, so I ended up steroid-dependent.

Had surgery 2/13 - subtotal colectomy with end ileostomy. Currently on no meds and in remission. Also prone to depression and anxiety. Ask me anything >_>

NiceCupOfTea
Elite Member


Date Joined Jan 2010
Total Posts : 10095
   Posted 1/23/2014 6:54 PM (GMT -7)   
Maybe a large part of your depression stems from regret?

It does for me. I keep on regretting the decision I made to have surgery. The logical part of me knows it's a complete waste of time; can't turn back the clock, grow a new colon, etc. But the emotional part of me takes over whenever the ileostomy irritates me in some way (which is often), and I just end up reliving the last two years all over again.

I really, really wish I had carried on until I had either found some respite with my disease or ended up needing emergency surgery; I think I was at the end of my tether and made the decision in a bad frame of mind. I think there was room to keep on going for a couple more years, to try a few more things. I never tried them and the regret of that just makes me feel like crying sometimes. I should have paid more attention to the fact that a colectomy is an irreversible operation, but I just got desperate and glossed over certain things, I think.
~
Dx Crohn's in summer of 2000.
Tried and failed: 5-ASAs, Azathioprine, 6MP, Remicade, Methotrexate, Humira.
Diet didn't make any difference either.
The only med which worked was Prednisolone, so I ended up steroid-dependent.

Had surgery 2/13 - subtotal colectomy with end ileostomy. Currently on no meds and in remission. Also prone to depression and anxiety. Ask me anything >_>

Dr-A
Veteran Member


Date Joined Jul 2006
Total Posts : 2105
   Posted 1/23/2014 7:08 PM (GMT -7)   
woofwoof said...
After 25 years of J Pouch hell, I'd be more than happy to take my chances with a transplant. Since I'd rather be dead now, I have nothing to lose.


I am sure I can find some people glad to take your place.

Canada Mark
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Date Joined Jan 2013
Total Posts : 3481
   Posted 1/23/2014 7:46 PM (GMT -7)   
www.gastroendonews.com/ViewArticle.aspx?d_id=184&a_id=7703

Here's something showing a pretty high 5 years survival rate for Crohn's for people who have had so much removed they have next to nothing left for their small intestine. I know someone with this.. short bowel syndrome. They eat and like right away they are in the can... But he still leads quite an active life. It's amazing actually.

I have not come across mention of recurring disease yet.
Diagnosed Crohns-Colitis 10 years ago - Past Meds: Antibiotics, Prednisone, Methotrexate, Imuran, Remicade - Current Meds: Imuran 150mg/daily, Natural: WOO/Thyme Oil, All organic food no additives. Reuteri and Plantarum probiotics.

“The only person you're destined to become, is the person you decide to be"

Angel By Choice
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Date Joined Apr 2014
Total Posts : 8
   Posted 2/9/2016 10:04 AM (GMT -7)   
notsosicklygirl said...
You can have your colon removed and not have a bag. Look up j-pouch. It's not like living with a colon though, you will go more times daily than a person with a colon but it gives you the ability to remove the UC without having an external appliance.
True, I still wish I could take a gamble on a colon transplant though since I'm unhappy with my J Pouch.

DMC2011
Veteran Member


Date Joined Jul 2011
Total Posts : 2504
   Posted 2/9/2016 3:33 PM (GMT -7)   
http://www.m.webmd.com/crohns-disease/tc/intestinal-transplant-for-crohns-disease-topic-overview

Might be some new info in this area.
Left sided dx. 2011
Current med: Apriso 6
6mp 75 mg split 2x a day
Canasa as needed
VSL3 As needed


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