Medical Emergencies Resulting from Crohn's Disease
Crohn's Disease is a life-long condition affecting the digestive tract. It can be treated with medication and surgery but careful monitoring is required as it can lead to painful, life-threatening complications.
What is Crohn's Disease?
Crohn's Disease is a chronic (on-going) condition that causes ulceration and inflammation of the digestive tract. It is most common in the lower part of the digestive system – the small or large intestine - but can also occur elsewhere. As well as reducing the body's ability to absorb nutrients from food and process waste, it can cause a range of symptoms including pain, tiredness, diarrhoea, mouth ulcers, weight loss and anaemia. As much as possible, surgery is avoided and the condition is treated with medication but, in some cases, surgery is necessary to remove the inflamed section of the gut.
Possible complications of Crohn's Disease
Careful monitoring of patients with Crohn's Disease is necessary as it can cause a range of additional complications. These include:
- Fissures (tears in the anus, causing pain and bleeding)
- Abscesses (pockets of pus formed on the intestinal wall, caused by bacterial infection)
- Malnutrition due to the reduced ability to absorb nutrients from food
- Small intestinal bacterial overgrowth, where bacteria digest food higher up in the gut than normal, causing bloating and pain
- Fistulas (ulcers within the gut that develop into holes or passages between two areas of the body not normally connected, such as the gut and the bladder, or the bowel and the vagina).
- Strictures within the intestine that can sometimes lead to perforation of the bowel
The last two complications listed – strictures and fistulas – can cause life-threatening infections.
Strictures in the intestinal tract
Crohn's disease can cause a stricture or narrowing of the intestinal tract, due to the accumulation of scar tissue over time. This is a common complication of crohn's disease in the bowel and its impact will vary depending on the extent to which the bowel and its function is obstructed. At the very least, this can cause pain and abdominal bloating. At worst, where there is a build-up of pressure due to restricted faecal matter, it can cause a splitting or perforation of the lining of the bowel.
Perforation of the bowel
Perforation of the bowel or gastrointestinal tract is a medical emergency and the chances of recovery from it are increased with early diagnosis and treatment. If the lining of the bowel splits, it can lead to leakage of contents of the bowel – faeces - into other parts of the body. This in turn can cause peritonitis - inflammation of the lining of the abdomen - and lead to sepsis, a life-threatening condition which can lead to multisystem organ failure and death if untreated.
Signs of a perforation of the gastrointestinal tract include:
- Fever
- Chills
- Severe stomach pain
- Nausea
- Vomiting
These signs should alert medical practitioners to the possibility of a split in the bowel and emergency x-rays or CT scans and blood tests are necessary to confirm the diagnosis. It is likely that prompt surgery will be necessary, providing the patient with a colostomy to divert the contents of the digestive tract while the bowel is repaired. In these circumstances, chances of recovery are good.
If the perforation of the bowel is not identified and treated promptly, the patient may develop peritonitis as bacteria from the bowel affect the lining of the abdomen. It is thought that 10% of people who develop peritonitis due to perforation of the bowel will die. Peritonitis needs treatment with injections of antibiotics and possible surgery if the lining of the peritoneum is damaged, in order to avoid the spread of bacteria into the blood stream, causing blood-poisoning and possible organ failure.
Fistulas
The scar tissue created by crohn's disease can also cause ulcers in the lining of the intestinal wall that can develop into fistulas (holes), thereby abnormally connecting the digestive system to a different part of the body, such as the bladder or the vagina. This will allow the contents of the digestive system to leak into that part of the body, possibly resulting in infection.
This can cause symptoms such as:
- Abdominal pain
- Diarrhoea
- Bleeding
- Leakage of waste via the vagina or bladder
Again, at worst, the spread of the contents of the bowel to other parts of the body can lead to sepsis or blood poisoning.
Approximately 30% of people with crohn's disease will develop a fistula, which, depending on the location and extent of the fistula, and the level of leakage, will require a course of antibiotics or, if the damage is severe, surgery.
Medical Negligence
Fistulas and perforation of the bowel are known to be possible complications of crohn's disease. Furthermore, the life-threatening potential of these conditions is also widely recognised. Therefore, it is important that medical practitioners should be alert to the symptoms of both conditions and act promptly if they are concerned that their patient may be developing these problems.
If the key symptoms of fistulas or bowel perforation are ignored or unrecognised, the patient may suffer long-term effects. In these circumstances, it may be possible to make a claim for compensation.
Glynns Solicitors are a team of medical negligence specialists. If you believe you have been the victim of poor medical care, please contact us to discuss your situation.
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