I saw this recent saw this article in the
Journal of Gastroenterology (my night time reading) that studied a group of
people from Olmsted County, Minnesota. The study is ongoing and looked at
people from 1970-2004 (updated from 2001). The study concluded that the
cumulative probably of having major abdominal surgery were 38% at 5 years, 48%
at 10 years, and 58% at 20 years. The
major factors that were significantly associated with major surgery were being
male, smoking, early steroid use, and penetrating disease behavior. What seems
to be positive though is that if you look at this
chart that shows the cumulative risk of having surgery after being
diagnosed in different decades. In
recent times it seems that the people who were diagnosed in the early 2000’s
who are a little below 10 years from diagnosis have the lowest risk out of all
the decades of having to have surgery at around 35% (which is down from 60%
which is was in the late 1970s). Also remember Humira was not introduced for
Crohn’s until February of 2007 which may bring down the requirement for surgery
even more. My gastro doctor had told me one time that with Humira he was
seeing fewer and fewer patients in the hospital and fewer requiring surgery
which fits the data. What was also interesting is that people claim Crohn’s has
a genetic component to it (however even my gastro doctor said none of his
patients had family members who have it and neither do I) and the data in this
graph supports that as close to 86% of patients have no family history of
inflammatory bowel disease.
This data makes me feel a little bit better. With the cost
of genome analysis going down it might be interesting to see if certain genes
affect who has to get surgery or multiple surgeries. Although the odds are by
definition I will need surgery I think I will be able to handle this and hope
it is years away when the technology will improve and perhaps down without a
scratch with NOTES as I mentioned in this
post. I will be honest the thing I am scared of most of having an ostomy
bag. I know other Crohn’s and ulcerative
colitis patients worry about it and I would even be okay with a temporary one
if I had to but a permanent one would scare me just a little bit.
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