If one has crohn's colitis, does colon removal make small bowel disease more likely?

I do not have an answer for you but can share my initial diAgnosis and what I have been dealing with since takedown two years ago.

I was diagnosed with UC and also showed ileitis on some scopes over the years. My original GI at one time indicated I had Crohn's colitis and later indicated he made an error in my diagnosis and I really had UC. I never had peri anal disease or granumolous or anything indicating Crohn's in my scopes. I did have some skip areas where i did not show disease on my final colectomy which I thought was odd for UC. Aside from these areas, my entire colon showed UC.

Since my takedown I struggle with pretty chronic pouchitis and i have ulcers in my ATZ and cuff. This has been chronic and I cycle on and off antibiotics to try and manage as best as possible and take nightly rectal meds for the anal issues.
This us definitely not what I anticipated after having this surgery and im not sure it bas anything to do with my prior history and ileitis. At this time no one has diagnosed me with Crohns despite the issues i have been experiencing since takedown,although I am skeptical this may change.

I'm not sure I'm a true believer in the term backwash ileitis.

Jeane- thanks, and sorry you have to endure so much pouchitis. My surgical consultant told me that pouchitis is substantially more frequent for those who had backwash ileitis- though I cannot find corroboration of this on pubmed. When they sliced and diced your colon, did they get any inklings of crohns there (sounds like they didnt, else they woukdnt have constructed the pouch). Hoping things improve for you.

I don't know if it makes it "more likely" but Crohn's disease can later show up in different areas or worsen. So if you do end up with Crohn's colitis instead of UC then in the future it would be possible for the Crohn's to show up in other areas of the GI tract.

Badplumbing,


All my scopes and symptoms over the years showed UC, as well as the promethius blood test. I had times where the scopes showed the ilieum was fine (most often) and a few times where there was inflammation.

What concerned me was the last colectomy path that showed an area in the transverse that was disease free and maybe one other area also. The scope prior to my booking surgery showed ileitis and I questioned my surgeon on this and he did not seem concerned (same thing backwash ileitus). The final surgery showed no inflammation in the ileim and again a UC dianosis. I have however, had pouchitis pretty much since takedown, although it is not severe.

My biggest concerns since my takedown are the anal issues (last two centimeters of anal anal). I have and the constant inflammation and ulceration in the cuff and ATZ which I never had with UC. The pain from this is worse than the pain I had with UC as I never had really bad anal involvement when I had my colon. I have been recommended for pouch advancement surgery, but I am trying to fight this as best as I can, but some days the pain is unbearable.

There is no guarantee that my case will in any way be anything that you would have to deal with. I will tell you if I knew I was going to have all these complications, in hindsight I would have opted for the ostomy at the start. I am at a point now where I am very fearful of additional surgery due to my experience so that is why I am not running to the OR despite the issues I have been dealing with. Also,another part of me wants to believe this will eventually improve, but after two years I am sure it is not likely.