Tracheostomy - Why It Is Used

Why it's used-Tracheostomy

Contents

1. Overview
2. Why it's used
3. Living with
4. Complications

A tracheostomy is sometimes needed if you're unable to breathe normally because of an underlying health condition or a blocked airway.

Breathing problems

A tracheostomy can deliver oxygen to the lungs if you can't breathe normally. This is known as respiratory failure.

Conditions that can lead to respiratory failure and the need for a tracheostomy include:

• being unconscious or in a coma as a result of a severe head injury or stroke
• an inability to move one or more muscles (paralysis) after a serious spinal cord injury
• a condition that damages the lungs, such as pneumoniaor cystic fibrosis
• a condition that damages the nervous system, such as motor neurone disease or Guillain-Barré syndrome

In some cases, a tube attached to an artificial breathing machine (ventilator) is inserted into the mouth and down the throat.

But this can be uncomfortable, so a tracheostomy may be carried out if you need help breathing for more than a few days.

Blockages

A tracheostomy can also be used to bypass an airway that's become blocked as a result of:

• accidentally swallowing something that gets stuck in the windpipe (trachea)
• an injury, infection, burn or severe allergic reaction (anaphylaxis) that causes the throat to become swollen and narrowed
• swelling after head or neck surgery
• a cancerous tumour – this can sometimes happen with mouth cancer, laryngeal cancer or thyroid gland cancer

In addition, some children born with birth defects that cause their airways to be abnormally narrow may need a tracheostomy to help them breathe.

Removing fluid

It may be necessary to carry out a tracheostomy to remove fluid that's built up in the airways.

This may be needed if you:

• are unable to cough properly because of chronic pain, muscle weakness or paralysis
• have a serious lung infection, such as pneumonia, that has caused your lungs to become clogged with fluid
• your airways or lungs have filled with blood as a result of an injury

Ileostomy - Why It Is Used

Why it's used-Ileostomy

Contents

1. Overview
2. Why it's used
3. How it's performed
4. Recovery
5. Complications
6. Living with an ileostomy
7. Reversal

An ileostomy may be needed if the colon is damaged, inflamed or does not work properly.

Some of the most common reasons why surgery to form an ileostomy is carried out are described below.

Crohn's disease

Crohn's disease is a long-term condition where the digestive system becomes inflamed.

Common symptoms include:

• diarrhoea
• abdominal pain
• extreme tiredness (fatigue)

Crohn's disease can usually be controlled with medication, but surgery to create an ileostomy may sometimes be recommended to temporarily divert digestive waste away from the inflamed section of the digestive system to give it a chance to heal.

Ulcerative colitis

Ulcerative colitis is a long-term condition where the lining of the large intestine or large bowel (colon or rectum) becomes inflamed.

Common symptoms include:

• bloody diarrhoea
• abdominal pain
• a frequent need to pass stools

In most cases, symptoms can be controlled with medication.

But surgery to remove the colon and form an ileostomy or ileo-anal pouch (an internal pouch to store stools created using the end of the small intestine) may be recommended if the condition is particularly severe or does not respond to medication.

Bowel cancer

Bowel cancer is a type of cancer that develops inside the colon or rectum.

Chemotherapy or radiotherapy, or a combination of both, may be used to shrink the cancer first before the affected section of bowel is removed.

Depending on the size and position of the removed section of bowel, a temporary ileostomy, permanent ileostomy or an ileo-anal pouch may be formed during the operation.

In some cases, a section of your colon may need to be diverted out of your tummy (abdomen). This is known as a colostomy, rather than an ileostomy.

Less common uses

Some of the less common reasons why surgery to form an ileostomy is needed are described below.

Familial adenomatous polyposis

Familial adenomatous polyposis (FAP) is a rare condition that triggers the growth of non-cancerous lumps of tissue inside the colon.

Although the lumps are non-cancerous to begin with, there's a very high risk that, over time, at least 1 will turn cancerous.

More than 99% of people with FAP have bowel cancer by the time they're 50 years old.

Because of the high risk of developing cancerous lumps, it's usually recommended that a person diagnosed with FAP has their colon removed.

It's usually replaced with an ileo-anal pouch, or occasionally a permanent ileostomy.

Bowel obstruction

A bowel obstruction occurs when part of the digestive system becomes blocked by food, fluids or waste products.

This can happen if part of the person's digestive system is scarred or inflamed, or if their digestive system is unusually narrow.

If the colon becomes completely blocked, it's usually necessary to remove the colon and form an ileostomy.

This can be temporary or permanent, depending on the underlying cause of the obstruction.

Injury

A significant injury to the colon, such as a puncture or impact injury, can result in the colon becoming permanently damaged.

In these cases, it may be necessary to remove the colon and form an ileostomy.

Whether this is a temporary or permanent ileostomy depends on the type and extent of the injury.

Gastroscopy - Why it is used

Why it's used-Gastroscopy

Contents

1. Overview
2. Why it's used
3. How it's performed
4. Risks

A gastroscopy can be used to check symptoms or confirm a diagnosis, or it can be used to treat a condition.

Checking symptoms

A gastroscopy may be recommended if you have symptoms that suggest a problem with your stomach, oesophagus (gullet), or the first section of your small intestine (duodenum).

Problems that are sometimes investigated using a gastroscopy include:

• abdominal (tummy) pain
• heartburn or indigestion
• persistently feeling and being sick
• difficulties swallowing or pain when swallowing (dysphagia)
• a reduced number of red blood cells (anaemia), which may be caused by persistent internal bleeding
• severe bleeding, which may have caused a sudden, sharp pain in your abdomen, vomiting blood or very dark or "tar-like" poo

Diagnosing conditions

A gastroscopy is also used to help confirm (or rule out) suspected conditions, such as:

• stomach ulcers (sometimes know as peptic ulcers) – open sores that develop on the lining of the stomach and small intestine
• gastro-oesophageal reflux disease (GORD) – where stomach acid leaks back up into the oesophagus
• coeliac disease – a common digestive condition, where a person has an adverse reaction to gluten in food
• Barrett's oesophagus – abnormal cells on the lining of the oesophagus
• portal hypertension – where the blood pressure inside the liver is abnormally high, causing swollen veins (varices) to develop on the lining of the stomach and oesophagus
• stomach cancer and oesophageal cancer

As well as examining the oesophagus, stomach and duodenum, the endoscope (a thin, flexible tube that's passed down your throat) can be used to remove small samples of tissue for testing. This is known as a biopsy.

Treating conditions

A gastroscopy can also be carried out to treat some problems affecting the oesophagus, stomach and duodenum.

For example, a gastroscopy can be used to:

• stop bleeding inside the stomach or oesophagus, such as bleeding caused by a stomach ulcer or enlarged veins (varices)
• widen a narrowed oesophagus that's causing pain or swallowing difficulties – this can be caused by GORD, oesophageal cancer, or radiotherapy to the oesophagus
• remove cancerous tumours, non-cancerous growths (polyps) or foreign objects
• provide nutrients – a gastroscopy can help doctors guide a feeding tube into the stomach, when a person is unable to eat in the normal way