Wendy Skrdlant, 41, married and mother of two teenagers, works as a business systems analyst and lives in Manhattan, Kansas, two hours from Kansas City. Today she leads a normal life, but three years ago her life was out of control because of a debilitating health problem. Wendy had ulcerative colitis, an inflammatory disease of the colon that has symptoms that may include bleeding with bowel movements, abdominal pain or bloating, constipation, diarrhea, or a combination.
Wendy believes she must have had ulcerative colitis since her early 20s, but didn't realize her symptoms of frequent diarrhea were due to this illness. She was putting in 50 to 70 hours a week at work and was very active in her church. Then, in May 1997, she found blood in her stools. In July, her gastroenterologist initially performed a sigmoidoscopy, an exam using a scope to look inside her lower intestine, and found some polyps or growths along the walls of her intestines. Then he performed a colonoscopy, an exam using a scope to view her entire colon, and the diagnosis was clear: Wendy had ulcerative colitis. Her doctor then began treating her with medications and she improved.
However in the fall of 1997, she suffered a serious cold that worsened her colitis and by mid-November she was too sick to go to work. She was unable to return for eight months. "I tried to use the phone to stay in contact with the office three or four hours a day. I was missing my kids' activities, and couldn't go to church," remembers Wendy. "Even though I was in really good shape until two years before I got sick, I was burning the candle at both ends. I ate the wrong things and I wore myself out. I was having bowel movements more than 50 times a day. I was practically living in the bathroom." On December 30, Wendy suddenly developed intense arthritis, an inflammation of the joints sometimes experienced by ulcerative colitis patients. Her doctor performed another colonoscopy and this time the news was as painful as the disease: Wendy's entire colon was ulcerated. She was no longer responding to the medication and the only solution was to surgically remove the colon. In January 1998, she checked herself into the Mayo Clinic, in Rochester, Minnesota, where she was referred to Bruce Wolff, MD, a colorectal surgeon. In addition to being proficient in general surgery, colorectal surgeons like Dr. Wolff have specialized training, knowledge and surgical skills relating to problems of the colon, rectum, anus and small bowel.
"Wendy came to the Mayo Clinic to find out about surgical options because she had run out of medical options for severe ulcerative colitis," explains Dr. Wolff. "I told her she had two remaining options: immunosuppressive treatment or surgery. Immunosuppressive treatment has risks and would not cure her. Surgery has the potential to cure."
After counseling Wendy about her treatment alternatives, Dr. Wolff successfully performed an ileoanal procedure, an operation that cures ulcerative colitis. The ileoanal or "pelvic pouch" procedure includes the removal of the entire large intestine, but saving the anal muscles. The last part of the small intestine is made into a "J-pouch," which serves as a new rectum and is attached to the anal canal. The ileoanal procedure is a recent advance in colorectal surgery that enables ulcerative colitis patients to avoid having a permanent external ileostomy bag, which is attached to the outside of the body and collects stool. Instead, they receive a temporary loop ileostomy until their "J pouch" has healed. This operation allows them to have almost normal bowel movements with good control and leads to a high quality of life.
Wendy needed the ileostomy for three months while her internal ileoanal pouch healed. Then, the ileostomy was closed on schedule and she began to pass bowel movements. Dr. Wolff advised her that full recovery would take 18 months to two years, which proved to be on target.
Now, three years after the procedure, Wendy remains healthy, is back to work full-time, and the only medication she has to take is Imodium. Best of all, she only has five to eight bowel movements a day, significantly down from the 50 or more she experienced prior to her operations. She has good control, is able to defer movements, and leads a normal life.