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Thursday, November 1, 2007
A pain in the....

Of all the bowel disorders, Crohn’s disease is perhaps the best known.
It mainly involves inflammation of the ileum, the lower portion of the small intestine, which becomes thick¬ened, scarred and rigid, while there may be adhesion between the adja¬cent loops of the bowel. The colon, rectum and other parts of the intes¬tine may also become infected.
Symptoms include bouts of abdomi¬nal pain, cramps, diarrhoea and fever.
The disease spreads and recurs by nature, and complete remission is not unknown. Onset is usually be¬tween the second and fourth decade.
Recurrence is most likely in those who contract the disease at a young age. It has also been noted that the longer the duration since the last recurrence the better the risk.
Acute attacks may be treated con¬servatively or may require short courses of steroids; though these are not usually the preferred solution as their long-term use increases the risk of bowel perforation or ulceration of the digestive tract.

There are a number or surgical procedures which can be adopted, the following being the most common:
• Proctocolectomy and ileostomy: complete removal of the rectum and colon and the insertion of the lower  end of the intestine through the ab-dominal wall;
• Resection: surgical removal of a segment of the colon;
• Colectomy and ileorectal anasto¬mosis: removal of all or part of the colon and insertion of an artificial connection between the ilium and the rectum.

The operation of choice is the proc¬tocolectomy, where recurrence of the disease is found in only 10 % of cases.
Rating is usually in the form of a per¬manent extra pre¬mium. The most favourable terms are offered to those treated by procto¬colectomy and ileostomy.
Ratings decrease with duration since the last episode.

Copyright © Insurance Times and Investments® Vol:20.10 1st November, 2007
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