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Please make sure that all required medical records are sent to the center before you come in for your second appointment. Necessary information often includes:
all clinic records and lab results from your current pediatric gastroenterologist
pathology reports and biopsy slides from previous endoscopic procedures
film and reports from any radiology testing (ultrasound, UGI w/sbft, etc.)
growth chart from the primary care physician
list of medications
Please send this information to:
Inflammatory Bowel Disease Center
Boston Children's Hospital
300 Longwood Avenue, Hunnewell 103
Boston, MA 02215
Name of Test
What it Measures
Explanation in IBD
Hemoglobin - Hb or Hgb
Oxygen-carrying compound in red blood cells.
Blood loss, acute bleeding from active disease or chronic or low grade loss not always apparent in the stool. Inability to make blood due to vitamin deficiency - iron, Folic acid, B-12. Hemolysis - body chews up its own blood. Direct bone marrow suppression, possibly due to medication.
12-17 grams per 100mL of blood
Red Blood Cell Count (RBC)
Number of red blood cells per cc of blood.
4-6 million per cc
Height of red blood cell column compared with height of whole blood column.
White Blood Cell Count (WBC)
Number of white blood cells per cc of blood.
Elevated values reflect infection, inflammation, severe, stress on the body or the result of medicines (corticosteroids). Low values reflect liver or spleen disease, autoimmune disease or the result of a drug reaction.
4,000 - 10,000 per cc
Platelets are small cells. "Sticky factor" that help stop bleeding.
High values correlate with increased activity in IBD. Low values causes similar to low values for WBC above.
150,000 - 300,000 per cc of blood
Erythrocyte Sedimentation Rate (SED Rate or ESR)
The speed at which a column of anticoagulated blood settles.
This test is a non-specific indicator of inflammation or infection somewhere in the body. Reliability varies between paatients but is helpful in monitoring changes within a particular patient.
2-20 mm per hour
Total protein and albumin fraction.
Low serum proteins suggests chronic disease, malnutrition, liver disease or loss of excess protein through the bowel in diarrhea.
Sodium (Na), potassium (K), chloride (Cl), and bicarbonate (CO2). Electrolytes help to determine the acid, base, and fluid balance in the body.
Severe diarrhea can lead to the loss of significant fluid, potassium and sodium (salt). Bowel resection alters the absorption of digestive juices and can lead to electrolyte imbalance. Medications can predispose selective electrolyte loss.
Renal Function Tests
Blood urea nitrogen (BUN), serum creatinine and uric acid.
These tests measure how effectively the body is excreting waste products in the urine and help determine fluid balance and kidney function.
Medications and severe infections can elevate the blood sugar and uncover a patient's tendency toward diabetes.
Liver Function Tests
Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), bilirubin, alkaline phosphatase.
Abnormal values reflect liver disease, sclerosing cholangitis, gallstones plus infection of the liver or abscess formation, all of which can be related to inflammatory bowel disease. (Alkaline phosphatase is normally elevated in children.)
Typically, treatment for IBD is handled through a combination of medication and a modified diet. However, there are cases that do not respond to typical treatments. For these patients surgery may be needed to repair or remove parts of the intestines.
A majority of the surgeries done at Boston Children's to treat IBD are minimally invasive, laparoscopic procedures, which means they're performed using a video camera and several very thin instruments. During the procedure a small incision (about half an inch) is made in the child's lower abdomen and plastic tubes called ports are placed inside the body. The camera and the instruments are then used through the ports, allowing access to the inside of the patient without needing to make larger incisions.
The camera produces images from inside the abdomen onto a television monitor, which the surgeon uses to guide the movements of his or her surgical instruments.
Laparoscopic surgery is beneficial because:
there is less post operative discomfort since the incisions are much smaller
quicker recovery times
shorter hospital stays
earlier return to full activities
much smaller scars
there may be less internal scarring when the procedures are performed in a minimally invasive fashion compared to standard open surgery.
Boston Children's handles more pediatric surgeries to treat IBD than any other medical center in the area. In addition our vast surgical experience, our team provides world-class medical management and treatment prior to surgery—ensuring our patients are in the best possible health before their operation—often leading to a faster recovery and quicker discharge from the hospital.
A multi-step surgery to treat ulcerative colitis
If surgery is needed to treat your child's ulcerative colitis, it's likely that they'll need to have all, or a portion, of their colon removed, called a colectomy. (Ulcerative colitis exists in the lining of the colon and rectum, so removal of these organs removes the disease from the body.)
Once the colon is removed, a temporary ileostomy stoma is created which is used to remove waste from the body. After some recovery time the patient then has a illeoanal J-pouch, or reservoir, created by surgeons. This pouch is made from the lowest part of the small intestine (bowel) and provides a storage place for stool in the absence of the large intestine.
After another recovery period the patient will have a final procedure called an ostomy takedown, after which he or she will be able to use the bathroom in the same way they did before the operations.
In cases where a patient's Crohn's disease has left scaring or tiny holes in the bowel (known as perforation), or the disease has caused significant inflammation and/or narrowing of the intestine, surgery may be required to repair the damage and/or remove a portion of the damaged the intestine.
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