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Causes of a stoma

 

There are many different reasons why someone should have a stoma formed. On this page we show the most common causes in a row.

Anusatresia
Diverticulitis
Polyps on the large intestine
Cancer
Fistula
Rectum Prolepses
Auto-immune diseases
Spina Bifida
Hirschsprung disease
Slow Transit Constipation/Obstruction
C.I.I.P.
An accident, abuse or medical mistake
Endometriosis
Bladder problems
Stomach problems
Cystic Fibrosis
Multiple sclerosis (MS)
Paraplegia

 

 

Picture resource: the book Anatomy & Pathologie, 4th Edition

 

 

Anusatresia

It means: an incomplete anus. Anus is Latin for “shitting hole” and atresia stems from Greek and means “it is not constructed or later closure of natural openings or canals”. There are around 40 babies born annually with this condition, the cause of which is unknown. With some children an exit is visible, but in an incorrect place and very narrow. In every case the anus cannot function normally and therefore the child cannot get rid of his or her faeces. Often a child born with anusatresia has further deviances, such as the urethras or kidneys, gullet, skeleton or the sexual organs.

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Diverticulitis

Diverticules are small bulges of the mucus membranes throughout the muscle layer of the intestines. You could compare them with the inner tube of a bicycle which pushes through the outer tyre via a weak spot. Diverticules can form on any spot along the stomach-intestinal canal, but form predominately in the large intestine (the colon) and primarily in the last part thereof (the sigmoid colon).

 

Diverticulitis (the appearance of diverticules in the large intestine) is viewed as the most common deviation in the western world. The chance that someone develops diverticules in their lifetime is reckoned at approximately 40 to 50 %. You can have diverticules without realising it, only 5 to 20% of the occurrences of diverticules cause complaints. The problems primarily happen when food particles remain in the diverticules, whereby causing bacteria to multiply. A diverticule can then become inflamed: this is called diverticulitis. On rare occasions the inflammation is so bad that the diverticule snaps and the intestinal contents stream into the abdominal cavity (perforation). This causes peritonitis. This is a life threatening situation which always leads to an operation.

 

Picture resource: Mayo clinic

 

Diverticles should not be confused with intestinal polyps. Polyps grow in the intestinal mucus inwards and can cause intestinal cancer, whilst diverticles grow through the intestinal wall towards the abdominal cavity and never become malignant.

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Polyps on the large intestine

A large intestine polyp is a rampant growth of the large intestine mucus and grows from the outside of the intestine inwards. A polyp can have various forms. It can look like a ball, a mushroom or as flat as a button. Large intestine polyps can be very small (as small as a pinhead) however they can also measure several centimetres across. Some people have just one polyp in the large intestine, but usually there are several and rarely the mucus of the large intestine is dotted with polyps.

 

Example of a flat and a stemmed polyp. Picture resource: Delft integraal

 

Many people become concerned when they hear that they have large intestinal polyps. Fortunately most large intestinal polyps are benign tumours (non neoplastic polyps). Only in a small percentage can ‘agitated cells’ happen (called adenoma). These adenomas can change over time into malignant tumours (neoplastic polyps) and so cause large intestine cancer. It is not possible to see from the “outside” if a polyp is benign or malignant. That is only revealed after investigation. Therefore every polyp must be removed and investigated. Also because 1 in 20 benign large intestinal polyps later becomes malignant, it is reasonable to remove all polyps. This prevents a polyp from growing larger and blocking the throughput of the large intestine.

 

Picture resource: Health.yahoo.com

 

In some cases heredity has a role in the formation of polyps and intestinal cancer. For example by ‘Hereditary Non- Polyposis Colorectal Carcinoma’, abbreviated HNPCC, called ‘family (hereditary) large intestinal cancer’ or ‘Lynch syndrome’. There are not an extreme number of polyps, by these people those that come into existence can develop quicker into cancer. Approximately 1-5% of all people with large intestinal cancer acquire the sickness due to a hereditary tendency to HNPCC. There is also the sickness ’Familiar adenomatous Polyposis’, abbreviated to FAP. FAP is a hereditary disorder whereby many benign swellings (polyps) develop in the intestines. This begins normally at the ages 10-30. If nothing is done about the polyps, in the end large intestinal cancer develops. Due to the very high risk of malignancy of one or more polyps, people with FAP often have the whole large intestine surgically removed as a precaution. People with FAP who do not have this done, have around their 45th practically 100% chance of large intestinal cancer. Approximately 1% of all people with large intestinal cancer acquire the sickness because of FAP. Moreover there also exists MUTYH associated Polyposis (MAP), this sits on a different gene to FAP and seems to grow more slowly and is less hereditary.

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Cancer

You can acquire a stoma due to various forms of cancer. Consider hereby cancer in the intestine, bladder, gullet or stomach. However also through ovarian or cervical cancer it can be necessary to create a stoma (gynecological cancer). A common characteristic of all forms of cancer is an unrestrained cell division. Millions of cells form the building blocks of our body. Many cells have the potential to divide: from 1 cell develops 2 new cells, which in their turn divide again etc. Cell division is necessary to grow and to replace damaged and old cells.

 

Picture resource: ThinkQuest

 

Body cells can be damaged by all sorts of influences. Often the damage can be repaired, but a cell can also be irreparably damaged. The damage can lead to a number of changes in the genes. This can affect the growth, division and the development of the cell. Unrestrained cell division can bring about a swelling or tumour. There are benign and malignant tumours and only by malignant tumours is there talk of cancer.

Large intestinal cancer is the second most predominant form of cancer. However as mentioned in a previous page, is a very good possibility to treat.

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Fistula

A fistula is an unnatural tubular connection between a body cavity or gland and the skin. A fistula normally forms after an inflammation. If the inflammation has spread to the skin this can spontaneously break open, or can break through after an incision. If the inflammation cures itself, a fistula can still remain where occasionally waste or fluid can exit (or even faeces if the connection concerns the intestines). Mostly the fistula grows closed by itself if the inflammation is cured. However sometimes there is no apparent reason for a fistula. Fistulas happen more often by people with Crohn’s, diverticulitis and cancer. By Crohn’s it has a 33% chance that after 10 years you have or have had a fistula. This rises to 50% after 20 years.
 

Picture resource: Atrium MC

 

There are various sorts of fistulas. A perianal fistula (anal fistula, also known as a pipe ulcer) is a joining of the rectum which leads via the sphincter to the skin area around the anus. The fistula can have a direct route to the sphincter, but can also a very complicated route (or example a winding and even with branches, or higher up through the sphincter). Therefore it can be that for example a fistula opening by the right hand buttock has an internal joining with the left hand side of the sphincter. Therefore the place of the exit opening is not always the place where the internal opening can be found. A perianal fistula can be better operatively emptied and cured than leaving to cure itself. A fistula can also develop between 2 bowel irises, the intestines and the bladder (vesicorectal fistula), between the vagina and the bladder (urethrorectal fistula), and between the vagina and the bladder (urethavaginal fistula) or the intestines (rectovaginal fistula).

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Rectum Prolepses

One cause of a stoma can be a rectum subsidence. The cause is often weak pelvic floor muscles. 90% of these are women, the primary causes are pregnancy and childbirth. Often the urethras and the womb also subside, sinking towards the pelvic floor. If the subsidence continues, the sphincter itself can extend outwards (rectum prolapse). The consequence of a intestinal subsidence is a blockage (constipation).

 

Picture resource: ICG

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Auto-immune diseases

Chronic intestinal inflammation, also called Inflammatory intestinal sicknesses, are recognised by an inflammation of the intestinal lining membranes (mucus). Wherefore no clear cause is found. In English the term IBD, Inflammatory Bowel Disease is used. Herein you can distinguish between the two following sicknesses: Crohn’s disease (enteritis regonalis, granulomateuse enteritis), and Colitis Ulcerosa (idiopathic procotcolotis). Next to this there also exist forms of idiopathic proctitis and collagen colitis, which are very rare. It is estimated that in The Netherlands there are between 10,000 and 21,000 people with Crohn’s Disease and between 17,000 and 35,000 people with Colitis Ulcerosa. Around 20% of people who suffer from one of these two sicknesses have a family member that also suffers from inflammatory bowel diseases.

 

Picture resource: LeadDiscovery

 

Despite the two sicknesses coming under one name, there is a clear difference between the two. Colitis Ulcerosa (CU) is an inflammation illness of the large intestine which is paired with the formation of ulcers (Ulcerosa). Colitis Ulcerosa only affects the large intestine and/or the rectum and the acute inflammation is restricted to the mucosa (the intestinal mucus). Colitis Ulcerosa always starts in the rectum and spreads slowly over the whole large intestine. If solely the rectum is affected one talks of proctitis, and if the sigmoid (the intestinal part of the rectum) is also affected, of procto-sigmoiditis. By 75% of people the inflammation is restricted to the left hand part of the large intestine (the descending part). In pancolitis the whole large intestine is affected.

 

Picture resource: Medicineworld

 

Crohn’s sickness, named for the American doctor Burrill Crohn (1884 – 1983) is much vaster and can manifest itself from the mouth to the anus. By most people Crohn’s sickness first appears between the 15th and the 30th year. Predominately the inflammation appears in the lowest art of the small intestine (terminal ileum), the large intestine (often primarily the ascending colon), or a combination of both. The inflammation goes deeper into the wall, therefore past the mucosa, whereby this sickness fistulas and abscesses can also form. The inflammation of the intestine by Crohn’s sickness has an extremely capricious course. It can vary between a quick spreading to other intestinal parts (acute phase) to a relatively quiet picture that throughout the years causes few complaints and rarely needs treatment (chronic phase).

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Spina Bifida

Spina Bifida literally means: split spinal column. Also commonly known as “open spine”. It is a construction defect of the lower part of the back which in a normal situation grows together. This is about the spinal cord, the membranes around the spinal cord, the vertebrae and the skin. This is a birth defect (neural tube defect) and arises in the first 4 weeks of pregnancy. In Spina Bifida the vertebrae and muscles do not close properly around the spinal cord. There are two different types: Spina Bifida Occulta (hidden open back) and Spina Bifida Aperta (open back). Although it concerns the same deviation, both forms are different on the outside. We talk about Spina Bifida occulta, whenever the spinal cord fault is still covered with skin. Spina Bifida aperta is immediately after the birth visible: the back is actually open and there is a sort of wound.

 

Picture resource: SBAC

 

There is not much known about the cause of Spina Bifida. What is known is that genetics, nutrition and environment are all factors that can play a role. In the Netherlands Spina Bifida occurs in roughly 4.5 out of 10,000 births. If there are occurrences of spina bifida in the family, then the chances of a child being born with this disorder is roughly 10 times larger. There are different bodily consequences of Spina Bifida, in less or more serious degree, depending on the place, size and seriousness of the Spina Bifida. The spinal cord is like a telephone cable which delivers the messages between the brain and the various body parts. Whenever this is damaged, problems can exist because messages are not, or incompletely, delivered, such as: paralysis of foot, leg and hip muscles. The sphincters which control the exit of the bladder and rectum can be totally or partially paralysed. There are often deviations of the bladder whereby damage to the kidneys can occur. The drainage of the fluid which flows around the brain and the spinal cord can be damaged. Water on the brain then develops (hydrocephalus).

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Hirschsprung disease

Hirschsprung’s disease is a chronic congenital aganglionic megacolon and develops in the fourth or fifth week, when the nervous system is developed. A characteristic of Hirschsprung’s disease is that, in a short or longer part of the wall of the intestine and in the internal sphincter of the anus, vital nerve cells (parasympathetic ganglion cells) are missing. Often it only affects the rectum, sometimes also the last piece of large intestine. In some cases the entire large intestine (3%) and on rare occasions the small intestine as well (When the nerves are formed this process ‘travels’ from the small intestine in the direction of the anus, the earlier this process stops, the worse the condition). The intestine can not make the movement (peristaltic) in order to move the faeces in the direction of the rectum and the anus. The faeces piles up (constipation), the bowel turns off (megacolon congenitum) and the mucus of the bowel wall can become enflamed.

 

Picture resource: Healthofchildren

 

The condition is named for the Danish pediatrician Harald Hirschsprung (1830 – 1916), who in 1886 first described the condition at a congress. This condition is often discovered in the first week of life. Newborns can be slow to release the first faeces; the stomach distends and the baby can vomit. The disrupted faeces pattern can also only after a few weeks or years become so serious that Hirschsprung’s disease is suggested. With Hirschsprung’s an operation is necessary. In The Netherlands Hirschsprung’s Disease occurs in 1 in 5000 births. Annually around 40 children are born with this condition. The condition is more prevalent in the white race than in the black race. In any case since 1996 5 genes have been identified that are tied to Hirschsprung’s disease. It is not really known why this deviation occurs. In 4-8% of victims it is inherited. In 10% of the victims this condition is a part of Down’s Syndrome.

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Slow Transit Constipation/Obstruction

5-15% of the population have problems with obstruction (also known as constipation). About 20% of people with chronic constipation have Slow Transit Constipation/Obstruction (STC/STO). People with is complaint suffer from serious blockages and have a slow colon passage, sometimes 3 times as slow as normal. The faeces remain in the large intestine for too long and pile up. It can solidify because the large intestine absorbs fluids. You could also suffer from overflow diarrhoea: thin faeces leaks past the hard faeces (also known as ‘paradoxical diarrhoea’). Laxatives often do not work or work insufficiently. These people are also often more sensitive to stimulus in the stomach-intestinal canal. This condition primarily affects the large intestine, but often the rest of the stomach-intestinal canal is also slower. It is not (yet) clear if the complaints in the rest of the stomach-intestinal canal are a result of the blockage in the large intestine (congestion). This is being investigated in The Netherlands and overseas, but it is assumed that disturbances in the nervous system play a role. Unfortunately already many doctors consider that the cause is psychiatric, sometimes causing a battle in order to be taken seriously.

 

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C.I.I.P

C.I.I.P in full means: Chronic Idiopathic (for an unknown reason) Intestinal Pseudo-obstruction. It is a disease if the stomach-intestinal canal. You could call C.I.I.P. the serious form of STC. It can affect the whole alimentary canal, from the gullet to the rectum (from mouth to anus). In C.I.I.P. the muscular tissue or the nerve cells of the stomach-intestinal canal slowly fail. Through this damage the intestine has increasing less peristaltic movement and the faeces piles up. The same problem counts for the stomach, gullet etc. It is a reasonably unknown and uncommon disorder. In certain families it occurs more often than normal, creating a suspicion that heredity plays a role. In 1995 this condition happened 12 times in The Netherlands and about a thousand times in the whole world. Because this disease is now increasingly recognised, this figure will probably rise in the future. Because the symptoms that you have in the beginning are very similar to other bowel disease, this is often diagnosed as irritable bowel. Unfortunately, the complaints are ultimately worse than in irritable bowel syndrome. C.I.I.P. is a disease which cannot be healed. There are medicines (pro-kinetics), which slows the progress of this disease. In extreme cases, there is a small intestinal transplant done, but that is a very serious and not very successful operation.


Picture resource: Erfelijkheid.nl

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An accident, abuse or medical mistake

Also through an accident, abuse or by a medical error, a stoma should be built. The bowel or bladder may have been damaged so that the urine or faeces can no longer leave the body through the natural way. Sometimes this is temporary; however it can also be, if the damage is so severe, permanent.

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Endometriosis

Endometriosis is a benign chronic disease which only occurs in women in their reproductive years. The tissues which normally cover (= endometrium) the inside of the womb (uterus) by endometriosis grow also in places outside of the uterus. It can attach itself to other organs in the abdominal cavity, such as the outside of the uterus, the fallopian tubes, but also the bladder and the intestines. It can also occasionally occur in a scar after abdominal operation. And in very rare cases outside the abdominal cavity, such as the naval, nose, eye or in the lungs.

Picture resource: Gezondheid.be

 

Every month the endometrial build hormones to prepare for a possible pregnancy. If nothing is fertilised in about 28 days, the uterus gets the signal to divest the upper layer of the endometrial. This is menstruation. The endometrial which is located outside the uterus – the endometriosis – is identical to what sits in the uterus: it therefore joins the monthly cycle. This results in small bleeding in the abdominal cavity. This blood can not, unlike menstruation blood, leave via the normal way (vagina), and ends up on the surface of surrounding organs and tissues. This causes irritation, which can lead to inflammation, scarring and sometimes to adhesions between organs. Endometriosis can also occur in the ovaries. The blood which during menstruation is released from the uterus then collects in the ovaries. This leads to cavities (cysts) that can grow ever large and are filled with blood. Because old blood looks like chocolate, it is popularly known as ‘chocolate-cysts’. The medical term for this is endometriomen.

Although we now know what endometriosis is, we still do not know how it is caused. It is also not clear why with endometriosis gives one woman little or no complaints and another will grow to serious proportions. But heredity plays a role. Endometriosis is the second most common gynaecological disease (related to the female reproductive system) and it is thought that it affects around 7-10% of women during the years when they menstruate. Globally, around 80 million women suffer from it. It is also one of the most common causes of infertility in women over 25 years and it has been proven that 35-40% of childless women can have a certain stage of endometriosis.

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Bladder problems

Through various problems with the bladder it can be necessary to create an urostoma/urinestoma. For example these problems could be: the closing of the urethers (urinary tract) through for example a lump or a narrowing (stenosis). Also the malfunctioning of the bladder can lead to a stoma, for example due to nerves damaged by multiple sclerosis or another cause whereby one becomes incontinent. Also whenever the bladder can no longer fill to its normal capacity as a result of radiation could mean a need for a stoma. Also bladder pain syndrome (Interstitial cystitis) can be a cause; especially if at a latter stage a fibriotic shrivelled bladder (scarred bladder) develops. It can also happen that the bladder muscles no longer pull together whereby spontaneous urination is impossible, for example as a consequence of an enlarged prostrate or nerve problems. Finally a stoma can also be formed if the kidneys do not work properly.

 

Picture resource: Kanker wie helpt

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Stomach problems

Through all sorts of causes it can be that your stomach does not work (properly). For example by dumping syndrome, where you have a very fast throughput and the bolus (food lump) enters the small intestine insufficiently digested (”dumping”). There are two sorts of dumping complaints.

Early dumping complaints, these problems develop in the first hour after food and liquid intake. They develop because food enters the small intestine in large lumps, because the stomach has not broken down the food small enough. A badly working stomach sphincter can be the cause of these complaints. The problem of early dumping is that the food in the small intestine attracts a large amount of fluid (osmotic reaction). This can amongst other things cause diarreah, a full feeling, nausea, and stomach pain. Blood pressure can also lower, because so much fluid is being attracted to the blood vessels. This causes palpitations, dizziness and a drowsy feeling.

Late dumping complaints develop one and a half to two hours after food or liquid intake. They develop because the small intestine is not yet ready for the food mush which comes from the stomach. The food clumps are too big and enter the intestine much quicker than usual. The digestive juices (gall fluids or pancreatic juices) are insufficiently entered into the small intestine. The sugars in the food are absorbed too quickly and stimulate the production of insulin. This situation appears as a sugar deficit in people with diabetes (reactive hypoglycaemia). Amongst other things you can have problems with sweating, trembling, dizziness, heart palpations, yawning and sometimes fainting.

Some people have trouble with both patterns of problems, but they can also occur separately. Mainly early dumping or a combination of early and late dumping happens. The complaints develop in an attack often happen a half hour to an hour after the meal. The dumping syndrome can be the result of an operation whereby the stomach totally or partially is removed (stomach resection). Sometimes the problem arrives as the result of damage to the nerves which lead to the stomach (vagus nerve). Approximately 1% of the people with dumping syndrome have not undergone a stomach operation. Dumping complaints are very rare with this sort of group and the cause of the complaint is often unknown by them.

Picture source: gerd.com

 

Another stomach problem is stomach paralysis. This is a severely delayed stomach emptying whereby the stomach does not empty or delays emptying into the small intestine, meaning there is talk of mechanical obstruction. This problem happens if the stomach sphincter is damaged or the muscles of the stomach and intestines doe not work properly. The food does not move or moves very slowly through the digestive canal. Complaints associated with this can be: a full feeling, stomach acid, throwing up (even hours after the meal) and feeling full very quickly. The prominent cause of this complaint is diabetes. An operation on the stomach, a viral infection and problems with the nervous system can also be the cause. Many people have “idiopathic gastro paralysis”, which means that the cause cannot be determined after investigations.

In these cases it can happen that a stoma has to be formed eventually: a so-called feeding stoma. Liquid food inserted via this directly into the stomach or the small intestine. Sometimes TPN feeding can also be necessary. Click on this page for that.

 

Picture resource: Nutricia

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Cystic Fibrosis

Cystic Fibrosis (CF, cystic fibrosis) is a serious hereditary congenital disorder which (currently) cannot be cured. CF is persistent, whereby during the course of the disease, the complaints tend to get worse. Unfortunately this normally leads to a limited lifespan (the average life expectancy is currently around 35-40years). It is estimated that in The Netherlands there are around 1300 people with this disease, of which 600 are adults. One is every 3600 pregnancies in The Netherlands leads to a child with cystic Fibrosis. Worldwide there are more than 50,000 people with CF. This seems very little, but it is one of the most common hereditary diseases amongst the while race. The lungs especially cause most patients serious problems

 

Picture resource: Health.Yahoo

 

  In Cystic Fibrosis there is something wrong with the production of mucus. In CF there are in various parts of the body mucus which is thick and tough, instead of watery and thin. CF is therefore also known as ‘cystic fibrosis’. This mucus accumulates and causes problems especially in the airways and in the digestive tract (pancreas, intestine and liver). In the airways, the tough mucus (sputum) is not properly disposed of and causes clogging, which may be followed by respiratory tract infections. In a later phase the lung tissue is damaged and reduces the functioning of the lungs. Via the digestive organs often the drainage canals from the pancreas can become clogged with slime. The slime in the intestines is also tough, whereby blockages and other symptoms may occur.

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Multiple sclerosis (MS)

Multiple sclerosis is a chronic illness with a capricious, unforeseeable course. There are around 16,000 people with MS in the Netherlands and every year they are joined by around 350 new people. It is the most prevalent neurological condition in young adults. The first symptoms normally appear between the 20 – 40’s. People younger than 12 and older than 55 rarely hear the diagnosis of MS. It occurs at a younger age with women than with men, and above all it is two to three times more prevalent amongst women. There is as yet no explanation for this difference. Just as the cause is not known, science believes that MS exists because of a combination of factors.

 

Picture source: ms-centrum.be

 

It is a condition of the central nervous system, the brain and the spinal column. Multiple means many. Sclerosis means: scars/calluses. With MS there are adhesions and damages to the brain and spinal column whereby the central nervous system cannot perform certain signals correctly, because the insulation layer (the myeline) around the nerve paths is damaged. A number of bodily functions no longer work or do not work optimally. The cause is a fault in the immune system (defence system). It is not a muscle sickness but a neurological condition. The complaints depend on the pace in the nervous system where the adhesions are, and therefore are very varied between different people. One of the complaints is constipation or even incontinence. This can be such an impediment that a stoma can be considered.

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Paraplegia

A paraplegic, which in everyday language is known as a ‘broken neck’ or ‘broken spine’, literally means ‘cross injury’. With a paraplegic the spinal column is damaged. Plegic means ‘damage’. A vertebra can be broken or moved breaking the nerve pathway. The nerves can no longer send their messages any further down the spinal column. Being a paraplegic does not have to mean that the spinal column is totally cut through. Also smaller damage to the spinal column can stop the messages getting through correctly. Hereby the brains can no longer communicate optimally with the rest of the body, causing disruptions in movement or feeling. Through this damage you become totally or partially crippled from the place of the damage below. With a high spinal damage is in the neck for example, whilst with a low spinal damage it is in the back. You lose control over a part of your body. You also lose either totally or partially feeling in that part of the body. Often control over the bladder- and bowel muscles is lost, causing incontinence. Many people suffer from urinary tract infections (27%). Also pain (61%), spasms (69%) and decubitus (lying down) (14%) are common problems. With a ‘high’ paraplegia whereby both arms as well as legs are paralysed, ones talks of tetraplegia (from the Greek tetra which means four, four limbs). With a lesion below, whereby only the legs are paralysed, of a paraplegic. The higher the paraplegia, the greater the restriction. A paraplegic can be complete or incomplete. With an incomplete paraplegia there can be feeling in some places under the lesion, whilst with a complete paraplegia the feeling has vanished completely. The precise location is indicated with a letter/number combination which stands for the vertebrae where the break is. In the early time after the spinal cord injury there is talk of a ‘spinal shock phase’, as a reaction of the body after the event. Some functions can stop temporarily, which later return. Sometimes some returning functions work partially but the remaining function loss in permanent.

 

Picture source: Stichting Stap vooruit

 

In the Netherlands around 5000 people are paraplegics and every year around 400 to 500 paraplegics join them, whereby around 60% have a high paraplegia. There are twice as many men as women with paraplegia, and the average age is 39. Paraplegia often happens suddenly, you were not born with it. For example it happens because of a traffic accident (35%), or during sport (15%, primarily football or diving in shallow water),a fall from a height (9%)or an accident at work (13%). The spinal column can then break or shatter, whereby parts of the spinal column come against the spinal cord. Spinal cord injuries as a result of an accident are known as “trauma” or “traumatic”, the injury is a “traumatic lesion” of the spine. A lesion may also result through shot or knife wounds or through damage during an operation. Damage to the spinal cord can also happen gradually, through an illness of the spinal column/ and or spinal cord (18%), for example multiple sclerosis, a virus infection, bleeding, adhesions, a hernia or a tumour.

 

 

 

 

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