James Redford and His Experience With Ulcerative Colitis

Diagnosed With UC and PSC, Redford Is a Transplant Advocate

James Redford

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James Redford, writer, producer, director, and son of actor Robert Redford was diagnosed with ulcerative colitis at the age of 15. He had been sick with what was initially diagnosed as the "stomach flu," and saw several doctors before he was finally given the diagnosis of inflammatory bowel disease (IBD) in 1980.

Ulcerative colitis is an auto-immune disease caused by the immune system mistaking the normal contents of the colon as being foreign invaders. The immune system then mounts an attack, sending white blood cells to the lining of the colon, which results in the inflammation and ulceration that characterize the disease. The disease is chronic and causes debilitating symptoms such as diarrhea, abdominal pain, fatigue, blood in the stool, and anemia.

There is no cure for ulcerative colitis, although anti-inflammatory medications and immunomodulators may help control the disease and its symptoms. In severe cases, patients may require surgery to remove the large intestine, resulting in either a j-pouch (ileal pouch anal anastamosis or IPAA) or an ileostomy. Redford, however, experienced a rare and serious extra-intestinal complication of ulcerative colitis just seven years after his diagnosis, when he was only 25. He developed a condition that causes inflammation in the liver, which is called primary sclerosing cholangitis (PSC).

Primary Sclerosing Cholangitis

PSC is rare, affecting only about 2 percent of patients with ulcerative colitis, but is a serious complication that causes fever, jaundice, and abdominal pain. Of those who develop PSC, about 20 percent will also develop bile duct cancer.

In 1991, Redford's liver began to fail due to PSC, and he received a liver transplant. Only a week after the surgery doctors discovered a blood clot in Redford's new liver and were unable to repair it. He was once again on placed on the transplant list.

Redford's condition deteriorated rapidly, but a donor was found in time, and he received another liver transplant. He was released from the hospital only weeks after the surgery, with the anti-rejection medication that he'll need to take for the rest of his life.

Other Potential Complications of Ulcerative Colitis

PSC is a rare and life-threatening complication of ulcerative colitis, but other complications of IBD can occur with greater frequency. These can include:

Extra-intestinal complications (those outside the colon) such as delayed growth in children, eye diseases, arthritis, skin conditions, and mouth ulcers. Most of these extra-intestinal symptoms follow the course of the ulcerative colitis⁠—they may get worse when the ulcerative colitis is flaring, and improve when the ulcerative colitis is under control.

Intestinal, or local, complications such as bowel perforation, fissures, toxic megacolon, and worsening of symptoms during menstruation. Some of these complications can be treated with medications or other non-invasive methods, but others, such as a bowel perforation or toxic megacolon, are true medical emergencies and need prompt treatment to prevent more serious disease.

Redford's Philanthropy

Redford was so moved by the experience of receiving not one, but two liver transplants, that he founded the James Redford Institute for Transplant Awareness. The Institute works to raise awareness about the need for organ and tissue donors as well as educating people about what it means to be an organ donor. A documentary film created by the Institute, The Kindness of Strangers, is the story of 4 transplant patients and the families of the organ donors. The film, which premiered on HBO, was shown at several international film festivals and won the Crystal Heart Award.

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