dear Dr. Gott: my 19-year-old grandson was diagnosed with Crohn’s disease two years ago. he has taken every medication I can imagine, including Humira injections into his stomach. At present, he is taking hyoscyamine and Apriso plus pain medication when it gets too severe. he has been to the hospital at least 15 times in the past two years and has seen at least six different doctors. we hope that you can help us. please.
dear Reader: Crohn’s disease is a type of inflammatory bowel disease (IBD). While there is no cure, today’s treatments can greatly reduce symptoms and may lead to long-term remission.
Common symptoms include diarrhea, abdominal pain and cramping, reduced appetite, weight loss, ulcers and blood in the stool. Those with severe Crohn’s, may also experience inflammation of the liver or bile ducts, arthritis, fever, fatigue, skin disorders and eye inflammation. Complications include bowel obstruction, malnutrition, anal fissures, ulcers, fistulas (an abnormal connection between different parts of the intestine). there is also an increased risk of colon cancer; however, the majority of sufferers never develop it.
Several types of treatment are available. The first type is anti-inflammatory drugs, such as the Apriso (mesalamine) as well as azulfidine and corticosteroids. Immune-system suppressors are also used, and Humira (adalimumab) is one. Antibiotics may be helpful in treating ulcers, abscesses and fistulas. Re-
searchers believe that antibiotics will reduce levels of harmful bacteria within the intestine, as well as suppress its immune system.
Commonly used medications include pain relievers, antidiarrheals, iron supplements, laxatives, vitamin B12 injections, calcium and vitamin D, and/or special diets, such as nutrients introduced directly into the veins, which can bypass the stomach and intestine.
If diet, lifestyle changes, medication and other treatment fail to relieve symptoms, surgery to remove a damaged portion, close fistulas or remove scar tissue may be recommended. At best, surgery can provide years of remission, but it will be temporary. nearly three-quarters of patients who undergo surgery will experience recurrence, with approximately half of them requiring a second procedure or more.
Write to Dr. Gott c/o United Media, 200 Madison Ave., Fourth Floor, New York, NY 10016.