Please note: My rosacea diagnosis is not connected to my taking Complera. I just chose to blog about them at the same time.

In 2008 I started my HIV medications. My first regimen was Truvada, Reyataz, and Norvir — a three-pill-a-day regimen that my body, at least at first, was fine dealing with. Then after a couple of months of taking the medication my eyes began to turn yellow and my new doctor said that jaundice was why my eyes were turning yellow. Jaundice is a yellow color of the skin, mucus membranes, or eyes. The yellow coloring comes from bilirubin, a byproduct of old red blood cells. Jaundice can be a symptom of other health problems. Every day, a small number of red blood cells in your body die, and are replaced by new ones. The liver removes the old blood cells, forming bilirubin. The liver helps break down bilirubin so that it can be removed by the body in the stool. When too much bilirubin builds up in the body, jaundice may result. Jaundice can occur if there are too many red blood cells dying or breaking down and going to the liver, the liver is overloaded or damaged and/or the bilirubin from the liver is unable to move through the digestive tract properly. So because of that I was put on another regimen.

The second regimen that I was put on was Prezista, Truvada, and Norvir. that is a four-a-day regimen. I often wondered if the reason why I sometimes forgot to take my meds is because of how many medications I had to take daily. My T cells remained the same but were not where they needed to be. My T cells have been as high as 500 to as low as 300, and right now they are the latter. I’m starting to cut back more and more on bad habits like smoking and drinking. But now I’ve been put on a new regimen called Complera.

I started Complera about one week ago; it is a one-pill-a-day regimen. The FDA approved the new drug this year. It’s been about a week and I haven’t had any bad things or side effects yet. I’m just now very tired usually, but the other side effects haven’t happened to me. I’m very happy about this one-pill-a-day regimen; this is what I’ve been waiting for and I’m so happy about it. Now there are side effects to Complera.

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Complera:

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Back pain; cough; darkened skin color on the palms of hands or soles of feet; diarrhea; dizziness; gas; headache; indigestion; joint pain; loss of appetite; mild stomach pain or discomfort; nausea; sinus drainage; skin discoloration (small spots or freckles); strange dreams; tiredness; trouble sleeping; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur when using Complera:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); bone pain; chest pain; fever; irregular heartbeat; mental or mood changes (e.g., depression, unusual negative thoughts, anxiety, restlessness); muscle pain or weakness; numbness, burning, pain, or tingling; severe or persistent dizziness; severe or persistent nausea, vomiting, or stomach or back pain; shortness of breath; suicidal thoughts or behaviors; symptoms of kidney problems (e.g., increased or decreased urination, increased thirst); symptoms of lactic acidosis (e.g., unusual weakness or tiredness; unusual muscle pain; fast or difficult breathing; stomach pain with nausea and vomiting; feeling cold, especially in the arms and legs; dizziness or light-headedness; fast or irregular heartbeat); symptoms of liver problems (e.g., yellowing of the skin or eyes, dark urine, pale stools, persistent loss of appetite).

SO BASICALLY WHAT YOU’RE SAYING IS I WOULD GET THE SAME SIDE EFFECTS AS IF I WAS ON ANY OTHER MEDICATIONS. LMAO OKAY NOT a BIG DEAL.

Tony Mills, M.D., Director of Medical Research, Anthony Mills M.D., inc. and a participating investigator in ongoing Complera studies, said:

“In the 30 years since the first AIDS cases were reported, we’ve made incredible strides in the treatment of this disease. The concept of a single-tablet regimen has become a goal in HIV drug development, and the standard of care in medical practice in the United States. However, no one therapy is appropriate for all patients.

Given its efficacy, safety and convenience, the availability of Complera represents an exciting milestone in addressing the individual needs of patients new to HIV therapy.”

Complera’s approval is supported by data from two Phase III active controlled, double blind, randomized studies carried out by Tibotec. The ECHO and THRIVE trials evaluated rilpivirine compared to efavirenz for efficacy and safety among HIV-1 infected adults who had not received medications before. John C. Martin, PhD, Chairman and Chief Executive Officer, Gilead Sciences, said:

“Complera is the second complete single-tablet regimen that Gilead has introduced, and it represents a collaboration between two organizations that share a vision of simplifying HIV therapy for patients. Tremendous progress has been made in the field of HIV, but we recognize new therapies are still needed, and we continue to work to advance options that address the needs of patients.”

Gilead wrote that Complera is the second complete antiretroviral treatment regimen for treatment-naïve HIV-1 patients in a single pill that is taken once a day. The first was Atripla (efavirenz 600 mg/emtricitabine 200 mg/tenofovir disoproxil fumarate 300 mg), which is marketed by Bristol-Myers Squibb and Gilead.

But I am the producer for an event which at times can be stressful around the same time of year. because of this stress I’ve been diagnosed with rosacea. Rosacea is a chronic skin condition involving inflammation of the cheeks, nose, chin, forehead, or eyelids. it may appear as redness, prominent spider-like blood vessels, swelling, or skin eruptions similar to acne. Symptoms are: redness of the face in discrete areas or covering the entire face, a tendency to flush or blush easily, increased number of spider-like blood vessels (telangiectasia) of the face, a red, bulbous nose, acne-like skin eruptions (may ooze or crust), a burning or stinging sensation of the face, irritated, bloodshot, watery eyes.

There is no known cure for rosacea. The goal is to identify and avoid possible triggers, and thus reduce flare-ups. By keeping a symptom diary to identify the specific triggers you may have, you may be able to see a pattern of what makes your rosacea worse. Use this information to avoid future flare-ups.

Here are some steps that may help: avoid sun exposure, use sunscreen every day, avoid prolonged exertion in hot weather, try to reduce stress, try deep breathing, yoga, or other relaxation techniques, limit spicy foods, alcohol, and hot beverages.

Triggers vary from person to person. Other triggers may include wind, hot baths, cold weather, specific skin products, exercise, or other factors.

Antibiotics taken by mouth (such as tetracycline, minocycline, or doxycycline) or applied to the skin (such as metronidazole) may control skin eruptions. Other medications (isoretinol or Accutane), which are similar to vitamin a, are stronger alternatives that your doctor or dermatologist might consider. Rosacea is not acne and will not improve with over-the-counter acne treatment.

In severe cases, laser surgery may help reduce the redness. Surgical reduction of enlarged nose tissue may also improve your appearance, if you so choose.

AND YES, BLACK PEOPLE DO GET ROSACEA TOO. I can’t tell you how many people have said to me “Really?? I didn’t know black people got rosacea.” Come on people, JEEZ!!!

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More News & Research on Complera (Rilpivirine/Tenofovir/FTC)

My fiance has Crohn's and I just recently found out that there might be foods that help his digestive tract. Any ideas?

Why are you asking non-medical people? If you're really interested in helping him, go with him on his next doctor's visit.
Read WebMD for symptoms and dietary ideas but mainly trust the doctor. you need to do the research and ask the doctor and your fiance about symptoms and treatment.

Accutane lawsuit is one of the biggest lawsuits ever filed for medical malfunction. Patients suffering from extreme inflammatory bowel disease issues proceed to file Accutane lawsuit ulcerative colitis claims. Ulcerative colitis can be a form of inflammatory bowel disease, which can be a gastrointestinal problem. Specifically, it’s a persistent irritation with the digestive tract accompanied by ulcers about the lining from the large intestine and rectum. Ulcerative colitis is typically one of the most severe in the rectal area, and leads to frequent diarrhea. some individuals have noted an instant onset of symptoms, whilst other people created ulcerative colitis months or perhaps many years right after Accutane remedy was stopped. Remedy is available for Accutane ulcerative colitis, although there is no known remedy.

Accutane was developed by Hoffmann-La Roche, a Usa drug producer. Accutane was introduced in 1982 and has handled more than 13 million sufferers. Accutane was to begin with prescribed for folks with significant acne that didn’t react to other remedies, but it continues to be more frequently prescribed inside the last 25 a long time for less significant acne. this apply has long been criticized due to the fact it’s got triggered serious negative effects, including Accutane ulcerative colitis problems.

In case you or a family member suffers from colitis after taking Accutane please speak to us for a free of charge no-obligation consultation regarding your legal rights such as submitting an Houston Accutane lawsuit ulcerative colitis declare. we present nationwide representation and there’s by no means any cost to research your prospective claims.

Indigestion, also known as dyspepsia describes the feeling of fullness or pressure like discomfort that many people feel after eating a meal.  it may or may not be accompanied by heartburn or a burning pain in the upper stomach or esophagus region.

Indigestion can affect people of any age or sex.  There can be many things that cause indigestion.  Many people only experience indigestion with increase stress or times of extreme emotion. the risk sometimes increases with alcohol intake or medications that may irritate the lining of the stomach and digestive system.

Medical conditions which may cause indigestion include stomach ulcers, GERD, Irritable bowel syndrome, thyroid disease, infections of the stomach and several others.  some medications which can irritate the digestive tract are pain medications, especially those containing aspirin, steroids, some antibiotics, thyroid medications and some hormones.  Cigarette smoking, alcohol, eating too much or too fast and increased stress or fatigue can also contribute to indigestion symptoms.

The symptoms of indigestion include:

• A feeling of fullness or bloating after meals
• Belching and gas
• Noises from your stomach, such as gurgling or growling
• Nausea and vomiting
• Upper abdominal pain
• Acidic taste in your mouth or throat
• Sometimes accompanied by heartburn, or burning feelings in the upper stomach or esophagus which is caused by stomach acid flowing up into the esophagus.

If you are experiencing these symptoms frequently you should speak to your doctor about them.  they may increase in times of increased stress, anxiety or with depression.

If indigestion is not usual for you and is combined with shortness of breath, increased sweating or pain in your arm, neck, upper back or jaw you should seek immediate medical attention.  These are symptoms of a heart attack which are often confused with indigestion.

Other symptoms that you should notify your doctor that you are experiencing with indigestion include:

• Severe pain in the right upper abdomen
• If you notice blood in your vomit, or if it resembles coffee grounds
• Loss of appetite
• Blood noted in your stools or tarry stools that are dark in color
• Loss of weight that is unintentional or unwarranted
• Repeated discomforts of indigestion that are not related to meal consumption

Indigestion is a symptom of many illnesses and conditions.  If your indigestion is becoming increasingly frequent and impairing your ability to nourish yourself of causing you discomfort each day you should see your physician to determine the cause.

Related Posts shyley. May 13th, 2010 no comments

Colon and rectal cancer kill 51,730 people a year in the United States. each year there are 102,900 new cases of colon cancer and 39,670 new cases of rectal cancer diagnosed.“My biggest mistake was not taking the symptoms and signs seriously,” said John Porter, 53, a Fort Wayne attorney, who was diagnosed with Stage 2 rectal cancer in fall 2009. Porter says he didn’t see a doctor despite having had a troubling change in his lower digestive tract for a year.“I was self-diagnosing myself,” Porter said. the symptoms persisted, and finally Porter saw his doctor. his doctor immediately sent him to a gastroenterologist, who scheduled him for a colonoscopy. Porter says he recalls waking up with the doctor standing over him saying, “mr. Porter, this is very bad, very bad indeed,” Porter recalled.According to the National Cancer Institute, in the U.S., “Colorectal cancer is the fourth-most-common cancer in men, after skin, prostate and lung cancer. it is also the fourth-most-common cancer in women, after skin, breast and lung cancer.” more then 90 percent of the people diagnosed with this disease are over 50. Risk factors include a family history of the disease, a previous cancer, diets high in fat and low in fiber, and smoking.when he was diagnosed, Porter was overweight, had been eating a high-fat diet and was not exercising.Nancy Ehmke, a registered nurse at Parkview Comprehensive Cancer Center, said few people realize inherited cancers are a small fraction of those diagnosed. for most people, diet, exercise and environmental factors are the culprits.“One of our goals at Parkview is to help people try and prevent cancer,” Ehmke said. the staff uses a team approach to decide on the best treatment for each cancer patient. from surgeons to dietitians, choices are made for the best outcome.Porter said he couldn’t have had better care. He received a month of chemotherapy and radiation to shrink the large tumor, and after a seven-week recovery he had surgery around Thanksgiving. Before surgery doctors discovered he had diabetes and high blood pressure.Porter was lucky. He made it through surgery, losing 12 1/2 inches of his colon, but the surgeon did a full bowel resection. Since his surgery Porter has dropped 50 pounds.He has is controlling his diabetes through his diet, and his blood pressure has also been brought under control.“At my last checkup I was told everything looked good,” he said.the Colorectal Awareness Network will host “Take Charge of your Health” at Carew Medical Center on Thursday as part of Colorectal Cancer Awareness month. There will be free screenings and services checking for asthma, high blood pressure, bone density, EZ detect colon- rectal kits, glucose, mammograms, oral screenings, prostate specific Antigen (PSA) blood tests, skin cancer, smoking cessation and vision.Porter encourages people to get a colonoscopy. After he was diagnosed he said he called all his friends from college and urged them not to wait too long, as he did.Ehmke says a colonoscopy is the golden measure for colorectal health. By using it doctors can find and remove developing polyps before they become cancerous. People who have no family history of colorectal cancer should get them every 10 years starting at age 50. for those with a family history, doctors may recommend starting younger and repeating every five years.“a colonoscopy may be truly unpleasant, but it’s worthwhile, and it’s only a momentary passing discomfort,” said Porter.

The symptoms vary from patient to patient and may affect different parts of the digestive tract, say a particular arrangement is not that for everyone. it is also important to make some adjustments due to the outbreak of Crohn’s disease diet. Remicade soon became known as Avakine. This is done through the mediation, symptoms crohn disease of TNF-alpha in the cell membrane and in the blood and excretion of TNF-alpha production cells. it is considered effective in the treatment of Crohn’s disease with moderate and severe to reduce the symptoms of the disease. for some patients, positive responses were given in both periods. Regarded as the, symptoms crohn disease best in patients with a positive outcome of conventional treatment.

For this reason, Crohn’s disease, and a balanced diet, do not fill the deficit, symptoms crohn disease of nutrients to the patient. As the product is a steroid and has no side effects of steroids moon face, acne, osteoporosis. This is achieved by the food inspection agency that works and what is not done. the biggest problem for the patient with the possibility of malnutrition and small, symptoms crohn disease intestine can not digest or absorb nutrients from food consumption. the best diet for the disease has to be balanced with all food groups like fruits, vegetables, whole grains, fats, proteins and their proportions. currently, Remicade is a proven treatment for Crohn’s disease, debilitating long-term bowel and has a great, symptoms crohn disease impact on the lives of patients. look forward to the quality of life of the victim.

But it is still the patient’s gastroenterologist may decide to stop or reduce the use of steroids and / or it is not good for him. it is therefore very clearly how this product, symptoms crohn disease for Crohn’s disease patients from quick and comprehensive benefits. This can help the patient to a large extent control the epidemic. In addition, the food is more asthma attacks must be made from the food source or at least reduced. Remicade is effective as in reducing intestinal inflammation in patients with Crohn’s disease. You can symptoms of the disease but not yet supported in clinical studies. However, the effectiveness of the product may differ in each case.

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Pancreatitis is the inflammation of the pancreas which is a gland located behind the stomach in the upper abdomen. this gland carries out vital functions that deal with the digestion of food. the Pancreas produces enzymes and insulin which regulates blood sugar. Inflammation can take place quickly and acutely over a period of days (acute pancreatitis) or can take place and reoccur over a period of many years (chronic pancreatitis). Gallstones are normally the cause of acute pancreatitis as well as over indulging in alcohol consumption. But these are not the only causes of acute pancreatitis. Symptoms of acute pancreatitis include upper abdominal pain that lasts for a few days.

The sufferer of this condition could experience damage to the gland if the enzymes that are part of the digestive tract achieve a state of premature activation. this means that they become activated prior to experiencing secretion in the region of the duodenum. once this occurs, the enzymes immediately start a full attack on the pancreas. the pain of pancreatitis begins when the digestive enzymes become active inside the pancreas instead of waiting to begin working inside the small intestine. When this happens, the digestive enzymes are essentially digesting the pancreas. Acute pancreatitis conveys a single episode of the self-digestion of the pancreas.

Chronic pancreatitis symptoms treatment begins with knowing the symptoms of pancreatitis. Upper abdominal pain, radiating toward the back area, is indicative of pancreatitis. this pain is difficult to treat with ordinary painkillers or analgesics, especially since some painkillers can mask the consequent nausea and vomiting that also accompany pancreatitis. if not the right treatments are carried out, such pain, including all the other symptoms associated with pancreatitis may exacerbate. Long-term complications may even develop, and such diseases are diabetes, bleeding, anemia, jaundice and the inability to digest food. So in order to stay clear of these additional health problems, pancreatitis symptoms treatment should be conducted easily and efficiently.

Some of these pancreatitis early symptoms may not actually be caused by pancreatitis because other conditions can also make these symptoms occur. a doctor is the best person who will first study your pancreatitis early symptoms and then diagnose whether or not the symptoms are being caused by pancreatitis or by some other health problem. When a person has pancreatic cancer, enzymes that would normally be produced by the pancreas get halted. this is a problem since these enzymes help ensure a healthier digestion. as a result a pancreatic cancer sufferer may encounter digestive problems, especially if the foods they are consuming are high in fat.

Two New Studies Illustrate How Hepcidin Affects Beta-Thalassemia and Hemochromatosis Diseases

Newswise — a hormone made by the body may be a potential therapeutic tool for the treatment of two anemic blood disorders — beta-thalassemia and hemochromatosis. The new research was led by scientists at Weill Cornell Medical College and published in the Journal of Clinical Investigation and the journal Blood.

Commonly known as Cooley’s anemia, beta-thalassemia affects nearly 1,000 individuals in the United States; worldwide, approximately 300,000 children are born each year with thalassemias. The conditions cause excessive iron absorption in the body’s organs, with symptoms including fatigue, liver disease, heart failure, growth impairment, diabetes and osteoporosis. Standard treatment involves regular blood transfusions, which are often ineffective, or bone marrow transplants, which can help to replace and repair the broken blood production of the body.

Hepcidin, a hormone found naturally in the bloodstream and acting at the level of the digestive tract, has been known to be at low-levels in patients with beta-thalessemia. Now, the researchers have evidence that boosting levels of hepcidin may actually have a direct effect in relieving anemic patients of their body’s iron overload, potentially relieving the ravages of these conditions.

“The major consequence of iron-overload is that the lifespan of a red blood cell is half that of a normal red blood cell. these blood cells are not properly formed, are not as healthy as normal blood cells, and, therefore, cannot properly function,” explains Dr. Stefano Rivella, associate professor of genetic medicine in the Department of Pediatrics at Weill Cornell Medical College.

In the Journal of Clinical Investigation study published online on Nov. 22, Dr. Rivella and his colleagues report that breeding mice that overproduce hepcidin with other mice suffering from beta-thalassemia led to offspring that were almost as healthy as normal mice. however, when they crossed the hepcidin-expressing mice with normal mice, hepcidin levels were too high, leading to too much iron removal and an inability to produce healthy red blood cells.

“We see from this evidence that there is a balance in the body — not too much iron and not too little iron — that must be maintained to keep iron levels normal in order to produce normal blood cells,” says Dr. Rivella.

He explains that under normal conditions, hepcidin recognizes when there are not enough red blood cells. in turn, the body will then produce the correct amount of hepcidin, which regulates the amount of iron needed.

“In patients with beta-thalassemia, this mechanism isn’t working — it’s as if the raw materials — the iron — are being sent into a factory, but since no products — blood cells — are being made, more and more iron is being sent in and stored in the body’s organs,” explains Dr. Rivella.

Hepcidin’s Influence on Hemochromatosis and Iron Overload

A second study published in a recent issue of the journal Blood, and authored by Dr. Rivella and his lab, illustrates a potential new dietary treatment for patients with hemochromatosis. This anemic disease is caused by a mutation to the HFE gene, leading to lowered production of hepcidin. The disorder affects nearly 1.5 million individuals in the United States.

Hemochromatosis interferes with the body’s ability to break down iron, resulting in too much iron being absorbed from the gastrointestinal tract. Like in beta-thalassemia, patients often have iron buildup within the liver, which could lead to liver failure and sometimes liver cancer.

For treatment, patients often have blood taken out of their body, called phlebotomy. Doing so is believed to force the body to remove iron from the liver, reducing iron overload within the organ. Patients return regularly to the doctor’s office to have blood removed, in order to lower iron levels in the body, but the procedure is not so effective and could be improved, as Dr. Rivella and his colleagues describe in their study.

“We’ve learned that in hemochromatosis the body will always look to the diet in the gut for iron and not take it from the liver,” explains Dr. Rivella. “Therefore, a low-iron diet immediately following phlebotomy may force the body to look primarily to the liver for its iron supply.”

To test their hypothesis, Dr. Rivella tested three different groups of mice: normal mice on a normal diet (group 1), normal mice given a high-iron diet (group 2), and mice with hemochromatosis on a normal diet (group 3). Group 2 was given a high-iron diet in order to raise iron levels in the liver, similar to mice in group 3.

Each group had blood removed through phlebotomy and then had their hepcidin levels tested. a low level of hepcidin would indicate that the hepcidin is being utilized to absorb iron from the gut.

Results indicated that group 1 behaved as expected: Blood was removed and found to have low levels of hepcidin, meaning that the body was absorbing iron from the digestive tract.

Group 2 had higher levels of hepcidin because the body was able to recognize that there was a reservoir of iron within the liver, illustrating that hepcidin was needed to prevent the iron from being absorbed from the gut.

However, the levels of hepcidin in group 3 was low because the body was unable to recognize a high level of iron in the liver because a genetic mutation lowered the production of hepcidin, resulting in iron being taken from the gut instead of the liver.

“The implications of these findings are that if you take out the blood from patients with hemochromatosis, the body will still look to take readily available iron from the diet, instead of from the overloaded iron packed in the liver,” explains Dr. Rivella.

Recently, Dr. Rivella and collaborators at UCLA were awarded a $4 million grant from the National Institutes of Health to test a drug that mimics hepcidin in people with beta-thalassemia and hemochromatosis. they hope to show that boosting hepcidin in the body helps to better treat their iron overload and anemia.

First author of the Journal of Clinical Investigation study is Dr. Sara Gardenghi of Weill Cornell Medical College. Co-authors include Pedro Ramos, Maria Franca Marongiu, Luca Melchiori, Laura Breda, Ella Guy, Kristen Muirhead, Niva Rao, Patricia Giardina and Robert Grady, all from Weill Cornell Medical College; Cindy Roy, from Johns Hopkins University School of Medicine, Baltimore, Md.; Nancy Andrews, from Duke University School of Medicine, Durham, N.C.; Elizabeta Nemeth, from the David Geffen School of Medicine, University of California, Los Angeles, Calif.; Antonia Follenzi, from Albert Einstein College of Medicine, Bronx, N.Y.; Xiuli an and Narla Mohandas, from the Red Cell Physiology Laboratory, New York Blood Center, New York, N.Y.; Yelena Ginzburg, from the Erythropoiesis Laboratory, New York Blood Center, New York, N.Y.; and Eliezer a. Rachmilewitz, from the Hematology Department, Edith Wolfson Medical Center, Holon, Israel.

Research conducted in the JCI study is supported by funding from the National Institutes of Health, the Cooley’s Anemia Foundation, the Associazione Veneta per la Lotta alla Talassemia, the Carlo and Micol Schejola Foundation, the Children’s Cancer and Blood Foundation, and the American Portuguese Biomedical Research Fund.

First author of the Blood study is Dr. Pedro Ramos of Weill Cornell Medical College. Co-authors include Ella Guy, Nan Chen, Sara Gardenghi, Carla Casu, Catia C. Proenca and Robert W. Grady — all from Weill Cornell; Antonia Follenzi, from the Albert Einstein College of Medicine, Bronx, N.Y.; Nico Van Rooijen, from the Department of Molecular Cell Biology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands; and Maria de Sousa, from the Instituto de Ciências Biomédicas de Abel Salazar, Porto, Portugal.

Research conducted in the BLOOD study was supported by grants from The National Institutes of Health, the Carlo and Micol Schejola Foundation, the Children’s Cancer and Blood Foundation, and the American Portuguese Biomedical Research Fund.

Weill Cornell Medical College 

Weill Cornell Medical College, Cornell University’s medical school located in New York City, is committed to excellence in research, teaching, patient care and the advancement of the art and science of medicine, locally, nationally and globally. Physicians and scientists of Weill Cornell Medical College are engaged in cutting-edge research from bench to bedside, aimed at unlocking mysteries of the human body in health and sickness and toward developing new treatments and prevention strategies. in its commitment to global health and education, Weill Cornell has a strong presence in places such as Qatar, Tanzania, Haiti, Brazil, Austria and Turkey. through the historic Weill Cornell Medical College in Qatar, the Medical College is the first in the U.S. to offer its M.D. degree overseas. Weill Cornell is the birthplace of many medical advances — including the development of the Pap test for cervical cancer, the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial of gene therapy for Parkinson’s disease, and most recently, the world’s first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient. Weill Cornell Medical College is affiliated with NewYork-Presbyterian Hospital, where its faculty provides comprehensive patient care at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. The Medical College is also affiliated with the Methodist Hospital in Houston, making Weill Cornell one of only two medical colleges in the country affiliated with two U.S.News & World Report Honor Roll hospitals. For more information, visit weill.cornell.edu.

Posted on: Thursday, 2 December 2010, 15:22 CST

Post-traumatic stress in Crohn’s disease and its association with disease activity

The inflammatory bowel disorder Crohn’s disease produces its own variant of post traumatic stress (PTSD), indicates research published online in Frontline Gastroenterology.

PTSD creates a vicious circle by worsening the Crohn’s symptoms, indicates the study.

Crohn’s disease is incurable and can potentially affect the entire digestive tract, producing severe pain and diarrhoea. It is particularly common in Northern Europe, including the UK, and North America.

Its precise cause is not known, but its unpredictability makes it difficult to treat, and treatment is itself expensive, exhausting, and onerous, and carries its own risk of complications, say the authors.

The researchers tracked the health and psychological wellbeing of almost 600 adults over a period of 18 months. All of them had been diagnosed with Crohn’s disease and lived in various different locations in Switzerland.

At the start of the study, each patient’s mental health was assessed using a 17-item validated PTSD scale, which scores the degree of fear, suffering and impaired quality of life associated with PTSD from 0 to 51.

A score of 15 or more points is suggestive of post traumatic stress disorder, and almost one in five (19%) of the patients achieved this score.

The worsening of symptoms was then monitored during the subsequent 18 months to see if there was any link with the scores and a diagnosis of PSTD.

The results showed that those individuals with PSTD were more than four times as likely to experience worsening symptoms as those who scored below this threshold, and more than 13 times as likely to do so as those scoring zero.

Post traumatic stress occurs in response to traumatic experiences, and is typically manifest in recurring dreams/thoughts, avoidance tactics, irritability and sleeping difficulties.

It is normally associated with violence, emergency situations and natural disasters, but increasingly, research indicates that particular illnesses, such as cancer and HIV infection, plus the diagnostic and treatment procedures that accompany them, also take a hefty emotional toll, say the authors.

They add that over the long term, post traumatic stress permanently changes the body’s hormonal and immune responses, so making the sufferer potentially more prone to serious ill health.

"in most cases patients avoid talking about cures which remind them of having the disease…such behaviour may unwillingly be encouraged by the usual shortness of consultation time and unfamiliarity of [gut specialists] in dealing with the psychological needs of their patients," warn the authors.

Crohn’s disease can’t be cured, but PTSD can, and doctors should be alert to the psychological fall-out and refer patients for appropriate therapy, they suggest.

• BMJ-British Medical Journal
• Frontline Gastroenterology

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