Diet and Health FAQ

Tagged As: Crohns Medication

Question:
A work colleague of mine had mentioned that he's crohn?s-colitis. Can anybody tell me what it is & what he can do. I really want to help him if I could. What type of medication would he be on?

Answer:
The best thing that you can do for him is to be there for him, listen to him and believe it when he says he is tired, has pain, diarrhea, intestinal bleeding and feels generally terrible. You are helping him a lot by coming here and asking for advice, because the worst thing for a Crohn's sufferer is the lack of understanding received from the people around him/her (including the doctors). You can also refer him to us and we will try to support him. Anecdotal information obviously only refers to the individual telling the tale and will not necessarily be applicable to the next Crohn's patient. This is not a disease where you are ill for a week and then everything is hunky dory. It can take months or years to get into remission if you are lucky enough to experience remission. In the interim, you end up feeling chronically tired/exhausted, extremely unwell and unable to do the basics in life. Depending where he is remission/mild/moderate/severe Crohn's he will need different levels of support. ?Sometimes remission will only be achieved by surgery and I read recently that approximately 75% Crohn's patients will need an operation in their lives. A diagnosis of Crohn's Disease does not necessarily mean a shorter lifespan, this depends on the severity of the disease. However, the more operations, the higher the probability of an earlier death so this pulls the average life span down a few years or so. There was a Crohn's patient operated on in 2003 in Berlin at the Charite hospital who had 8 organs transplanted, because she suffered gastrointestinal tract failure and had to be fed parenterally for 3 years, which additionally resulted in the destruction of her liver and one kidney http://www.lhsc.on.ca/transplant/imptdate.htm. I do not know whether she is still alive, but this publication refers indirectly to the operation: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&... Your colleague will have some very real fears, one of which will be losing his job, another will be losing his colon. I am telling you this in the belief that you are close to him and that you will not spread this particular bit of information around the workplace, which would be a breach of his confidence, in my opinion. This additional stress, over and above the stress of having the disease, might lead him to become depressed. A high percentage of Crohn's patients have admitted to being on anti-depressants and if he does find himself getting depressed, it is necessary to nip this in the bud and get the appropriate treatment. Most people with chronic disease experience depression at sometime. It is important to know that Crohn's disease hits anywhere from the mouth to the anus. It can also be accompanied by a multitude of extraintestinal complications/symptoms - enteropathic arthritis, abscesses, fistulas, kidney stones, gallstones, peritoneal inclusion cysts (ladies only), skin, eye, lung, liver, pancreas, spleen, adhesions, etc. http://www.umm.edu/patiented/articles/what_symptoms_of_crohns_disease... I had Crohn's colitis and on diagnosis in 1992, at the age of 32, ?it was clear that my caecum, colon and rectum had to be removed and I now have an ileostomy (1993). Not all Crohn's patients with Crohn's Colitis lose their colon, but there is an increased risk of colon cancer over the years and routine olonoscopy should be carried out after 10 years or so. The Crohn's is occasionally mildly active in my small intestine and I occasionally have arthritis, mouth ulcers, eye problems, abscesses and I have a 2 cm gallstone (currently non symptomatic). ?I also have the Crohn's tiredness, but have been able to work. I still need to rest a lot and my social life is very tame as a result. Like most Crohn's sufferers I have had to change my job and came out of the laboratory (lots of standing) to take a desk job (albeit with a relatively high amount of traveling). I have been operated on 4 times over the past 3 years - twice this year: complete adhesiolysis, 30 cm dying crohn?s intestine removed, ileostoma refashioned (for the second time), pelvic fluid drainage. I have not been on any Crohn's medication since 1993. This might have been a mistake, but the effective medications have severe side-effects particularly when taken on a long-term basis, for example, lymphoma. Sport: Unlimited when in remission - I have scuba dived, go swimming, cycling, walking, etc. (also with the ileostomy). However, a severe case of Crohn's will hardly be able to get out of bed or walk. A little bit of encouragement to go out walking would be good if he feels up to it - a lunchtime walk might be a good proposal. A lot of working Crohn's patients (with active disease) end up working a full day and then collapsing into bed at 8 pm with nothing much else in their lives. I have spent many a weekend sleeping in order to be fit for the coming working week, which the average person cannot relate to. I obviously cannot advise on medication - that is for his competent gastroenterologist to do. However, if he has any doubts about his doctor he should not delay, but get a second opinion. I communicate with my doctors through a health CV, which documents all relevant docs with contact details, all surgeries (8 to date), all stays in hospital, allergies, current medication, current diagnoses and current symptoms. I update this as required. Doctors like to see things written down because a very sick patient is generally a very incoherent patient and depending on the length and severity of the disease one can build up an extensive portfolio extremely quickly. What I can say is that he should be taking Calcium with vitamin D as an osteoporosis prophylaxis. Crohn's patients are very likely to develop osteoporosis as a result of the disease and the side-effects of certain drugs they are given. I also take fish capsules which are meant to help with inflammation. I also take an adult vitamin tablet a day and an artichoke tablet for my gallbladder. If he is prone to kidney stones then oxalate containing foods should be avoided. The Crohn's usually necessitates a drastic change in diet and the medications generally contraindicate alcohol. I homogenise, juice, well-cook all foods and avoid hard to digest foods, such as red meat, nuts, etc.