Womans Weight Loss & Chrons Disease

A woman form from Pontypool in Wales with Chrons Disease (Crohn's Disease), the debilitating and incurable inflammatory bowel condition lost a quarter of her body weight and took nine months to get properly diagnosed has decided to help spread the word about it and the other related condition of colitis.

It is said that there are 80,000 people in the UK who have the disease and yet so few people are even ware of the conditions' existence, there is much general ignorance to overcome.

Samara Kemp (24) who now has her Chrons symptoms mostly under control said that before she was diagnosed "Doctors put it down to other things, problems with food, food poisoning. I'd been eight-and-a-half stone and went down to six-and-a-half stone." Along with the weight loss she had symptoms of extreme tiredness.

Eventually the correct diagnosis and similar to what happened to me, came from a private doctor. Chrons Disease often affects the small intestine, causing inflammation, deep ulcers and scarring and typical symptoms include pain, urgent diarrhoea, severe tiredness and loss of weight.

After the diagnosis, she again like I was put on a 6 month course of steroids, daily medication, supplements such as iron and calcium, and a low fibre diet.

"I was close to nine months without a diagnosis and it was a relief at last to know what was wrong," she said.

The severity of symptoms mean Chrons and colitis patients can take over your life with the lack of awareness among most people makes it even more difficult. "There needs to be quicker diagnosis and more awareness. I have trouble getting keys for disabled toilets because people don't believe I am ill," said Ms Kemp, because of this and many other day to day situations that arise because of the disease, it has taken Samara time for her to rebuild her confidence before venturing out regularly.

Samara is now working as a substance misuse and mental health officer, she added: "South Wales Police have been great too, but it's not like that everywhere, and many people suffer in silence."

Currently there is no surgical or medical treatment that can guarantee a complete cure from the condition, however there are treatments available that can effectively treat the symptoms and bring prolonged of relief from a Chrons inflammation.

Chrons Disease and Remicade

So what it Remicade?

• First off it is important to note that Remicade is the brand name of the generic medication called infliximab.
• Infliximab (Remicade) is an antibody that attaches to a protein called tumor necrosis factor-alpha (TNF-alpha). TNF-alpha is one of the proteins produced by immune cells during activation of the immune system. TNF-alpha, in turn, stimulates other cells of the immune system to produce and release other proteins that promote inflammation.
• Remicade is used to treat Crohn's disease, rheumatoid arthritis, as well as other conditions that cause inflammation.
  

How Does Remicade help people with Chrons Disease?

• In Chrons disease, there is continued production of TNF-alpha as part of the immune activation. Remicade (Infliximab) attaches to TNF-alpha and blocks its activity and in so doing decreases the inflammation.
• So Remicade helps put Crohn's into remission by neutralizing TNF-alpha. Remicade is therefore called a TNF "antagonist" that works with your body's immune system to block TNF-alpha, reducing inflammation
• It is now generally agreed that people with chrons who respond well to an initial dose of Remicade will typically continue to improve with more treatments. If a patient does not respond to an initial dosage of Remicade, he or she is unlikely to respond with further treatment.
• The people who respond well to Remicade, the improvements in symptoms can excellent, with rapid healing of the ulcers and the inflammation in the intestines after just one infusion.
• Remicade has also been shown to be effective for treating anal fistulas.
  

How is Remicade (Infliximab) Made?

Infliximab is produced by the immune system of mice. The process involves injecting mice with with human TNF-alpha, the mouse antibody then is modified to make it look more like a human antibody, this is done to decrease the chances of an allergic reactions when it is given to humans. This modified antibody is infliximab.

What are the Side effects of Remicade (Infliximab)?

Remicade suppresses the immune system, generally the medication is well tollerated by the body, but it can have serious side effects and patients must be carefully monitored throughout the treatment.

• Because infliximab is partly a mouse protein, it may induce an immune reaction when given to people with Chrons Diseas, especially with repeated infusions.
• There is also the possibility of a delayed allergic reaction that occurs a week to ten days after receiving the infliximab.
• There have been a few cases of side effects during the infusions, including chest pain, shortness of breath, and nausea.
• Rare cases of nerve inflammation such as inflammation of the nerve of the eye (optic neuritis )

So whilst Remicade represents an exciting new development in the fight against Chrons disease, the long-term safety and effectiveness of infliximab is not yet known.

Chrons Disease and Pregnancy

It was not long ago that women with chrons disease were encouraged against pregnancy, but advances in the knowledge of Chrons disease and it's treatments mean that it is now safer than ever for women with chrons to get pregnant.

Studies have shown that the severity of the Chrons symptoms that are present in the mother at the time conception often continue throughout pregnancy. So if you have Chrons disease and are planning on having a baby the advice is to get the Chron's disease under control and in remission before getting pregnant. This can also give you time to get your body ready for pregnancy as most women even without chrons should do: by increasing the intake of folic acid, quitting smoking, getting more exercise and eating healthier.

Chrons Disease Drugs and Pregnancy
Naturally there are some chrons medications that are best avoided during the pregnancy, but now through research and a history of use, others are considered safe.

What drugs are not safe to take during pregncncy?
Two immunosuppressive drugs that are often used by chrons patients: Methotrexate and thalidomide should not be used during pregnancy. Thalidomide is well known for causing limb defects as well as other major organ complications in an unborn child, whilst the use of Methotrexate should be discontinued at least three months before conception as it has been known to cause abortion and skeletal abnormalities.

What drugs have been deemed safe for use during pregnancy?
So far the research has shown drugs commonly used in the treatment of chrons appear to be safe to take during pregnancy, these include: infliximab (Remicade), azathioprine (Imuran, Azasan), adalimumab (Humira) and certolizumab (Cimzia)

A few other drugs that are often used in Chrons disease flare-ups are also safe for pregnant women to use, these include: sulfasalazine (Azulfidine), forms of mesalamine (Asacol, Pentasa, Rowasa) and corticosteroids (Prednisone).

The best advice is to work very closely with your doctor that you are seeing for Crohn's disease as well as your obstetrician and your baby's pediatrician and don't be afraid to ask questions. As it is important point to remember that the biggest factor influencing a healthy pregnancy is the state of the chrons disease activity, so a well planned pregnancy when your chrons is in remission has the greatest chance for the best outcome.

Inflammatory bowel disease should be controlled prior to pregnancy: ulcerative colitis, Crohn's disease. (Women's Health).: An article from: Family Practice News

Children with Chrons Disease & Folic Acid Link

It has been found that Children with inflammatory bowel disease (IBD), that includes children with chrons and ulcerative colitis have low levels of Folic Acid in their blood, this ads to the theory that people with chrons and ulcerative colitis are lacking in Folate (Folic Acid)

What is Folic Acid?
Folic acid which is also called Folate, Vitamin B9 or Folacin are the types of the water-soluble Vitamin B9. The names of Folate and Folic acid come from the Latin word folium which means leaf.

Why is Folic Acid important?
Vitamin B9 that is essential to numerous bodily functions. It is vitally important during periods of rapid cell division and growth, this includes childhood and when a person is pregnant. Both children and adults require folic acid to produce healthy red blood cells and prevent anemia.

Researchers from the University of California in San Francisco believe that IBD in children may be different from the IBD that affects adults. This discovery was made when they measured blood folate levels in 78 children, nearly half of whom had recently been diagnosed with IBD while the remainder were healthy controls. Folate levels were nearly 20 per cent higher in the IBD group, the researchers found, even though the controls were ingesting around 18 per cent more folate from their diet.

Folic Acid in Foods
Folate is found in leafy vegetables, so things like spinach, turnip greens, lettuces, dried beans and peas, fortified cereal products, sunflower seeds and certain other fruits and vegetables are rich sources of folate. Liver and liver products also contain high amounts of folate, as does baker's yeast. Some breakfast cereals (ready-to-eat and others) are fortified with 25% to 100% of the recommended dietary allowance (RDA) for folic acid.

Folic acid is added to grain products in many countries, and in these countries fortified products make up a significant source of folate.

Sources: American Journal of Clinical Nutrition, 2009; 89: 545-50 & Wikipedia.

Can Digestive Advantage help Chrons & Colitis?

Today I read about an over the counter drug that has been approved by the Food and Drug Administration (FDA), that is supposed to help people with conditions including Irritable Bowel Syndrome, Chrons disease and colitis.

The drug known as Digestive Advantage™ Crohn's & Colitis Therapy mostly contains a patented probiotic called GanedenBC30 that is said to help the functioning of the digestive system. The specially isolated cultures are protected by a hardened layer of organic material that enables them to go through your acidic stomach environment and successfully arrive to your intestines, which is where they can have the most benefit.

I wonder how well these are going to help people with chrons disease, what I do know is that it won't be a miracle cure as the do say in the small print that "Digestive Advantage™ Crohn’s & Colitis Therapy is a Medical Food product that is intended for use by Crohn’s & colitis sufferers who are under the supervision of a physician. It is not a cure for Chrons or ulcerative colitis nor is it intended to replace any medications that were prescribed by a physician"

What ever the case, at the moment I think that it is only available in the US at a cost of about 55c per day, it could be worth speaking to your doctor about.

If anyone has tried them or knows any thing more I would love to get your feedback.

You can find more information on their website: Digestive Advantage™ Crohn’s & Colitis

Children with Chrons Disease Helped with Growth Hormone

Kids with Chrons disease can experience stunted growth, which at this very important period of their lives can have huge implications. Now according to a US report, it may be possible that some shots with a growth hormone may help children with Chrons disease with a growth spurt as well as improve bone mineralisation and body composition.

Encouraging Results
For the duration of 1 year at the University of California San Francisco, Dr. Melvin B. Heyman and his and colleagues treated 10 Children with Chrons Disease all aged between 4 and 19 years old with daily shots of the growth hormone. In this small study, there were shown to be healthy gains in bone mineralization at the lumbar spine as well as the average percent of body fat decrease in the children, this would indicate an increase in lean body mass.

With the growth hormone, the average height of the children increased from 3.00cm per year at the outset to 8.32cm per year after the 1 year of treatment, which is a real significant increase.

More Research Needed
Before these results, previous trials using growth hormone treatment on children with Crohn's disease showed mixed results, with many of them conflicting, so whilst these latest results are very promising, there is still much work and research to be done before the growth hormone can be used to treat pediatric patients with Chrons disease who also have stunted growth.

SOURCE: The Journal of Pediatrics, November 2008.

USA: Chrons Disease Books




UK: Chrons Disease Books

Advances in Chrons Disease Surgeries

This week, leading Chrons Disease experts at the York-Presbyterian Hospital, in the US have said that today people who suffer from chrons disease, the chronic inflammatory bowel condition are living longer healthier lives and this is mainly down to innovative new surgery.

There are an estimated half a million people in the USA alone who suffer from Chrons disease, which starts off inflammation along the gastrointestinal tract and is most often found in the lower bowel. Today there are certain drugs can help ease symptoms of chrons disease, but to date there is no cure for crohn's. There are often complications related to Crohn's disease and these often include fistulas which are abnormal, obstructive connections between tissues in the body, strictures which is basically the narrowing of the bowel, abscesses, perforations, haemorrhage and even cancers. Because of these complications chrons disease sufferers will often require some sort of surgery.

Dr Fabrizio Michelassi who is an author as well as a professor and chairman in the Department of Surgery at Weill Cornell Medical College he is also the surgeon in chief at New York-Presbyterian Hospital/Weill Cornell Medical Center said that out of five patients with chrons disease, four of them will need some kind of surgery during some point of their lives. The new,advanced and minimally invasive techniques however are sparing the patients precious bowel tissue and at the same time improving quality of life.

Dr. Sharon Stein who is the assistant professor of surgery at Weill Cornell Medical College and colorectal surgeon at New York-Presbyterian Hospital/Weill Cornell Medical Centre said that "In the past, this was limited to complex, invasive surgeries that required the removal of whole sections of the affected bowel. But over the past two decades, advances in surgery have changed that paradigm,"

Innovations in Chrons Disease Surgery

Fistula Plugs:

For anyone who has had a fistula, and I will know they are often painful as well as being dangerous as they can cause the contents of your intestines to diverge from the anal canal. This can often progress to anal incontinence, abscesses and in the most serious cases systemic infection. There are now certain surgical procedures that can drain the fistula tract but for more difficult lesions there is a new new surgical anal plug which is made from grafted porcine tissue and is then placed over the fistula. This fistula plug then is the catalyst for the growth of fibrotic tissue in the area that will then close off the fistula passage. According to Dr Stein, recent studies have shown this method to be successful in up to half of Chrons patients.


Laparoscopic surgery:

Another new innovation in surgery for people with Chrons disease is known as Laparoscopic surgery which are minimally invasive techniques requiring only a small incision and leaves very little external scarring. Laparoscopic surgery can take longer to perform than conventional surgery techniques, but lead to shorter stays in hospital, which not only saves money, but because chrons disease patients often spend long periods in hospitals can be very important to them.


Strictureplasty:

The technique of Strictureplasty has completely changed bowel surgery as the technique alows the surgeon to leave the disease affected length of bowel in place but widen it, it is "much like letting out the seams on a pant-leg," explains Dr Michelassi, who is a world renowned pioneer in the technique of Strictureplasty. This saves bowel tissue while "restructuring" it, so that intestinal contents can safely pass through. before Strictureplasty, surgeons would have to cut out whole sections of bowel affected with Chrons disease, shortening the organ which leads to the limiting of the gastrointestinal tract.

(Source: New advances in surgical treatment of Crohn's disease. Practical Gastroenterology: November 2008)

USA:
Books on Crohn's Disease from Amazon.com

UK:
Books on Crohn's Disease from Amazon.co.uk