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Coronavirus: What Happens When You Get Infected?

There are many types of coronaviruses. Some give you the common cold. The new coronavirus behind the 2019-2020 pandemic causes an illness called COVID-19.

How Does Coronavirus Attack Your Body?

virus infects your body by entering healthy cells. There, the invader makes copies of itself and multiplies throughout your body.

The new coronavirus latches its spiky surface proteins to receptors on healthy cells, especially those in your lungs.

Specifically, the viral proteins bust into cells through ACE2 receptors. Once inside, the coronavirus hijacks healthy cells and takes command. Eventually, it kills some of the healthy cells.

How Does Coronavirus Move Through Your Body?

COVID-19, the illness caused by the coronavirus, starts with droplets from an infected person’s cough, sneeze, or breath. They could be in the air or on a surface that you touch before touching your eyes, nose, or mouth. That gives the virus a passage to the mucous membranes in your throat. Within 2 to 14 days, your immune system may respond with symptoms including:CONTINUE READING BELOW

  • Fever
  • A cough
  • Shortness of breath
  • Trouble breathing
  • Fatigue
  • Chills, sometimes with shaking
  • Body aches
  • Headache
  • A sore throat
  • Loss of taste
  • Loss of smell
  • Nausea
  • Diarrhea

The virus moves down your respiratory tract. That’s the airway that includes your mouth, nose, throat, and lungs. Your lower airways have more ACE2 receptors than the rest of your respiratory tract. So COVID-19 is more likely to go deeper than viruses like the common cold.

Your lungs might become inflamed, making it tough for you to breathe. This can lead to pneumonia, an infection of the tiny air sacs (called alveoli) inside your lungs where your blood exchanges oxygen and carbon dioxide.

If your doctor does a CT scan of your chest, they’ll probably see shadows or patchy areas called “ground-glass opacity.”

For most people, the symptoms end with a cough and a fever. More than 8 in 10 cases are mild. But for some, the infection gets more severe. About 5 to 8 days after symptoms begin, they have shortness of breath (known as dyspnea). Acute respiratory distress syndrome (ARDS) begins a few days later.

ARDS can cause rapid breathing, a fast heart rate, dizziness, and sweating. It damages the tissues and blood vessels in your alveoli, causing debris to collect inside them. This makes it harder or even impossible for you to breathe.

Many people who get ARDS need help breathing from a machine called a ventilator.

As fluid collects in your lungs, they carry less oxygen to your blood. That means your blood may not supply your organs with enough oxygen to survive. This can cause your kidneys, lungs, and liver to shut down and stop working.

Not everyone who has COVID-19 has these serious complications. And not everyone needs medical care. But if your symptoms include trouble breathing, get help right away.NEWSLETTERStay Up-to-Date on COVID-19

What Else Does COVID-19 Do to Your Body?

Some people also have symptoms including:

  • Pinkeye
  • Rashes
  • Liver problems or damage
  • Heart problems
  • Kidney damage
  • Dangerous blood clots, including in their legs, lungs, and arteries. Some clots may cause a stroke.

Researchers are also looking into a few reports of skin rashes, including some reddish-purple spots on fingers or toes.

A few children and teens have been admitted to the hospital with an inflammatory syndrome that may be linked to the new coronavirus. Symptoms include a fever, rash, belly pain, vomiting, diarrhea, and heart problems. The syndrome, now being referred to as multisystem inflammatory syndrome in children, or MIS-C is similar to toxic shock or to Kawasaki disease, a condition in children that causes inflammation in blood vessels. We’re still learning about these cases.

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Screen Time Damaging Your Eye Health?

Protecting your vision is easier than you think, says Nutritional Therapist Kerry O’Connor.

We’ve all experienced tired and strained eyes, be it from time spent watching our favourite Netflix series or from working too many hours in front of the computer. However, if this is becoming the norm for you and you suffer from dry eyes, irritation, blurry vision and tiredness you could be suffering from a condition called digital eye strain.

Most of us are unaware of the amount of blue light we are exposed to and it comes from far more sources than we think. We have smartphones, laptops, computers, tablets, gaming systems and LED TV, so it’s easy to see how blue light exposure can accumulate over the course of a day. Symptoms including red eyes and headaches are thought to be due to overexposure to blue light emitted from digital devices. The waves emitted from these devices can penetrate deep into the eyes and create a glare that leads to irritation and tiredness.

We tend to blink less frequently when looking at devices, your eyes react to images changing and shifting focus and the screens flicker, glare and contrast, which puts a lot of strain on eye muscles. Research shows that between 50-90% of people working in front of a computer suffer from some form of digital eye strain, and as you can imagine it is now greatly affecting children’s eyesight too. Ophthalmologists are seeing a large increase in children with dry eyes and strain due to too much screen time.

It’s very important to make sure you stay hydrated, so remember to drink plenty of water. Taking a good Omega 3 supplement that contains phospholipids and astaxanthin such as Cleanmarine Krill Oil will help with lubrication. Try to spend plenty of time in daylight too.

Many people who suffer from dry eyes or wear contact lenses use a product called Eye Logic, which they find very beneficial. Eye Logic comes in a spray or drops and incorporates a revolutionary delivery system which works immediately on irritated and tired eyes. It helps treat the deficiency in the lipid layer (the oily layer of the tear film) with phospholipid liposomes, which are small bubbles made of the same material as the cell membrane, which can carry nutrients to cells.

Eye Logic is made from natural soy lecithin and is preservative free, safe and easy to use even whilst wearing contact lenses and can be used up to six months after opening. It doesn’t distort your vision and won’t disturb the natural tear mechanism like artificial tear products.

click here to buy Eye Logic

click here to get cleanmarine Krill oil

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Coronavirus 2020 Outbreak: Latest Updates

The United States leads the world in cases of COVID-19. We’ll provide the latest updates on coronavirus cases, government response, impacts to our daily life, and more.

What is the latest news?

Summer Camp Groups Release COVID-19 Guidance

May 18, 6:45 p.m. 

Two of the nation’s largest summer camp organizations — the YMCA of the USA and the American Camp Association — released a “field guide” on Monday to operate safely this summer amid coronavirus concerns. About 14 million people typically attend 8,400 overnight and 5,600 summer day camps, according to the guide.

The 80-page document gives detailed advice for social distancing, transportation, and campers and staff with preexisting medical conditions. The guide also gives specific information about activities such as crafts, swimming and performing arts. The information is meant to supplement the one-page flowchart released by the CDC last week.EXPANDED COVERAGELatest News

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According to the guide, camps shouldn’t open if state and local officials don’t allow it. They should also be in areas that met the third phase of White House guidelines, which call for a two-week decline in COVID-19 cases and hospital capacity to care for new patients.

First, camps should pre-screen all staff and campers for COVID-19 symptoms, according to the guide. During camp, directors and administrators may choose to take temperatures daily and isolate or send home people with symptoms.

The guide suggests that overnight camps operate as a “bubble,” allowing only staff and campers who have tested negative. They may also follow shelter-in-place guidelines for the duration of the camp.

In addition to the “bubble” concept, camps may incorporate “cohort” or “household” rules that keep staff and campers in small groups for daily activities, particularly ones that require close contact. This tactic could limit the spread of a potential outbreak and allow staff to trace contacts.

Other recommendations include frequent disinfection, handwashing procedures and enough equipment, such as life preservers, so campers don’t have to share during the program.

Some of the recommendations could make operating a camp more expensive, NPR reported.

“I am aware of some Y camps that have made basically a business decision that it’s better to forego this summer, cut expenses way back and be prepared for next year,” Paul McEntire, chief operations officer of the YMCA, told NPR.

Some summer camps are planning to reopen, even if delayed, the news outlet reported, including camps in Arizona, Colorado, Connecticut, Montana, New York and Texas. Other have canceled programs entirely.

VA: More Than 1,000 Have Died From COVID-19

More than 1,000 people have died from COVID-19 in the Department of Veterans Affairs health care system, the agency reported on its tracking site. The official tally was 1,015 on Monday afternoon.

Among those, 700 died at one of the agency’s veteran hospitals. The other deaths occurred elsewhere but were reported to the department. The VA has reported more than 12,300 positive cases, with 9,200 recovered and 2,100 still active, according to the tracking site.

The total number of veterans who have died from COVID-19 is even higher, the Washington Post reported. About 550 veterans have died in state-run veterans homes as well, according to Vietnam Veterans of America, and 28 states aren’t reporting veteran deaths. The advocacy group is collecting data for an upcoming report, the newspaper said.

“VA grieves for all of the Veterans and loved ones affected by this heartbreaking situation,” said agency spokeswoman Christina Noel.

The agency’s death toll includes active duty service members, patients with military health care and civilians enrolled in VA care in humanitarian cases. Most cases are likely among the 9.5 million veterans enrolled in VA care, the newspaper reported.

One active duty service member has died from the coronavirus. A sailor on the USS Theodore Roosevelt died in a Naval hospital in Guam in April, the newspaper reported previously. A National Guard soldier died in March before he was mobilized, the newspaper also reported.

The coronavirus has affected VA staffers as well. More than 2,000 have tested positive, and 30 have died, the VA reported on a separate tracking page. Six employees who died were in New Jersey.

The number of active COVID-19 cases in VA care has declined since the beginning of May, the Military Times reported Monday. The decrease could indicate a return to normal operations at some hospitals in coming weeks, the news outlet said.

VA Secretary Robert Wilkie was invited to a House Appropriations Committee hearing to give an update on the agency’s coronavirus response. The hearing, which was scheduled for Tuesday, has been postponed.

Pro Sports Should Plan to Resume Play: NY Governor

Professional sports teams should start planning to resume play without fans, New York Gov. Andrew Cuomo said Monday.

“New York state will help those major sport franchises to do just that,” Cuomo said, CBS News reported. “Hockey, basketball, baseball, football, whoever can reopen, we’re a ready, willing, and able partner.”

Even if there are no fans at games, they could be televised, Cuomo said.

He made the comments as the state continued to have declines in coronavirus-related hospitalizations, intubations, and deaths, CBS News reported.

Major League Baseball is already making plans to start play.

Texas Reports Biggest 1-Day Increase in New Cases

As Texas moves forward with reopening, the state department of health reported 1,800 new coronavirus cases on Saturday — the largest one-day increase in the state since the pandemic began.

Many of those new cases were reported in counties with meat-packing plants. Gov. Greg Abbott said he’s sending “surge response” teams to hot spots and that increased testing explains the rise in new cases. 

“As Texas continues ramping up its testing capabilities, there will be an increase in positive cases as the state targets the most high-risk areas: nursing homes, meat packing plants and jails,” Abbott said in a news release. “That is exactly why I established surge response teams. By immediately deploying resources and supplies to these high risk areas, we will identify the positive cases, isolate the individuals and ensure any outbreak is quickly contained.”

Abbott also announced the Texas Division of Emergency Management will work with local fire departments to expand testing in nursing homes.

Under relaxed state restrictions, gyms in Texas were allowed to reopen on Monday at 25% capacity, with proper spacing of equipment and gym users, TV station KHOU reported. Nonessential manufacturing and work offices can reopen with 25% capacity as well.     

The state now has more than 47,000 reported cases, with 27,000 people who have recovered, the state department of health said.

First COVID Vaccine Tested on Humans Shows Promise

May 18, 11:20 a.m.

The first coronavirus vaccine tested on humans has yielded positive results, with a small number of people who were tested showing an immunity against the virus, drugmaker Moderna said Monday in a news release.

Moderna, a Massachusetts-based company, said the vaccine called mRNA-1273 “was generally safe and well tolerated.” The company said it plans to move ahead with the next two phases, in which larger numbers of people will be tested this year.

The news release said three different dosage levels — 25, 100 and 250 micrograms — were given to 45 participants, and all of them developed detectable antibodies. 

But the eight people who received doses of 25 and 100 micrograms in March responded best, developing antibodies that were just as high or higher than the antibodies found in people who’d gotten the coronavirus and then recovered, the company said.

The vaccine uses something called the messenger RNA approach. It does not require a virus to make the vaccine.

“I think the totality of science tells us that this is the right antigen and it should be protective,” Tal Zaks, Moderna’s chief medical officer, said Monday on a call with journalists to discuss the results, according to Business Insider.

The testing is being done in coordination with the National Institutes of Health and the National Institute of Allergy and Infectious Diseases. It has not been peer-reviewed or published in a medical journal. 

There currently is no vaccine against the coronavirus. Moderna and other companies are racing to develop a vaccine against the virus, which has killed 89,000 people in the United States alone.

It’s unclear how soon a vaccine might hit the market. Anthony Fauci, MD, of the White House coronavirus task force, has cited a 12- to 18-month timeline for development.

At least 90 potential COVID-19 vaccines are under study, and six of those are already being tested on humans in clinical trials to determine if they’re safe. 

HHS Secretary: Reopening Requires ‘Very Localized’ Decisions

May 17, 6:40 p.m. 

Communities will ultimately decide whether places where people gather — such as bars, restaurants, and schools — are ready to reopen due to coronavirus concerns, Department of Health and Human Services Secretary Alex Azar said Sunday.

“These are very localized determinants. There should not be one-size-fits-all approaches to reopening,” he said on CNN’s State of the Union.

Azar said it is safe to reopen the country because half of U.S. counties reporting cases of the coronavirus “haven’t had a single death,” The Washington Post reported.

He also mentioned other health consequences from extending shelter-in-place orders, such as suicides, and delayed heart procedures, cancer screenings, and childhood vaccines.

At the same time, people in crowded bars aren’t wearing masks or practicing social distancing, said CNN host Jake Tapper.

“I think, in any individual instance, you’re going to see people doing things that are irresponsible,” Azar said. “That’s part of the freedom that we have here in America.”

Under the first phase of reopening, the White House guidelines state that people should still physically distance themselves from others, stick to social settings with fewer than 10 people, and avoid places where “appropriate distancing may not be practical.”

“We count on local leaders to implement and interpret that, according to the local situation,” Azar said.

In states that are opening, cases haven’t spiked so far, he said, though new case numbers could be delayed. Officials are using surveillance systems to track respiratory diseases to watch for an increase, he said. They’re now testing for asymptomatic cases in places where people are in close quarters, such as nursing homes, prisons, and meatpacking plants.

“We look for early indicators,” Azar said. “Then we use the traditional public health tools to surge in there” with testing, isolation, and contact tracing.

Even still, some states are seeing an increase in cases. During its first weekend without statewide restrictions, Wisconsin received an influx of visitors from Illinois, where stay-at-home orders are still in place, according the Milwaukee Journal-Sentinel. Hundreds of people traveled to Lake Geneva on Saturday, even as Wisconsin reported its highest one-day count of 502 new cases.

And Texas reported its highest one-day count, according to The Texas Tribune. More than 1,800 new cases were recorded on Saturday, including more than 700 from Amarillo, where meatpacking plants have led to a cluster of infections.

Disney: Shopping Area in Florida Reopens Wednesday

Walt Disney Co. will reopen parts of the Disney Springs entertainment and shopping complex at Walt Disney World Resort in Florida on Wednesday, the company announced on Saturday.

The company and unions representing the workers reached an agreement about the safeguards to protect employees, according to Reuters, which has been one of the biggest questions in reopening theme parks.

“While our theme parks and resort hotels remain temporarily closed, the phased reopening of Disney Springs is a welcome milestone as we navigate through this unprecedented time together as responsibly as we can,” Disney Springs Vice President Matt Simon said in the statement.

Some third-party stores will reopen at Disney Springs this week, and on May 27, three venues operated by Disney — World of Disney, D-Luxe Burger and the Marketplace Co-Op — will reopen.

“Rest assured, there is plenty of magic awaiting you at Disney Springs — it just may feel a bit different than before,” Simon said.

To reopen safely, Disney Springs will have several new changes. All guests over age 3, cast members, and third-party employees will be required to wear “appropriate” face coverings that cover the nose and mouth at all times, except when sitting at a dining table.

Temperature screenings will be required at the entrances, and anyone with a temperature of 100.4 or higher will be sent to another location for rescreening. People who measure 100.4 or higher again won’t be allowed inside.

Disney Springs will also maintain physical distancing during the reopening phase and limit the number of people allowed in each location. Markings on the ground will show proper distancing in lines. Cashless and contactless payment options will be available, too.

The company also has increased cleaning and disinfection procedures, including high-traffic areas such as elevators, escalators, handrails, benches, tables, and restrooms. Handwashing and hand sanitizer stations will be available.

Cast members are being trained to explain new procedures and answer questions. They’ll also encourage guests to follow the new rules.

“I understand this is a great deal of change to absorb,” Simon said in the statement. “Today’s world is different, and it’s going to require a shared responsibility, with everyone doing their part.”

The latest information about shopping and dining locations, operating hours, and safety procedures will be posted at DisneySprings.com/reopening.

More USS Roosevelt Sailors Test Positive Again

May 17, 11:18 am. 

Eight more sailors on the USS Theodore Roosevelt tested positive for the coronavirus again, according to The Associated Press. That means 13 now seem to have COVID-19 a second time while working on the ship.

All of these sailors went through 2 weeks of quarantine and isolation and tested negative twice over a couple of days before working again.

On Friday, the Navy said that five sailors tested positive a second time. On Saturday, a Navy official, who requested anonymity, said that eight more tested positive.

Officials discovered the outbreak on the aircraft carrier in March and stopped in Guam. More than 1,000 crew tested positive, and 4,000 of the 4,800 crew members went to shore for quarantine and isolation. In late April, hundreds of sailors returned to the ship in waves to get ready to sail again.

But some sailors began showing symptoms again in early May, such as a cough and fever, according to Politico. Others had body aches and headaches.

The 13 sailors have left the ship and are back in isolation on the U.S. Naval Base Guam, officials told the news outlet.

FDA Authorizes First at-Home COVID-19 Sample Kit

May 16, 4:40 p.m.

A new at-home coronavirus kit will be available to collect a sample and send it to a lab for analysis, the FDA announced on Saturday.

The FDA issued an emergency use authorization to Everlywell Inc. for the Everlywell COVID-19 Test Home Collection Kit. Under separate authorizations, the FDA also allowed two COVID-19 diagnostic tests to be used at the laboratories for the at-home samples.

“The authorization of a COVID-19 at-home collection kit that can be used with multiple tests at multiple labs not only provides increased patient access to tests, but also protects others from potential exposure,” Jeffrey Shuren, MD, director of the FDA’s Center for Devices and Radiological Health, said in the news release.

People can use the kit at home after completing an online questionnaire, which is reviewed by a doctor. The kit has nasal swabs to collect the sample. Then patients put the swab in a saline tube for transport, which they can ship overnight to a specific lab — either Fulgent Therapeutics or Assurance Scientific Laboratories — that is authorized to test the at-home samples.

Once results are ready, patients can check them through Everlywell’s online portal or the company’s network of doctors.

Although the FDA previously issued two emergency use authorizations for at-home diagnostic tests, the Everlywell collection kit is the first sample kit that can be used with multiple authorized labs, the FDA said. The kit is available by prescription only.

“It is important to note that this is not a general authorization for at-home collection of patient samples using other collection kits, swabs, media, or tests, or for tests fully conducted at home,” according to the news release.

UK Trial Tests Whether Dogs Can Sniff Out Coronavirus

May 16, 3:47 p.m.

A new trial in the United Kingdom will study whether dogs that are trained as medical sniffers can detect the coronavirus in infected humans.

Dogs have been trained to detect malaria, Parkinson’s disease, and some types of cancers, according to Medical Detection Dogs, the UK charity that runs the training program.

“In principle, we’re sure that dogs could detect COVID-19. We are now looking into how we can safely catch the odour of the virus from patients and present it to the dogs,” said Claire Guest, CEO and co-founder of the organization.

The London School of Hygiene and Tropical Medicine and Durham University will work with Medical Detection Dogs to do the trial. Dogs would learn to distinguish the scent by sniffing samples during training, which would be collected from patients at London hospitals. The trial has received more than 500,000 pounds in funding, according to Durham University.

Respiratory diseases such as COVID-19 change a human’s body odor, so the researchers believe there is a “high chance” that dogs could detect it. Dogs could potentially detect differences in temperature that could indicate a fever, too.

If successful, dogs could be ready after a 6-week training program, according to the organization. Within 6 months, trained dogs could be deployed to airports and borders to identify infected travelers.

“The aim is that dogs will be able to screen anyone, including those who are asymptomatic, and tell us whether they need to be tested,” Guest said.

The dogs could potentially screen up to 250 people per hour, the BBC reported. Called “bio-detection dogs” or “Covid dogs,” the group of six trial participants would include Labradors and cocker spaniels.

CDC Warns Pediatricians About Rare Inflammatory Condition

May 16, 12:08 p.m.

The CDC has updated its coronavirus advisory to pediatricians to warn about a rare and sometimes deadly inflammatory condition that affects children and may be connected COVID-19.

Called multisystem inflammatory syndrome in children, or MIS-C, the condition has caused at least three deaths in the United States, health authorities say.

“Healthcare providers who have cared or are caring for patients younger than 21 years of age meeting MIS-C criteria should report suspected cases to their local, state, or territorial health department,” the CDC advisory says.

Symptoms include a fever, low blood pressure, rashes, red eyes, stomach upset, and inflammation of the heart and its arteries. Some of these symptoms overlap with toxic shock syndrome and Kawasaki disease, which is one of the leading causes of heart disease in children.

Children don’t appear to be as vulnerable to the coronavirus as adults. But in New York, the hot spot for MIS-C in the United States, the state health department said there appeared to be a connection between this new illness and COVID-19 because many of the young patients tested positive for the coronavirus or its antibodies.

MIS-C cases have been reported in 15 states and some European nations. More than 100 cases have been reported in New York state, where three children, aged 5, 7, and 18, have died.

Not many of the children have shown breathing problems, which is a common symptom of the coronavirus.

Tests Show Vaccine Protects Monkeys Against COVID-19

 May 16, 11:29 a.m.

There’s good news about a coronavirus vaccine being developed by Oxford University in England.

Tests show that the vaccine provided protection against the virus when given to rhesus macaque monkeys at the U.S. National Institute of Allergy and Infectious Diseases’ Rocky Mountain Laboratories in Hamilton, MT, according to the National Institutes of Health (NIH) and a preprint paper posted on the server bioRxiv

Six monkeys received the vaccine 28 days before being infected with the coronavirus. Three other animals served as the control group and did not receive the vaccine, the preprint paper said.

The vaccinated animals didn’t get sick or develop lung problems, the NIH said in a news release. Two of the three control animals developed some form of pneumonia.

Rhesus monkeys are often used in tests because they share about 93% of their genes with humans, according to the National Primates Research Center. 

Based on the research, testing on humans began April 23 in the United Kingdom, the NIH said.

The information has not been peer-reviewed but is shared online to help other researchers in the race to develop a COVID-19 vaccine.

The Oxford scientists are making the vaccine from a weakened version of a common cold viruscalled the adenovirus taken from chimpanzees. The vaccine is combined with genes to trigger antibodies that allow the immune system to destroy the virus

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Is the Risk of Crohn’s Higher If a Sibling Has It?

Q1. I am 25 years old and have a 29-year-old brother with Crohn’s disease. I have heard that Crohn’s runs in families and that you’re much more likely to get it if a sibling has been diagnosed with it. I want to take any action I can to prevent it. At this point in my life, I do not have any regular symptoms that lead me to believe that I should be seeing a doctor. Am I in the clear? Or should I still be worried? If so, is there anything I can do to help prevent Crohn’s?

Crohn’s disease does run in families, probably because of certain genetic mutations that get passed on through the generations. Unfortunately, we do not know all of the genetic mutations associated with Crohn’s disease. Also, even if a known genetic mutation exists in a family, not everyone with the mutation will develop Crohn’s disease. Therefore, it’s not useful to test for mutations known to be associated with Crohn’s disease, such as the NOD2/CARD15 gene on chromosome 16.

The lifetime risk that first-degree relatives of Crohn’s disease patients will develop Crohn’s disease themselves is just 1 percent. Therefore, if you and your brother had 98 other siblings, just one would be expected to develop Crohn’s disease! Even though this risk seems low, it is much higher than the expected lifetime risk of developing Crohn’s disease in the general population.

It would behoove you to see a doctor if you develop possible Crohn’s symptoms, such as abdominal pain, diarrhea, or weight loss. The best preventive measure you can take is to quit smoking cigarettes or never start. Cigarette smoking is associated with Crohn’s disease, and quitting has been shown to be associated with a less aggressive course of the disease.

Q2. I have just been diagnosed with Crohn’s disease at age 45. This definitely came on all of a sudden. I just want to know what I have to do to keep this from progressing any further. Also, what symptoms do people have if they have mild Crohn’s?

Crohn’s disease occurring at age 45 is unusual, but not rare. The typical symptoms of Crohn’s disease are diarrhea and abdominal pain, particularly in the right lower quadrant of the abdomen. Once the disease comes under control, remissions can be maintained with such medicines as azathioprine (Imuran), 6-mercaptopurine (6-MP), budesonide (Entocourt EC), infliximab (Remicade) and, in patients with Crohn’s colitis (involvement of the colon), 5-aminosalicylic acid agents (Asacol, Pentasa, Rowasa). Your physician will be able to pick the right medicine for you. Also, if you are a cigarette smoker, quitting will diminish your recurrence rate.

Q3. My identical twin uncles both have Crohn’s disease, and have had it since 1982. I read that in some patients, neurological problems occur, but I was just wondering if identical twins should have the same symptoms. Both of them go to different doctors, are on different medications, and one has granmal seizures while the other does not. Do you think it’s possible that medication could cause the seizures? Would you suggest having my uncle go to get a second opinion? I was under the impression that identical twins had the same DNA, and problems in one usually surface in the other. Do you think it’s possible that the medication could cause the seizures?

We do not know what causes Crohn’s disease, but many believe both genetic and environmental factors play important roles in its development. Twin studies have shown that disease concordance rates approach 50 percent. (Pure genetic disorders have concordance rates of 100 percent.) While identical twins share the same genes, they do not share the same environmental factors, possibly explaining differences in disease behavior in identical twins. Seizures are not a typical manifestation of Crohn’s disease but may be a side effect of several medications. Your uncle may benefit from an evaluation by a gastroenterologist or inflammatory bowel disease expert.

Q4. My son was first diagnosed with Crohn’s three years ago at the age of 8. He turned 11 in April, and his condition and symptoms have been controlled by taking Pentasa (mesalamine) ever since diagnosis. In the beginning he took six capsules a day plus iron and last year, the doctor lowered his prescription to four per day plus an iron supplement once a day in the morning. His symptoms are very much under control in that he seldom has stomachaches and doesn’t go to the bathroom much more than normal. His energy level seems to be normal, and his blood tests came back very good and all within the limits last month. Our concern now is growth. The doctor noticed that he’s grown little over the past year and very little weight added since a year ago. He said the Crohn’s has kicked in a little more now. We did a bone age scan a couple weeks ago and the results of this were that of a 10- to 11-year-old. The doctor suggested changing the medication to Remicade (infliximab) or 6-MP (6-mercaptopurine). Are there other meds that you would suggest instead or combining with the Pentasa? Or other alternatives? We’re just entering a phase of eating habits now that will be healthier for him. His appetite has been getting better for vegetables, fish, etc. He’s always liked fruit, apple juice, meats, chicken, pasta and cereals in the morning. I try to balance his diet. He drinks a Scandishake once daily as well. Thank you for your help.

I am glad to hear that your son’s Crohn’s disease symptoms are well-controlled on iron and Pentasa. Growth retardation can be a problem with some children with Crohn’s disease, but your son may not be affected by it. His physician should be able to tell you if he is affected by looking at his growth over time and checking some other nutritional parameters.

The best therapy for growth retardation is nutritional support. Your son may need more or different nutritional supplements than he is taking. You are right to do your best to improve his dietary intake. Remicade and 6-MP are not likely to be helpful.

Q5. Is Crohn’s disease possibly genetic? My husband and I are afraid to conceive a child because he does not want to risk the child having Crohn’s disease.

Crohn’s disease is believed to be caused by an environmental trigger (such as diet, microbes or chemicals) that sets off the inflammation in a person who is already genetically predisposed. The risk of developing Crohn’s disease is greatly increased if a family member already has Crohn’s disease.

To date, two genes — the CARD15 gene and the IL-23R gene — have been found to be associated with Crohn’s disease, but only a minority of Crohn’s disease patients has mutations in these genes. If a parent has Crohn’s disease, the lifetime risk to the child of developing Crohn’s disease is less than 1 percent. While this risk is greatly increased compared to the general population, I believe that it is low enough to encourage our patients with Crohn’s disease to conceive children if they so choose. This may also depend on the degree of family history. In other words, how many relatives have had it? Does it go back in the family quite far and affects everyone, or is it new or sporadic? Do both of you have the disease or just one? Does it run in both families or just one? Your doctor can also recommend a genetic counselor for you to see if you have concerns.

Q6. My 10-year-old daughter has many of the same symptoms of Crohn’s as my sister and me — we have both been diagnosed with Crohn’s. I have talked to my gastrointestinal doctor and her pediatrician about her, but they don’t seem concerned. They will not see her unless there is blood in her stool, which at this point she doesn’t have. Is there any other way to tell if she has Crohn’s or maybe IBS? She has always had loose stools even as a child and within half an hour of eating she is having cramps and is going to the bathroom.

Crohn’s disease tends to run in families, with about 1 percent of offspring of Crohn’s disease patients developing the disease. Furthermore, the age of onset of Crohn’s disease is usually earlier in the child than in the parent – a phenomenon known as “genetic anticipation.” I would encourage your daughter’s pediatrician to evaluate her for Crohn’s disease now. Early diagnosis and treatment leads to better outcomes. Since gastrointestinal bleeding is rare in Crohn’s disease patients, it is not reasonable to wait for bleeding to occur before initiating an evaluation. Perhaps she should be evaluated by a gastroenterologist who is familiar with treating children.

Q7. My fiancé, who is now deceased, had active Crohn’s and it was pretty bad at times. We conceived a daughter and I would like to know when is the right time to have her checked for the disease or if it is even necessary. She has had acid reflux problems in the past as an infant but still has bouts from time to time. I know Crohn’s is hereditary sometimes, I just want to get it under control while I can.

Crohn’s disease is, in part, hereditary. Your child has about a 1 percent lifetime risk of developing the disease, which is low but is much higher than if her father did not have Crohn’s disease. There is no need to perform tests unless she becomes symptomatic with chronic abdominal pain, diarrhea, or if her growth rate significantly lags behind other girls her age (known as growth failure).

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