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About Crohn's Disease

Things Doctors Really Want You to Know About Crohn’s Disease

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Crohn’s disease may not be as well-known as cancer or heart disease, but it can consume a person’s life just as much, if not more so. Crohn’s is a chronic inflammatory disease of the gastrointestinal (GI) tract. It most often affects the large and small bowels, though it can wreak havoc on any part of the GI tract.

Here are 14 things doctors want you to know about this disease.

1.Most people with Crohn’s disease cycle through flare-ups and remissions. Symptoms related to GI inflammation are at their worst during a Crohn’s flare-up. During a remission phase, Crohn’s sufferers feel pretty normal.

Common symptoms of a Crohn’s flare-up include:

  • abdominal pain (which typically worsens after meals)
  • diarrhea
  • painful bowel movements
  • blood in stool
  • weight loss
  • anemia
  • fatigue

2. More than 700,000 Americans have been diagnosed with Crohn’s disease, and that number is continuing to rise.

Immune-mediated diseases in general, including inflammatory bowel diseases and Crohn’s, have increased in recent years. This increase is mainly seen in industrialized countries.

Men and women are equally affected, and symptoms of the disease can start at any age. However, it most often shows up in adolescents and young adults between the ages of 15 and 35.

3. No one knows exactly what causes Crohn’s

The specific causes of Crohn’s disease are unclear. Most researchers believe it is the result of a combination of factors. These factors include the interaction of three things:

  • genetic or hereditary factors
  • environmental triggers, such as medications, pollution, excessive antibiotic use, diet, and infections
  • a wayward immune system that starts attacking its GI tissue

More research is being done around the connection between environmental factors and Crohn’s disease.

4. Family history could play a part

If you have a family history of irritable bowel disorders, you may be at an increased risk of developing Crohn’s disease. Most people with Crohn’s disease, however, have no previous family history. That’s why researchers believe the environment could play an important role in understanding this disease.

5. You can’t cause Crohn’s

Doctors don’t know what causes Crohn’s disease, but they do know that people aren’t causing it themselves, says Matilda Hagan, M.D., a gastroenterologist at Mercy Medical Center in Baltimore.

6. Smoking can make symptoms worse

There may be a connection between smoking cigarettes and Crohn’s disease. Not only can smoking cause people to have worse or more frequent symptoms, but some data suggest that cigarette smoking may even increase your chances of developing Crohn’s disease.

“Smoking has been reported to affect the overall severity of the disease, with smokers having a 34 percent higher recurrence rate than nonsmokers.

7. There are many ways to treat Crohn’s disease

Crohn’s disease can present itself in a myriad of different ways. Your symptoms and frequency of flares could be different from another person with the disease. Because of this, treatments are tailored to the particular symptoms and severity of any given individual at any given time.

8. Crohn’s disease may increase your risk of GI cancer

The risk of colorectal cancer is higher in people with Crohn’s disease. This risk increases the longer a person has Crohn’s.

9. Surgery is a reality, but rarely a cure

Many people with Crohn’s disease will undergo surgery at some point in their life. Surgery is used when medication is not enough to keep the disease under control. The disease and scar tissue can lead to bowel obstructions and other complications. Surgery is often only a temporary solution.

10. Early diagnosis is the best treatment

The sooner someone is diagnosed with Crohn’s, the better chance that doctors have at improving that person’s quality of life, says Rubin. Look for a doctor who has experience treating Crohn’s disease. Because the disease and the treatment options are often complex, you will want to work with a doctor who has extensive experience treating people with Crohn’s.

11. Crohn’s often goes undiagnosed for long periods

Crohn’s disease often goes undiagnosed for long periods. If you have chronic abdominal pain and diarrhea, or other persistent and unexplained GI symptoms, you should speak with your doctor about the possibility of having Crohn’s.

12. Crohn’s disease can have a huge impact on a person’s life

Crohn’s disease often starts when a person is young and continues to affect them throughout their life. Because of this, the disease can take a toll on even the strongest person. Not only can the symptoms become debilitating, but also people with Crohn’s often have multiple doctor’s appointments, tests, and procedures. Between the symptoms and the regular appointments, quality of life can be severely impacted.

A fear of rushing to the bathroom at any given moment, of being intimate, or explaining symptoms to friends can pervade everyday thoughts. Social outings can be stressful and your productivity at work may suffer.

13. Practical support can help as much as a hug

If someone you know or love has Crohn’s disease, emotional support is vitally important. Listen to their feelings, and be supportive and understanding. Practical aid can also be helpful.

Offer to do the grocery shopping, take them a home-cooked meal, or help out with other household errands. This can help remove stress from a person’s life. You may also offer to tag along to a doctor visit. Sometimes an extra ear is welcome and helpful.

14. Crohn’s is more controllable than ever before

Early diagnosis and access to the right experts can make it easier for Crohn’s to be controlled. If you suspect you may have the condition, speak with your doctor. The sooner you get help, the sooner you can lead a normal, pain-free life.

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About Crohn's Disease

Still Tired liveing with crohns

When my Crohn’s disease is active, my fatigue can be debilitating. Sometimes I’m forced to stop answering phone calls because I literally don’t have the energy to construct sentences. I don’t allow myself to drive because it doesn’t feel safe. I’m basically unable to do anything except the bare minimum, and when I come out on the other side I feel like I’ve been in the deepest fog.

How can I be so tired?

After experiencing fatigue like this on and off for quite a while, I began to wonder how I could possibly be SO tired. I was ‘sleeping’ ten to twelve hours a night and taking a nap during the day. What more could my body possibly want? I wasn’t working. I wasn’t moving much. In fact, I wasn’t using any more strength than necessary, and yet, it still felt like too much.

Anyone with IBD knows that when you’re sick, it often feels like more than just stool emptying from your bowels. It feels like life is emptying out too.

Fatigue and mental health

I found the fatigue contributed to my anxiety and depression, affecting my mental health too. It seemed like I was trapped in this awful cycle and all I could do is come up for air between episodes.

During that time, I took prescription sleep medication, I worked with a sleep doctor, and underwent multiple normal sleep studies. I even followed suggestions on reducing screen time, creating sleep hygiene and more, but no matter what, I felt exhausted all of the time.

Sleep versus rest

This was when I learned the difference between being asleep, and getting rest. Being in bed, tossing and turning, waking up during the night – they all impact our ability to achieve deep sleep cycles characterized by faster breathing, a faster pulse, and rapid eye movements, or REM. There were times that my body may have been unconscious, but it most certainly wasn’t at rest.

It became clear to me that I had to learn how to dedicate time to conscious rest when I was awake. To be honest, this felt awkward and like something I was embarrassed about. Have you ever sat down to do something like this?

Changes I made

There were three changes I made that over time have significantly impacted my levels of fatigue, and I’d really like to offer them as suggestions to anyone who is struggling.

  1. Scrolling through social media, even while laying in bed, doesn’t count as resting. When you brain is actively thinking about things you want, need, or are missing out on, it impacts your body’s ability to rest. Schedule in some breaks to put your phone down.
  2. Guided imagery and meditation are real things that relax your mind AND your body. I rely on the Calm app, but there are others out there as well which offer you these services right from your phone. Quieting your brain quiets your body in a real, lasting way.
  3. Aromatherapy – certain scents are tied to physical relaxation. Whether you purchase a linen spray, light a candle, burn incense or diffuse essential oils, or take a bath with bubbles or salts or bombs, aromatherapy draws upon the healing powers of the leaves, flowers, stems, bark, roots or petals of plants to stimulate the natural healing action of both your body and your mind.
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About Crohn's Disease

Tips on Asking for Support During Crohn’s or UC Flares

If you’re living with inflammatory bowel disease, you know that your life, health, abilities, and capabilities can change dramatically in a short period of time. From my experience, no matter how much I plan for the next flare, there are always things I wish I had done, I need but don’t have, or I would really benefit from help.

Asking for help during a Crohn’s or UC flare

I’ve thought a lot about this and about how it feels hard to ask for help. I don’t usually know what to ask for directly so I often keep quiet, and I never know who exactly I should reach out to in the event that I need (or want!) physical things or tangible assistance.

I wanted to share with you some thoughts I’ve put together after a lot of trial and error. To be honest, it’s SO MUCH better for my mental health and my stress levels as my symptoms increase to know that I know how to best ask for support and that I’m not alone in my trials, especially when this disease can feel so isolating.

Things that are helpful when dealing with a flare

In no particular order, here are some things that have worked for me:

  1. Keep a list in your phone of a few people who are local that you trust, and that might be able to do you a favor when you don’t feel well. Depending on your needs, this might mean stopping at the store, dropping off a cooked meal, picking up a prescription, taking you to a doctors appointment, sitting with you in the ER or visiting you at home or in the hospital.
  2. Then, add to the bottom of that list, a few people who might not necessarily be nearby, but who understand your heart. People you can call or facetime or text when you want to cry or vent or be distracted. One important note here: don’t leave out your other friends with IBD! I’ve often avoided telling them that I was doing poorly because I knew they had struggles of their own, and in retrospect, they wished they’d been able to be there for me. They understood my plight directly and agreed they’d tell me if whatever I was telling them or asking them in terms of support felt like too much at any given time.
  3. Think about your necessities during a flare: what foods or meal replacements you can tolerate, what clothes and basic household items that you both need and that would make you more comfortable, and anything that might cheer you up.
  4. If you have a roommate, live with family, have a spouse, children or pets, think about if they can help and/or have needs of their own while you are down and out.
  5. In the event that a friend or family member reaches out and asks what they can do for you, or what they can bring you or send to you, I’ve found politely declining over and over is a loss for both myself and the other person. They genuinely want to help, and I honestly could use it. I have found it to be easiest to have direct and tangible items I can ask for – such as groceries, prepared meals (or meal delivery), conversation to take my mind off of things or company when I don’t have the energy to talk.

Living with inflammatory bowel disease is hard enough, there’s absolutely no reason to decline help or support simply because you don’t know how to ask, or don’t want to inconvenience someone who has already offered.

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About Crohn's Disease

Inflammatory Bowel Disease

What is Inflammatory Bowel Disease (IBD)
Inflammatory Bowel Disease is a group of chronic lifelong conditions affecting the digestive tract. It includes both Ulcerative Colitis (UC) and Crohn’s Disease (CD) which are similar but affect different parts of the intestine. UC affects the inner lining of the large intestine while CD can affect any part of the digestive tract from the mouth to the anus. You can read further information on IBD in this patient information leaflet

Clinical features of Inflammatory Bowel Disease
The main features of IBD are bloody diarrhoea associated with frequency, urgency and abdominal cramps.  In severe attacks patients may suffer weight loss and anorexia.

In addition patients may have symptoms from outside the digestive tract including:

•         Arthritis (large joints)
•         ankylosing spondylitis
•         erythema nodosum
•         pyoderma gangrenosum
•         iritis and episcleritis (inflammation of the eyeball)
•         primary sclerosing cholangitis (75% pts have IBD, Geonzon –Gonzales 2006)

How common is IBD?

•         15,000 people in Ireland have IBD
•         Incidence in Ireland – 6,000 UC
                                        – 3,000 CD

What causes IBD?
The cause of IBD is unknown but is thought to include:   Genetic susceptibility
A familial tendency 
Environmental factors -smokingstress

non-steroidal anti-inflammatory drugs  

history of appendectomy

history of infection with mycobacteria  

activation of the immune system

possibly diet but not proven

•         Infective agents
•         Seasonal changes
•         Stress – implicated in aetiology of disease  (Mawdsley & Rampton 2005)

Treatment of IBD
Treatment for IBD is often simple and includes both local and oral medications, often the condition can be managed in the community by the patient’s General Practitioner after consultation with a Specialist. Regular review by a specialist is recommended for complex therapies and disease. Surgery may be required in difficult cases.

Mary Kennedy is the IBD Clinical Nurse Specialist at TUH. The IBD nurse is often your first point of contact if you require any advice regarding your disease. She provides a rapid point of access for IBD patients, in particular she can provide support, advice and information on your inflammatory bowel condition. Also, she will play an active role in disease and drug education and management. Treatments such as Infliximab (Remicade) and Adalimumab (Humira) are administered by the IBD Nurse.

An advice line is run by the IBD Nurse and the contact number is 01 414 3855.

TUH Gut Therapy Programme for IBS
The chronic diarrhoea pathway aims to provide patients with diarrhoea symptoms of Irritable Bowel Syndrome (IBS) with fast access to the most appropriate investigations and management of their condition. Patients aged over 45 with chronic diarrhoea of more than one month duration will be automatically be triaged for a colonoscopy. If this and blood tests are normal they subsequently attend the dietitian led gut therapy clinic.

Patients aged under 45 with chronic diarrhoea of more than one month duration with red flag symptoms such as bleeding, weight loss, anaemia and family history of bowel cancer or IBD will also be automatically be triaged for a colonoscopy. If this and blood tests are normal they subsequently attend the dietitian led gut therapy clinic. 

Patients under 45 who do not have red flag features will have blood and stool tests done. If these are normal they attend the dietitian led gut therapy clinic, if an abnormality is detected they have a colonoscopy and are managed as appropriate after that.

Its most notable attribute is its effect on wound management and healing. Manuka honey also has antibacterial, antiviral and anti-inflammatory properties that may help treat numerous ailments, including irritable bowel syndrome, gastric ulcers, periodontal disease and upper respiratory infections.

Honey is well known for its anti-inflammatory and antioxidant capacities, which may be useful for the prevention of chronic inflammatory process like atherosclerosis, diabetes mellitus and cardiovascular diseases. The antibacterial, anti- inflammatory and antioxidant properties of honey

What is the fastest way to get rid of inflammation in the body?Follow these six tips for reducing inflammation in your body:

  1. Load up on anti-inflammatory foods. …
  2. Cut back or eliminate inflammatory foods. …
  3. Control blood sugar. …
  4. Make time to exercise. …
  5. Lose weight. …
  6. Manage stress.

Does b12 reduce inflammation?Vitamin B6, folate (B9), and B12 can lower your levels of homocysteine, an amino acid that’s linked to a greater risk for heart disease and rheumatoid arthritis. But we can’t say for sure that lowering homocysteine will also lower your risk for disease. The same is true for C-reactive protein, a sign of inflammation.

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