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Recent content by Pangolin

  1. Pangolin

    Heard from Doc today

    I'm concerned that things sound like they're getting pretty serious, and she may be running out of nonsurgical options. This disease can be so hard to get under control. I hope things turn around for her soon.
  2. Pangolin

    Heard from Doc today

    Poor O. If you ask me, I think it might be time for a couple weeks or so of TPN and nothing by mouth, and possibly more antibiotics.
  3. Pangolin

    Remission start

    Since Crohn's results in increased intestinal permeability, food molecules that wouldn't normally get into tissues get exposed to the immune system. The result is that over time Crohn's patients do seem to become sensitive to a wide variety of foods. A big change in diet could definitely help...
  4. Pangolin

    New vaccine possibility (not MAP)

    https://presse.inserm.fr/en/un-vaccin-contre-les-maladies-inflammatoires-chroniques/37598/ This reminds me of the Qu Biologics approach, which is based on an immune deficiency model of Crohn's. In this study, the researchers injected mice with flagellin in order to promote anti-flagellin...
  5. Pangolin

    Iron question

    I wouldn't worry about slightly low ferritin, but the concentration issues may be due to inflammation.
  6. Pangolin

    Psoriasis risk anti tnf kids with auto

    Anti-TNFs are known to cause psoriasis, but I would expect it to go away some months after the anti-TNF is stopped.
  7. Pangolin

    Why does inflammation happen?

    These thoughts should not be interpreted to preclude a role for influence from the microbiota, specific foods, and/or immune deficiency in starting the Crohn's process and should be considered as complementary to other theories. The purpose here is to step back and look at things from first...
  8. Pangolin

    Why does inflammation happen?

    Inflammation is an immue response to material that the body has identified as foreign. The elements necessary for inflammation to happen are: 1. Molecules which may be identified by the immune system as foreign, 2. The movement of those molecules into regions accessible to the immune system...
  9. Pangolin

    Elemental Nutrition contains everything that it is not supposed to.

    This is the main reason I don't trust most dietary generalizations in relation to Crohn's. No theory properly reconciles this yet. For example, the theory behind the SCD has to do with eliminating certain carbohydrates (including sugar), yet EN is packed full of sugar. Clearly to the extent the...
  10. Pangolin

    Higher doses of Humira *not* better for induction

    This is important. Higher doses of adalimumab (Humira) were not more effective for INDUCTION of remission of #UC (and similarly presented this week, #Crohns) despite higher serum concentrations of drug. Maintenance study is ongoing. #UEGW2019 We will discuss further at #ACG2019...
  11. Pangolin

    Update on long-term EEN, switching from Remicade

    re FCP: hasn't been tested regularly. We'll find out more about that in a few weeks
  12. Pangolin

    Update on long-term EEN, switching from Remicade

    I assure you that these were inflammatory changes. We could literally see the inflammation. There was other testing done, for example MREs. These each showed similar thickening at the terminal ileum a year apart. We haven't been able to draw a lot of conclusions based on that. At that...
  13. Pangolin

    Update on long-term EEN, switching from Remicade

    10mg/kg/8 weeks, then 10mg/kg/6 weeks, then 12.5mg/kg/6 weeks. He was a picky & difficult eater from birth.
  14. Pangolin

    Update on long-term EEN, switching from Remicade

    Regarding EEN--here's how it went: EEN upon diagnosis (originally not intended as a treatment, but effectively at about 85% of calories) -> led to very fast symptom improvement at the same time as antibiotics End EEN after about 8 weeks -> quick increase in symptoms 3 months later, back to...
  15. Pangolin

    Update on long-term EEN, switching from Remicade

    No, we have ESR substantially higher on remicade and higher at higher doses. (Symptoms are actually pretty minimal right now, but in general he's been low on the usual Crohn's symptoms. No abdominal pain in the last few days, poops are just a bit soft)