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I figure that will take at least 5 to 10 years. And even for adults, they're going to be required to fail an anti-TNF and probably another biologic before they'll be allowed to get Skyrizi.

In general, antibiotics are more likely to help a little bit than to make things worse, even for IBD. Most likely they won't do much for you either way. Still, the GP is probably not unreasonable to want to try that first. However, that calprotectin really should get you to a gastroenterologist.

Your case sounds like a difficult one. I think you're going to need something else in addition to any biologics. Chances are pretty low that Entyvio alone will do any better than the other biologics you've been on. You probably already know that taking prednisone for long is not so good. An...

If it makes you feel any better, it's clear that there's a very large environmental component to Crohn's, given the increasing prevalence over time in much of the world. It appears that a substantial majority of Crohn's cases aren't determined by genetics. Shared family environment is not...

The low sodium and low albumin levels look like a significant concern to me. I know that whenever my son was doing worse, his sodium and albumin levels were always lower. I also hear that low sodium levels are far more common than high sodium levels in hospitalized patients. I think that...

I am not familiar with the arthritis issues, but I can talk about Crohn's. I believe arthritis could be a result of Crohn's (or the result of gut bacteria/antigens going places they shouldn't, due to the intestinal damage of Crohn's), but I don't know. This sounds like a severe case of Crohn's...

Sounds like this recovery has been significantly harder than expected. Do most people who have this surgery also have a recovery like this? If not, what do you think went wrong?

I'm thinking a nephrologist or endocrinologist might be able to help investigate the dehydration problem. Nephrologists are experts in salt and fluid balance. I know the Crohn's and now lack of colon contribute to it, but maybe they would have some tricks to improve the situation. Be sure she's...

"Remission" is a tricky thing with Crohn's, and it's defined in various ways. It sounds like you're not really in remission yet, but it sounds like the biologic is helping. Keep testing things like fecal calprotectin to make sure that you're continuing to get closer to remission.

The usual insurance requirement is to fail one anti-TNF before a different biologic like Stelara or Entyvio. In the studies, Skyrizi (which acts similarly to Stelara but more narrowly) seems to have even better efficacy than Stelara or anti-TNFs. Stelara and Entyvio have a better safety record...

My son's experience is similar to PDX's. Tried Remicade, results were not great and things got worse. Tried Entyvio, marginal results. Got a surgery removing the terminal ileum. Still had some inflammation a few months after surgery, so we started Stelara. Stelara is working great and there are...

This use of the rebound effect is fascinating.

Gosh, it's very good she didn't get on a plane today. One thing I've noticed a few times with people I know is that hospitals often discharge patients after surgeries when they're not really stable yet. I hope the situation improves soon!

Good luck. Sounds like this will be a big relief in the end.

Magnesium citrate supplements (gummies or capsules) are great for reducing constipation, and most people probably aren't getting enough magnesium in their diets anyway.

I've personally found that vitamin k2 supplementation causes a certain tooth pain to stop, which I believe is related to the vitamin k2 causing increased mineralization of the teeth, which is an effect it also has in other bones. Here's an article on k2 and osteoporosis...

Vitamin K2 supplements may reduce osteoporosis.

I wouldn't be surprised if oxidative stress is part of the equation here, but why only ulcerative colitis--what about Crohn's?

Appeals are often successful. A very common situation is that the insurance company has specific requirements that must be fulfilled before approval. Often those have already been fulfilled, but the insurance company doesn't realize that yet. Once you specifically point out during the appeal...

Crohn's is not an autoimmune disease. It's an immune-mediated disease, but there's no evidence that it's an immune reaction against the self. It appears to be an immune reaction against non-self molecules such as bacteria, yeast, and possibly foods.