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That shivering is probably due to a fever coming on, perhaps due to the Crohn's or an infection related to the Crohn's. You're kind of already maximizing biological therapy with Stelara ever 4 weeks, but there are some other things you could add on: EEN would make things easier on the inflamed...

Another possibility is that the body is responding to mycobacteria but that response is excessive or unnecessary. Perhaps people are fine without that immune response and the mycobacteria doesn't spread, but maybe eliminating the mycobacteria (which may not be possible) could also prevent the...

There is hope of durable remission if patients can reach the right targets, and the knowledge about what the right targets are is improving. I can't find the old study right now, but there was a promising one in which all of the patients who were on infliximab who had both mucosal healing and...

I think that defining remission--even "deep" remission--is a huge problem for many of these studies, and that's what may have been going on in some of those infliximab studies. The thing is, mucosal healing is only part of the picture--in particular, there's also transmural healing. It's also...

Oddly enough, my son just had a colonoscopy, too. He had perianal disease in addition to severe disease at the ileum, and neither Remicade nor Entyvio worked well. He had an ileocecal resection, and then even after that surgery there was still inflammation. So he went on Stelara (and was also...

Infection is definitely a possibility for starting Crohn's, but I wouldn't rule out the possibility some non-infectious toxin starting the inflammation cycle. The mouse model in which they induce colitis with DSS may be more similar than you would expect.

Nice, but I notice that they completely ignore the use of EEN as the very first thing to do in severe patients. First, stop aggravating the inflammation with ordinary food. Then work on other treatments, then work on transitioning away from EEN.

90 is a little elevated, not quite normal. People seem to have all kinds of combinations of lab tests and imaging and yet still have inflammation in many cases.

ESR measures how fast the blood separates. CRP measures a protein associated with cell death. Both are associated with inflammation. ESR is said to rise more slowly and persist longer, while CRP is said to be more spiky. When he had more inflammation, my son always had an elevated ESR but...

You shouldn't be kept on prednisone for long, and if you're still having problems despite being on Remicade then it might be time for a change in treatment. My son is 15 and doing well on Stelara now. It can be difficult, but it is usually possible to get Crohn's well under control with the...

This is really interesting. There's definitely a possibility that this is a real problem for humans, too. The study also found that mice with the lack of a certain enzyme related to serotonin production didn't get colitis when exposed to the dye.

I think you need to switch from Remicade. Clearly it's not bringing inflammation down to normal levels, and it sounds like it's causing some troublesome side effects.

800 is pretty high and should result in more investigation and/or a med change. EEN works on perianal disease, too--it worked just as well there as at the ileum for my son.

Can you risk trying some alternatives before you go to the more serious drugs? Personally, I think you can and should, but you shouldn't let things go too long if you're not succeeding at getting rid of the inflammation. EEN is your best bet for dietary therapy, and if you just want to buy some...

Symptoms can be vague, even with severe Crohn's. My son did have some diarrhea, abdominal pain, and low appetite, but they were not so extreme that severe disease was obvious. Later on, after starting treatment, symptoms were nearly gone yet serious inflammation continued, which made the...

Mostly because changes in diet usually don't do much. EEN is the one dietary intervention that does a lot, but people normally don't want to do that indefinitely and usually the inflammation comes back when people stop doing it. EEN is a great tool in the Crohn's arsenal, though.

That's not a lot of blood, but some blood like that can happen with Crohn's. I'd be more concerned about the pale color in the second picture. Very pale stool can be a sign of liver problems. Diarrhea and abdominal pain is consistent with Crohn's, but many other things could also cause those...

If things are fairly stable, I would expect the following testing: General blood tests about every 4 months (counts, metabolic panel, etc) Blood and poop tests for inflammation: ESR, CRP, calprotectin. Usually along with the other blood tests. MRI (MRE) or other imaging: maybe once a year at...

That doesn't sound like Crohn's, but it does sound like a very bad reaction to prednisone. Maybe with more investigation you could figure out what the problem with your ears is and find something other than steroids that would improve them?

ESR should really be below 10 in healthy children, and most often the results are 1 to 4 in healthy kids. When things were not under control for my son, his ESR was 15 to 30+, and now it's about 2. 18 is a positive signal for inflammation.