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Crohn's and Colitis: Understanding the Facts About IBD


Title:Crohn's and Colitis: Understanding the Facts About IBD
Author: Dr. Hillary Steinhart, MD, MSc, FRCP (C)
Date of Publication April 2006
Number of Pages: 224

This is an excellent and the most recent overview of Inflammatory Bowel Disease that is available in book form. Written by my very own Gastroenterologist, it goes touches on all aspects of the disease, giving the reader a very good overview of what they can expect with the disease, and ways they can manage it. It includes a good description of many of the common (and not so common) drugs that are recommended, including common side effects and purpose of each drug

Recommendation: A good book to have/give to someone newly diagnosed with the disease, or for anyone interested in getting a good overview of what the disease is all about.

Facts From the Book:

  • Everyone has some intestinal inflammation, but it is excessive in IBD
  • Normal inflammation is invisible to the eye (unless using a tool like microscope) and it does not affect normal functioning
  • Rectum is always inflammed in Ulcerative Colitis. Proctitis is no colon inflammation and Pancolitis is total colon inflammation
  • Skip Lesions: two seperate areas in Crohn's Disease affected intestine seperated by normal intestine
  • Indeterminate Colitis is an when the form of IBD can not be identified
  • Crohn's inflammation can occur from inner linning to deepest layers of the bowel and the outer surface (serosa). This can cause absecesses or fistulas. CD can also cause inflammation of joints, eyes and liver
  • Osteoporosis is 30% more common in people with IBD
  • IBD can be diagnosed through a blood test if white blood cell count is elevated, as well as some other antibodies (like C-reactive protein, which is high for people with inflammation)
  • Blood test can also show anemia, B-12/Calcium deficiency or liver disease
  • Upper GI Series a.k.a. Small Bowel Follow Through
  • Barium Enema is a test for the large intestine
  • Endoscopy is done to examine duodenum, stomach, esophogus and colonoscopy is for lower areas (done through rectum)
  • Wireless Capsule Endoscopy (Pill Cam) is about the size of a large pill and is swallowed. It takes 2 pictures every second. It is dangerous if severe inflammation as it can cause a blockage
  • 80% of people with IBD can resume normal activities (job/school, etc.)
  • 40% of Ulcerative Colitis and 80% of Crohn's Disease sufferers have surgery
  • Methotrexate should not be taken if pregnant
  • The bacterial infection Clostridium Difficile is sometimes found in IBD patients stools, but it is not known to cause IBD (having IBD might create good conditions for this bacterial infection)
  • Mycobacteria causes Johne's Disease in cows. It is like Crohn's Disease is humans and it survives pasturization to be consumed by people. Not enough research/knowledge is currently known about how this affects IBD (if at all)
  • Research shows with the human genome that at least 3 genes (maybe more) that when altered can increase the chance a person develops IBD.
  • There was a thoght that Paramyxoviruses (Measles) had an IBD link but it is now somewhat disproved. This was considered since there was a CD increase after vaccination programs in the 60's that gave people a small dose of live measles
  • Non-Steroid Anit-Inflammatory Druggs (NSAIDs) cn irritate or damage the lining of intestinal tract and cause ulcers (drugs like aspirin, ibuprofen, sulindac, naproxen)
  • 10-20% of individuals with IBD have a family member with it also. Risk increases to 10% chance of getting IBD if a family member gets it
  • If there is one copy of a person's two copies of their CARD 15 (NOD-2) gene is mutated their risk of CD is 2-3X greater. If both copies mutated the risk is 30x greater
  • If sibling has CD than their brother or sister has a 1 in 12 chance of getting it also. For UC it is 1 in 20. A child of one parent with CD has a 1 in 15 chance of getting it also and a 1 in 25 chance if parent has UC. If both parents have IBD then risk to child is somewhere between 10-33%
  • Steroid drugs can deplete vitamins, so take extra calcium (1500mg) and vitamin D (800IU)
  • B-12 is only absorbed by terminal ileum, so removal of this section may require injections. Stomach secretion of Intrinsic Factor (IF) also needed for absorbtion of it, so stomach surgery can require B-12 injections later also
  • Total Eternal Nutrition is done through nose and Total Parantal Nutrition is done through itravenous/PICC line
  • TPN can affect liver,gall bladder, cholesterol, blood sugar level
  • Synbiotics or prebiotics are non-digestible carbohydrates that ferment, providing energy for good bacteria/ probiotics
  • Omega-3 fats are anti-inflammatory and include: fish/flaxseed/walnut/canola oil and leafy green vegetables
  • Omega-6 fats are pro-inflmmatory and include: corn/sunflower/cottonsed oil and processed foods
  • 1/3rd of people think strss caused/affects their IBD in some way and 3/4ths believe that strss affects the course of their disease

The book can be purchased Here
I read this over a few days in hospital recovering form a blockage. I had only been diagnosed a few weeks prior and still had no idea what was going on. By the time the surgeon came by to see me for a consultation I understood enough to participate in the conversation with him. He was impressed and asked what I was doing to learn about the disease. I showed him this book and he took a good look at it. Thats up the road a few hours from you Mike, in Kingston.

This book helped me get my head around what happening and why. And it made me feel like I have some control over things. I found it was written in such an upbeat fashion that it made me feel better reading it. Pass along my Sincere thanks to your GI if have the opportunity ;)
does anyone know about remicade and strictures.... remicade was a miracle, and then pain, nausea, vomiting etc. The dr said you have lots of scar tissue from a previous resection and the remicade made it worse. What happens now?
This post reminded me to add a test to what I have the doctor test for when I see her.

C-Reactive Protein is one I forgot about, but this can indicate how well you are controlling the disease. The others I have tested are vitamin D and B-12 levels.

I am trying to increase my vitamin D levels well above the RDA, which was determined by the amount needed to prevent Rickets. The new thinking is that we probably need quite a bit more than that for the prevention of many diseases, including Cancer.

hijk199 said:
The bad weather, the cold, the white.Today's weather is becoming worse and worse.People really begin digging in. Just hope the future will be better,Really worried about our kids!
WTF that got do with the book??
I've been hearing a bit about omega 6

I take a fish oil capsule for omega 3, do I need another for omega 6 ??