Exploring Crohn's Treatment Options after Successful Surgery

[rastabanana]

Hello!

My name is CJ and I am twenty-three years old. I was officially diagnosed with Crohn's several months ago, although I have been dealing with symptoms for about five years. In November 2014, I went through a successful surgery in which two sections of my small intestine were removed, along with a fistula attached to my bladder. The surgery went well without any complications, although recovery is a slow process.

I am exploring treatment options for background research before I meet with my GI to discuss my next step. I don't suffer from much pain from Crohn's since my surgery, but I am also dealing with pain related to the surgery itself as my body adjusts to the new changes, as well as mental health issues, including depression and anxiety.

A friend of mine who also has Crohn's told me about the forum and I am excited to know that there is a community of support and information available to make this journey less difficult. I look forward to getting to know others with my condition and I hope that as my life progresses, I will be able to help others by sharing my story.

 

[SarahD]

Hi CJ, Welcome to the forum! Have you been on any medication previously for your Crohn's?

There are a few options:

1. Mesalazine based medications are the mildest treatment, not proven to be effective in Crohn's disease but they do help some people.

2. Immunsuppressants such as azathioprine, 6-mercaptopurine and methotrexate.

3. Biologics such as Humira or Remicade.

This list isn't exhaustive but these are the standard treatment options available. Some doctors take a bottom up approach and start at 1 and work there way up to 3, whilst some doctors take a top down approach and start straight at 3.

 

[DJW]

Hi and welcome.

 

[rastabanana]

Hi CJ, Welcome to the forum! Have you been on any medication previously for your Crohn's?

There are a few options:

1. Mesalazine based medications are the mildest treatment, not proven to be effective in Crohn's disease but they do help some people.

2. Immunsuppressants such as azathioprine, 6-mercaptopurine and methotrexate.

3. Biologics such as Humira or Remicade.

This list isn't exhaustive but these are the standard treatment options available. Some doctors take a bottom up approach and start at 1 and work there way up to 3, whilst some doctors take a top down approach and start straight at 3.

Hi, Sarah.

Thanks for your response. I have never been treated for Crohn's medicinally. Before my diagnosis and surgery, I was managing with changes to my diet. I have an appointment with my GI in a week to review my condition and discuss possible treatments. We'll see what happens!

 

[worriedboy]

Hi and Welcome,

Glad to hear that the surgery went well.
Regarding the treatment, if I am not mistaken, there is some research showing that if biologics are started right after surgery they significantly decrease the need for a second surgery.

 

[David]

Welcome to the community

As you have had a resection and fistulizing Crohn's disease, in my opinion, you want to throw the kitchen sink at your disease. For example:

- Western Medicine -Take what your doctor suggests. I'm a fan of the top-down approach, especially when the disease state is advanced as yours is.
- Dietary changes - Improve your n3-n6 fatty acid ratio, Enteral/elemental nutrition, [wiki]paleo diet[/wiki], or [wiki]specific carbohydrate diet[/wiki]. Juicing is also growing on me a lot and we now have a juicing subforum located here.
- Hydration - Dehydration and loss of electrolytes is common. Proper hydration and adding electrolytes back in can help you a lot.
- Alternative treatments - I'm a big fan of Low Dose Naltrexone. Two studies in adults and one in children have had great results (see the stuck thread when following that link) and there are very few side effects. It's also not very expensive. Medical marijuana has been shown to help a lot as well if that's something you're comfortable with and is legally available in your area.
- Stress reduction. Do whatever it takes to reduce your stress levels. In addition, a weekly or even monthly massage if funds are tight is great. Studies have actually shown that massage can reduce inflammation. Give yourself self-massages as often as possible in between the professional ones.
- Exercise if you're able - a gentle yoga is a good one
- Vitamins and minerals - find out which you're deficient in and properly supplement. People with Crohn's disease are commonly deficient in vitamin B12, vitamin D, and magnesium as well as a host of others. But those three first ones should definitely be checked. Do not blindly supplement vitamin D and B12, treat these as medications and get your levels tested first. Although the blood test for magnesium is pretty useless and I strongly suggest you eat foods high in magnesium or discuss supplementation of it with your doctor.
- Supplements - there are a variety that help improve overall health. Check our our diet/fitness/supplements forum for ideas. I'm personally a big fan of tumeric (curcumin) and strongly suggest utilizing it if your doctor is ok with it.
- Alternative medicine - This could be stuff like acupuncture, including a naturopath in your treatment team, etc.

Bring your doctor in on the conversation for all of this. Get their input and let them help supervise your disease state. Some doctors might need a little push on some of this stuff, but we can provide studies that showcase the efficacy of all the above.

 

[rastabanana]

Thank you so much, David! Your post is extremely helpful!