It's been awhile

[trixie]

When my daughter Jean was first ill it took almost 2 years to figure out what she had. We went to Mayo Clinic in MN and they started her on testes and after 3 weeks confirmed she had Crohn's. That was in 2008. She had emergency surgery October 2008 to remove about a foot of her small intestine. In December she was started on Humira. She has relatively been symptom free of the Crohn's for all this time. Clean colonoscopies and normal blood work.
BUT:
She gets bacterial infections behind her ears and in her groin area. She still has bouts of diarrhea for days at a time. She takes pills to stop the runs and a steroid cream for the ears and groin. She ahs seen a dermatologist and has had steroid shots in her groin area. That has helped some but has not gotten rid of it totally.
they are talking of taking her off the Humira and switching to something else. But it's still working. Prednisone helped to clear everything up but her doctor doesn't want her on it for too long. Any suggestions??

 

[David]

Hi there trixie.

I don't have any ideas for the bacterial infections, sorry

As for the diarrhea, do they think it's due to active Crohn's or due to the resection? For example, did they remove her ileocecal valve and that's what's causing the problems?

 

[Judith]

Hello Trixie,
I am so sorry your daughter is having these problems.

I have a couple of questions regarding the bacterial infections behind the ears and in the groin area.

First, are you certain that these infections are caused by bacteria? The reason I ask, is that a steroid cream will actually make things worse if it is applied to a bacterial or fungal infection when used by itself.
A steroid cream will quiet the immune system's response to a substance on the skin. This immune reaction can also be caused by a reaction to something she is eating or is exposed to (such as an environmental allergen).

Does your daughter wear glasses? If she is having a skin reaction to the metal/plastic of the glasses this might be a cause. Or, if she has glasses that are too tight and rub this could be causing a skin reaction as well.

Warning. Personal Questions. Please feel free to ignore if you are uncomfortable.
Regarding the groin infection: Is the irritation on the sides of the groin (sort of the edges of the pubic hair area)? Does she shave, wax or use hair remover cream for the bikini line? This irritation can be caused by the act of hair removal because she is sensitive to the chemical or metal used for the bikini line or if the razor does not dry effectively between uses it can build up and grow bacteria/fungi which can reinfect the area when she uses it again.

If she is having an irritation towards the elastic in the underwear or if this elastic is too tight around the legs you might consider switching to a "boy short" type panty with no elastic. Please dont use nylon underwear as they tend to not allow the area to breathe effectively and trap moisture. This allows bacteria and fungi to grow very easily.

If her "groin area" infection is in the Vaginal and/or Perianal regions she may be having trouble with Yeast Infections (also known as [wiki]Candidiasis[/wiki]). This condition can also be found in the mouth and is called [wiki]Thrush[/wiki] or [wiki]Oral Candidiasis[/wiki].
- If she has diabetes or eats a great deal of sugar this problem can be made worse.
- If your daughter takes [wiki]Antibiotics[/wiki], especially the more powerful types of antibiotics this can cause a Yeast Infection or make it worse.
- If she does have a Candida or Yeast infection the hydrocortisone treatment may actually make the infection worse as it can reduce the immune system response to the organism. It probably will help with the itching and irritation but the infection itself may need to be treated.

One very common problem in women is the belief that they have a Yeast Infection when in fact they have an "opposite" condition of Bacterial Overgrowth, called Bacterial Vaginosis, or BV. Treatment for a yeast infection when it is actually BV causing the trouble will make the Yeast infection worse. The opposite is also true. Treating BV when Yeast is the cause will make the BV worse.

If you wouldnt mind further describing your daughter's "groin infection" and what it looks like might help as well.

Has her dermatologist attempted to culture what bacteria or fungus is involved in the infection?

Welcome to CrohnsForum! I hope your daughter feels better soon.

 

[trixie]

Thank you both for replying. No they did not remove her valve.
The Drs. alway culture the areas when we go in. They always come back as bacteria infections. The last time we saw the Derm. he gave her steroids shots in her groin area along with 2 creams that were supposed to be used for 2 weeks and off for 2 weeks. Helped clear it up behind her ears and some in her groin. Last appointment he said just to use the cream. We would go back for another shot except it has caused her to have her period every 2 weeks now.
I'm afraid if we go back they will put her on birth control to regulate her periods and that they might upset the Crohn's.
She does not shave or wax her groin area. It covers the whole front and sides. I will have her try boxer type underwear. That at least would let it air out some more. The groin area is red and has sores sometimes pus filled. She also gets pus filled "dots" on her backside and legs. She has to "pop" them so they dry up and are not hurting her. She does wear glasses, plastic frames. Has had them for years even before the infections started. We have started using bag balm just to coat the area so it doesn't itch and relieves some of the soreness.
We aren't people who call or go to the Dr. everytime we have a problem. We would rather try home remedies first before we put more chemicals into her body.

 

[Judith]

Do you have the name of the creams?

I know this is a longshot but do you happen to have the name of the bacteria they were able to culture?

Are the pus filled "dots" pretty small? Kind of like acne?

How are her feet? Does she have dandruff? Itchy scalp?

This is an extremely odd question but does your daughter (or her rashes in general) smell like Corn Tortillas? Or do they smell sour? Any other remarkable smell?

I have a couple of "home remedy" type ideas since you requested them.
Does your daughter have allergies (environmental or contact type)? If so, she might be having a response to your laundry soap (even if it claims to be low allergy detergent). I am super sensitive to soaps in general and have found that adding an extra rinse using a cup or two of White Vinegar in the cycle helps to remove the soapy residue. Dont add any liquid fabric softener to the wash at all. A lot of people have sensitivities to it. For the dry cycle, dont add fabric sheets (again a lot of people are sensitive). Also, ensure the clothes (especially underpants) are completely dry. Hanging them is best especially if you live in a humid area.
-- The vinegar also helps reduce bacterial and fungal growth in the clothes.
-- I might try to stop using bleach in the wash cycle as well. If her underpants are mostly white (and you bleach them) there might be some bleach residue left in the underwear. The fact that they are so close to the skin may cause irritation in this area. (Regarding the ear irritation.... I dont know how it applies....)

One of my favorite home remedies is bathtime. If your daughter takes baths anyway (and the doctor hasnt restricted her to shower only to reduce spreading), a nice, relaxing, warm bath with about 1/4 - 3/4 cup of regular table salt or half salt and half baking soda mix (no soap) may help.
-- Why? The skin is completely covered by "helpful" bacteria that prevent "harmful" bacteria and fungi from being able to access the skin and take hold where they can invade and infect the skin. These "helpful" bacteria like a little salt in their environment. There are other bacteria that may be causing the infection that will be inhibited by the salt. Fungi like salt too so if the cause of the infection is fungal the salt bath may make things worse (probably not likely if you use the lesser amount of salt).
-- Before immersing her entire body in the salt bath I would try to mix up a glass with about a teaspoon or tablespoon of salt and try the "patch test". Get a clean cotton ball and clean a couple inch circle (work the circle inside to outside) follow this with a clean cotton ball dipped in the salt water (work the same area start inside circle to outside), repeat a few times. Maybe a couple of times a day (use fresh cotton, fresh salt solution). You should see if this will have an effect pretty quickly. 1-3 days.

Speaking of "patch test", I always do this test for myself or my husband if we have a rash or skin irritation that wont go away. Two different patches with two different medications (at the same time).
Patch #1 -- What happens if you put a small bit of neosporin on the affected region (one inch area). *Please dont do this if she is allergic / hypersensitive to any of the ingredients in neosporin*
---- Patch #1 will often become worse if the infection is fungal.
wash hands between testing of patches (or use disposable Q-tip for each patch)
Patch #2 -- The active ingredient in Lamisil Cream (terbinafine hydrochloride) is excellent for fungal infections. Repeat the patch test just as in Patch #1 on a different area using the Lamisil (keep them as separate as possible). Lamisil is pretty expensive but the generic is almost as good (as long as it has the terbinafine hydrochloride ingrident). Use the cream not the spray. The spray does not work anywhere near as well.
---- A similar premise holds here. If it is fungal it should get better, if bacterial it should get worse (although I have seen this medication work on bacterial infections as well). You should see a difference quickly (maybe in 1-2 days or less).

For the patch tests I would keep her regular creams away from the patch test areas so you can get an independent test result.
*Has she seen what happens when not using the cream (or a patch that she doesnt use the cream)? It is possible to get a hypersensitivity to medications in the creams.

The other thing I can think of offhand is hydrogen peroxide. The "beneficial type" bacteria produce a substance that causes the hydrogen peroxide to bubble and break down. *Some*, but not all, of the bad bacteria do not have this substance and the hydrogen peroxide can kill them. If she has open or bleeding wounds her own cells may cause the bubbling reaction and/or be damaged by the hydrogen peroxide. If you want to try, I am thinking patch test with a small area?? Maybe try this if the Patch Test #1 and #2 doesnt work?

I hope it helps. Let me know if you try any of these and whether or not they work.
I hope she feels better very soon.