To advertise on this site click here
Posts Tagged ‘Crohn S Disease’
New Treatment for Crohns Disease
Until now, treatment for Crohn’s has relied on surgery and anti-inflammatory and other drugs also used to treat other conditions. In August 1998, the Food and Drug Administration licensed the first treatment specifically for Crohn’s disease, an incurable and sometimes debilitating inflammation of the bowel.
Remicade (infliximab) is a genetically engineered antibody that blocks inflammation caused by a protein called tumor necrosis factor. After clinical trials showed benefit from Remicade treatment within a two-to-four week period following a single dose, FDA approved the drug for patients with moderate to severe Crohn’s disease who have not found relief with other treatments. The Food and Drug Administration (FDA) today approved Humira (adalimumab) to treat adult patients with moderately to severely active Crohn’s disease, a chronic inflammatory disease of the intestines, which affects an estimated one million Americans. Humira is a human-derived, genetically-engineered monoclonal antibody (a protein that can be produced in large quantities in a manufacturing plant). The product acts to reduce excessive levels of human tumor necrosis factor (TNF) alpha, which plays an important role in abnormal inflammatory and immune responses.
The labeling includes a boxed warning about potential serious adverse events. Crohn’s disease is a chronic, incurable, inflammatory bowel disease that causes diarrhea, cramping and abdominal pain, and in some cases, abnormal connections (fistulas) leading from the intestine to the skin. “Humira has been shown to reduce signs and symptoms, and to induce and maintain clinical remission of Crohn’s disease in patients who have had an inadequate response to conventional therapy, and in those patients who did not benefit from treatment, or who were intolerant to previous treatment with Remicade (infliximab) therapy,” said Dr. Douglas Throckmorton, Deputy Director of FDA’s Center for Drug Evaluation and Research. “Today’s approval provides patients and their health care providers with a new treatment option.”
The product has been studied in 1,478 patients with Crohn’s disease in four clinical trials comparing the drug to a placebo (contains no active ingredient) and two longer term extension studies. The labeling of Humira includes a boxed warning, the strongest type of label warning, that use of this product has been associated with serious, sometimes fatal, infections, including cases of tuberculosis, opportunistic infections, and sepsis.
Before initiating Humira treatment, patients should be evaluated for tuberculosis risk factors and tested for latent tuberculosis infection. Other serious adverse events reported by Humira users include lymphoma, a type of cancer. The most frequent adverse events included upper respiratory infections, sinusitis, and nausea. Humira requires subcutaneous injections (under the skin) to initiate treatment for Crohn’s disease, and maintenance treatment is administered as one injection every other week.
Humira was previously approved for the treatment of three autoimmune diseases: rheumatoid arthritis, a chronic inflammation of the joints; psoriatic arthritis, which causes joint swelling and scaly skin; and ankylosing spondylitis, a systemic rheumatic disease that affects the spine and sacroiliac joints. Humira is manufactured by Abbott Laboratories, Abbott Park, Ill.
Crohns Disease Medication
Treatment for Crohns disease depends on its location and severity, the presence of complications and the patient’s response to medications. The goal of treatment is to reduce the inflammation that triggers symptoms. Treatment relieves symptoms and results in long-term remission.
Treatment for Crohns disease usually involves medication and/or surgery.Drug therapies must be custom-designed for each patient. Finding which medications best alleviate the symptoms may take time. When a patient with Crohns disease undergoes surgery, it is important that the health care team (including the surgeon, anesthesiologist, and the primary treating physician) know which medications the patient is taking. Many patients with mild to moderate disease are treated with medications containing mesalamine.
These medications differ based on what parts of the bowel are treated. The use of mesalamine to treat Crohns disease, either to achieve or maintain remission, is sometimes controversial because not all studies have consistently shown that mesalamine is effective for Crohns disease. Mesalamine is usually well-tolerated and has no serious side effects. Patients may experience nausea, headache and diarrhea.
Some patients who have severe active disease or do not respond to mesalamine therapy may need corticosteroids such as prednisone to control inflammation and induce remission. These drugs are effective but have significant side effects, such as increased susceptibility to infection, mood swings, anxiety, depression, elevated blood pressure, glaucoma, cataracts and osteoporosis.
Physicians may use different strategies to administer these drugs in order to reduce side effects. Budesonide is a corticosteroid that is rapidly broken down by the liver, resulting in a much lower frequency of side effects. These medications are gradually reduced once remission is achieved — and mesalamine or a drug that suppresses the immune system is used to maintain remission.Antibiotics such as metronidazole are sometimes used to treat Crohns disease.
They are particularly helpful in patients with fistulas and are often combined with other medications. The use of metronidazole to treat active Crohns disease or to delay the recurrence of Crohn’s for the first two to three years after an ileum resection surgery is often controversial because not all studies have consistently shown that metronidazole and other antibiotics are effective in these patient groups.
Metronidazole can be effective in managing perineal Crohns disease (involving the pelvic area). Many patients require surgery because medical therapy does not control their symptoms or because complications such as blockage, abscess, perforation or bleeding into the intestines have developed
Possibly related posts: (automatically generated)
- Related posts on Anesthesiologist
- Growth As An Opiate, Part 2: The Hazards Of Happiness « DevInContext
- Twilight Sleep (IV Sedation) Allows Patients to Remain Alert and …
- liposuction in mexico | Laura Whites Fat Loss Blog
- Related posts on Antibiotics
- Antibiotics and overuse, side effects, pregnancy, immune system …
- Gleason's Announces Monthly Amateur Boxing Show – The CBZ Newswire
- Facts You Should Know About Bladder Infection
- Related posts on Cataracts
- Title: « isai3071842
- Emily's Art News | Pet People Can Pamper Their Pooches
- Series of Videos about Epilepsy
Crohns Disease Life Expectancy
In this cohort, there were 167 men and 227 women diagnosed between 1934 and 1984, with a median year of diagnosis of 1975. The median follow-up time for patients who died was 15 years (mean = 15.84 years) and for those still alive is 27 years (mean = 29.19 years), this overall median follow-up is 24 years with a range of 0–58 years (mean = 23.92).
The observed and expected numbers of deaths for men and women in each age group for each quinquenia . The overall SMR for the cohort from 1941 to 2000 was 1.29 (95% CI 1.12–1.45). It was higher in women, 1.43 (95% CI 1.22–1.65) compared with men, 1.13 (95% CI 0.87–1.35) although this difference was not statistically significant . SMR in the total cohort between 1941 and 2000 decreased with age, from 16.95 (95% CI 14.99–18.91) for patients aged 10–19 years, to 0.92 (95% CI 0.65–1.19) in patients aged over 75 years .
The overall SMR for this cohort has decreased over the period of this study, but the change is not statistically significant.
Cox regression was used to analyze trends in mortality according to gender and shows that there is a trend for men with Crohns disease to die younger and live for a shorter period following diagnosis than women. They have a 16% (95% CI −2% to 23%) increased mortality at all ages and survival following diagnosis 16% (95% CI −9% to 21%) shorter than women, but this is not statistically significant (P = 0.15) and is not adjusted to take into account the increased mortality seen in men in the general population.
Life table analysis shows that the life expectancy for men diagnosed with Crohns disease in this cohort is 77.3 years and 79.0 years for women. Overall life expectancy has not statistically significantly changed over the duration of the study and is not statistically significantly different from the life expectancy of the general population (population median over the study period is 71 for males and 77 for females).
However, Kaplan–Meier analysis of age at death of these patients shows that patients diagnosed under 20 years have a median age at death of 64 years (inter-quartile range 59–70 years), whilst those patients diagnosed over the age of 20 years do not experience reduced life expectancy. Some people may also experience fever, mouth ulcers or nausea and vomiting.
People with Crohns disease of the anus can experience pain (especially while passing a bowel motion) or an itch. A few people have disease effecting other parts of the body and may experience swollen joints, inflamed eyes, skin rashes or jaundice (yellow colour of the skin).
The symptoms and their severity vary from person to person and may flare up or improve over time. Many people will experience periods of remission when they are completely free of symptoms. With current medical treatment life expectancy is normal.
Possibly related posts: (automatically generated)
- Related posts on 19 Years
- US Church approves election of second gay bishop: The Church of …
- Watch The Thorn Birds 2 – The Missing Years Movie Online …
- Separated from husband a year ago…World of Warcraft addict…help …
Crohns Disease in Children
In the last quarter century, it has become clear that Crohns disease and ulcerative colitis affect large numbers of children and young teens. Nutritional deficiency is a major issue in treatment of children with Crohns disease. Children are growing machines.
Inflammatory bowel disease may not cause great weight loss for youngsters at first, so failure to grow normally or backsliding on height and weight charts should be taken as signs that something is wrong and worth investigating. Children facing Crohns disease also have significant self-image issues to deal with.
The disease changes their routines, and its effects may separate them from the normal activities of childhood and adolescence. Therefore, these youngsters need sensitive support from family, friends, and physicians to help them maintain their social, as well as their physical, growth. Crohns disease is a serious, chronic disease affecting the digestive system. Chronic means that the disease is long-term and persistent, usually lifelong. Crohns disease causes inflammation, most often in the small intestine (which has three parts: duodenum, jejunum, and ileum).
The walls and lining of the affected areas become red and inflamed, leading to ulcers and bleeding. Crohns disease sometimes is named by referring to inflammation in the part of the intestine affected, such as jejunoileitis, ileitis, ileocolitis, or colitis (when it involves the large intestine, also called the colon).
Crohns disease can appear at any age, but it is most often diagnosed in adults in their 20s and 30s. However, approximately 30% of people with Crohns disease develop symptoms before 20 years of age. In the United States, about 100,000 teens and preteens have Crohns disease.Along with ulcerative colitis, a similar illness, Crohns disease is also called inflammatory bowel disease, or IBD.
Ulcerative colitis attacks only the large intestine in a continuous manner and does not affect the entire thickness of the bowel wall. Crohns disease, on the other hand, can occur anywhere in the digestive tract, from mouth to the anus, attacks different sites in the intestine with areas of normal intestine in between (“skip lesions”), and affects the full thickness of the intestinal wall.
Both conditions wax and wane: there are times when symptoms reappear or get worse (exacerbations or “flares”) and other periods when symptoms get better or go away altogether (“remission”).While Crohns disease causes many problems for people of all ages, it can present special challenges for children and teens. In addition to bothersome and often painful symptoms, the disease can stunt growth, delay puberty, and weaken the bones. Crohns disease symptoms may sometimes prevent a child from participating in enjoyable activities.
The emotional and psychological issues of living with chronic disease can be especially difficult for young people. As many as 70% of children with the disease have inflammation of the lower part of the ileum. More than half of these children also have inflammation in variable segments of the colon.
• About 10%-20% of children have inflammation in the colon only.
• Another 10%-15% have inflammation scattered around the small bowel, mainly in the middle section (jejunum and upper ileum).
• A very small number have inflammation only in the stomach and the uppermost section of the small intestine where the stomach empties into the bowel (duodenum).
Possibly related posts: (automatically generated)
- Related posts on Bowel Wall
- » Title: Kendals Blog
- Do You Know This Important Information About Colon Disease? | All …
- What is Celiac Disease? | PreDisease.com Blog
Crohns Disease Cure
Mild to moderate cases are usually treated with oral medications called aminosalicylates that can relieve inflammation and keep Crohns in remission.More serious cases are treated with corticosteroids such as Prednisone, and medications such as Remicade and Humira that can reduce inflammation and heal fistulas.
Due to the potential side effects of these medications, many people opt for natural anti inflammatories such as fish oil. It has been proven to be beneficial in intestinal health, and can be as effective as prescription drugs as a Crohns treatment.
If you have Crohns disease, you will usually be seen regularly by a specialist team. Treatment will aim to increase your quality of life as much as possible, but there is no cure. If you have Crohns disease it’s important that you eat a healthy, balanced diet with a high fibre content, unless you are prone to blockages.
This is especially true when your symptoms flare up, as you will need to replace lost nutrients, although you may not feel like it. If you can eat a normal diet, you should continue to do so. However, you may find that certain foods disagree with you or that you need to eat more of particular types of food such as starchy carbohydrates (eg potatoes, bread and pasta).
When your Crohns disease is active, your doctor may recommend that you have a liquid diet, made up of simple forms of protein, carbohydrates and fats. This is called an elemental diet and is commonly used to treat children.
Many people with Crohns disease find that treatment with medicines is effective. Medicines used to treat Crohns disease include:
• corticosteroids (eg prednisolone) to reduce inflammation
• medicines to suppress your immune system (eg methotrexate or azathioprine)
• a medicine called infliximab – your doctor may recommend this if you have severe Crohns disease that hasn’t responded to other medicines
During flare-ups you may consider taking painkillers, but your GP may advise you not to take certain medicines such as ibuprofen (eg Nurofen) as they can make Crohns disease worse. It’s usually fine to take paracetamol as a painkiller, but check with your GP first. It’s not a good idea to take antidiarrhoeal medicines all the time as they may cover up signs that your disease has become more severe. Speak to your GP if diarrhoea is a problem.
Possibly related posts: (automatically generated)
- Related posts on Aminosalicylates
- Various Options for Crohn?s Disease
- Crohn's Disease Causes Symptoms Information With Treatment
- Crohn's Disease – Causes, Symptoms and Treatment
Crohns Disease and Complexion
Crohns disease is a chronic inflammatory condition involving the small intestine, most often the lower part called the ileum. However, inflammation may also affect the entire digestive tract, including the mouth, esophagus, stomach, duodenum, appendix or anus. Crohns disease is also called ileitis or enteritis.
Crohns disease affects a half million Americans, many aged 15 to 35 years.
Previous studies of vitamin D status in pediatric patients with inflammatory bowel disease have revealed conflicting results. We sought to report (1) the prevalence of vitamin D deficiency (serum 25-hydroxy-vitamin D concentration < or = 15 ng/mL) in a large population with inflammatory bowel disease, (2) factors predisposing to this problem, and (3) its relationship to bone health and serum parathyroid hormone concentration.
Vitamin D deficiency is highly prevalent among pediatric patients with inflammatory bowel disease. Factors predisposing to the problem include having a dark-skin complexion, winter season, lack of vitamin D supplementation, early stage of disease, more severe disease, and upper gastrointestinal tract involvement in patients with Crohns disease.
The long-term significance of vitamin D deficiency for this population is unknown at present and merits additional study. A 42-year-old blond Caucasian woman taking azathioprine for 8 years developed an intra-epidermal carcinoma of the shin. She regularly used a sun bed to maintain a tan. Although the increased risk of non-melanoma skin cancer in immunosuppressed transplant recipients is well recognized, patients with Crohns disease are not currently warned of the risk of exposure to ultraviolet light.
Individuals with inflammatory bowel disease who take azathioprine, especially those with a fair complexion, should be informed of the potential dangers of sun bathing and should be advised to limit sun exposure. Spleen Deficiency – may be due to constitutional deficiency or overeating cold and raw food.
Patients with Crohns disease usually have spleen deficiency characterized by a compromised ability of the spleen to transform and transport food. Symptoms include frequent and severe diarrhea, watery stool with undigested food, dull abdominal pain, poor appetite, poor digestion, gastric discomfort after food intake, pale facial complexion, fatigue and lethargy due to chronic malabsorption and malnutrition.
Diagnostic criteria for this type of ulcerative colitis includes loose bowels made worse by poor lifestyle habits or consumption of greasy foods, undigested foods in the stools, lack of appetite, distention, fatigue and sallow complexion. On examination, the tongue is pale and covered by white fur; the pulse is weak and thready. Diagnostic criteria for this type include diarrhea with mucus or darkish blood, straining for defecation, fixed stabbing pain, distention, belching and a darkish complexion. On examination, the tongue is purple with bleeding spots; the pulse is taut and hesitant.
Possibly related posts: (automatically generated)
- Related posts on 25 Hydroxy Vitamin D
- Carlson Vitamin D3 2000 Iu, 360 Softgels, Bottle | Ottopedia
Crohns Disease Drugs
Thirty-two years ago Ginger Gray walked into her doctor’s office complaining of abdominal pain, diarrhea, severe weight loss, and overwhelming joint pain. At 19, she hadn’t grown an inch since the sixth grade. But her doctor said there was nothing physically wrong with her, and even suggested she seek psychiatric counseling.
Fortunately for Gray, she sought another physician’s opinion.
Based on tests he conducted, the doctor recommended the 4-foot-11-inch Pennsylvania resident begin full-time treatment for Crohns disease.”Crohns disease robbed me of my stamina,” Gray says. “It took two years for me to fully regain my strength and weight so that I could begin working again.”Until now, treatment for Crohn’s has relied on surgery and anti-inflammatory and other drugs also used to treat other conditions.
In August 1998, the Food and Drug Administration licensed the first treatment specifically for Crohns disease, an incurable and sometimes debilitating inflammation of the bowel.Remicade (infliximab) is a genetically engineered antibody that blocks inflammation caused by a protein called tumor necrosis factor. After clinical trials showed benefit from Remicade treatment within a two-to-four week period following a single dose, FDA approved the drug for patients with moderate to severe Crohns disease who have not found relief with other treatments.
“We recognized that [Remicade] had such a dramatic effect on patients,” says Barbara Matthews, M.D., a medical officer in FDA’s Center for Biologics Evaluation and Research, “that it was given accelerated approval.”Remicade, which is taken intravenously, can decrease the amount of inflammation along the lining of the intestine.
Clinical trials also show that Remicade is effective in closing fistulas (abnormal passages or sores between the bowel and skin). Although not a cure, the drug reduces the symptoms in patients who have not responded well to traditional treatments.”This is an exciting development for two reasons,” says R. Balfour Sartor, M.D., professor of medicine, microbiology and immunology at the University of North Carolina, and chairman of the National Scientific Advisory Committee for the Crohn’s & Colitis Foundation of America (CCFA). “It is the first therapy for Crohns disease derived by molecular techniques, and it has the possibility of improving the quality of life for [Crohn's] patients.”
But Sartor also cautions that the long-term toxic effects of Remicade are unknown and that the drug is not needed by every Crohns disease patient. “Two-thirds of the people will have near immediate results,” he says, “but only those patients who do not respond to other therapies” are eligible to take the drug. The next step is to maintain a patient’s remission after the drug’s initial effect has worn off.
Currently, studies are being done to better define the risks and longer-term benefits of Remicade because drug reactions and potential adverse effects from suppressing tumor necrosis factor require further clarification. Crohns disease is one of two major types of inflammatory bowel diseases (IBD)–the general term for diseases that cause inflammation in the intestines–and has no cure and a high rate of recurrence following treatment.
It usually occurs in the lowest portion of the small intestine (ileum), and the large intestine (colon or bowel), but it can occur in other parts of the digestive tract. Crohn’s usually involves all layers of the intestinal wall.
The disease can be difficult to diagnose because its symptoms, which include chronic diarrhea, crampy abdominal pain, loss of appetite, and weight loss, often mimic those of the other IBD type–ulcerative colitis–which affects only the colon. (See “Is It Crohn’s Disease?”)
Possibly related posts: (automatically generated)
- Related posts on Abdominal Pain
- Optimum Nutrition Gold Standard 100% Whey, Double Rich Chocolate …
- Do I have to tell you that I have Crohn's disease and digenerative …
- Title: « fernando1986782
- Related posts on Antibody
- AIDS vaccines stop working after a few months, shocked researchers …
Crohns Disease Cause
Researchers have not yet identified the cause of Crohns disease, so it is described as an “idiopathic” disease. It is known that inflammation is part of the body’s immune response, and an immune response is usually triggered by something. But to date no specific “trigger” has been found to cause the inflammatory response seen in Crohns disease.
There is some evidence that Crohns disease has a genetic component. While there is no simple correlation from parent(s) to offspring, the disease tends to “run” in families. As many as 20 to 25 percent of patients with Crohns disease have a relative with CD or ulcerative colitis.
There is also a higher incidence among certain ethnic groups.In addition, some possible environmental factors have been linked to initial episodes or relapses. Crohns disease appears to be a disease that primarily affects those living in Western, industrialized societies. Whether this is due to some condition of the environment in which people live or their diet has not been determined.
The Role Of Heredity
Physicians classify Crohns disease as one of the “familial” or “complex” genetic diseases, as opposed to a “simple” genetic disease. In simple genetic diseases, such as sickle cell disease or cystic fibrosis, a person who inherits a copy of the defective gene from each parent is certain to get the disease. In Crohns disease, this is not the case. In fact, 75 to 80 percent of people with Crohns disease have no relative with either Crohns disease or ulcerative colitis.
But because there are fewer than 500,000 Americans with Crohns disease, the level of multiple incidence in families (20 to 25 percent of Crohn’s patients) means that the risk of being diagnosed with the disease is statistically somewhat higher in individuals who have a family member with either Crohns disease or ulcerative colitis.
Other evidence that suggests a genetic basis for Crohns disease is the fact that populations who have intermarried closely within their communities for many generations, such as Eastern European Jews, have a higher incidence of inflammatory bowel disease than do other groups.
Weakened Immune Response
In the healthy intestine, certain types of bacteria (enteric microflora) are present and necessary. In fact, between one billion and one trillion normal intestinal bacteria exist in every gram of intestinal content. These “normal” bacteria contribute to the process of digestion and keep abnormal bacteria, which can enter the GI tract in food, water, etc., from surviving and causing illness. If abnormal bacteria do survive and multiply, the body recognizes them as invading organisms, or “antigens.”
To a certain extent, these antigens are ignored in the GI tract – the immune system has a certain level of tolerance for them. But immunologic evidence shows that in the intestines of those with inflammatory bowel disease, some of this tolerance for bacteria is lost.
The TH1 cells, which are responsible for activating the immune response against invading organisms, do their job. But the TH2 cells, which are responsible for deactivating the immunologic response after invading organisms are destroyed, fail to perform theirs. The result is an inflammatory overreaction, resulting in pain, fever, and, sometimes, tissue damage.Some evidence also suggests that flare-ups of Crohns disease or ulcerative colitis are a heightened response to seasonal allergies, upper-respiratory infections, or other transient illnesses.
Crohns Disease and Pregnancy
Women with Crohns disease who are considering having children can be comforted to know that the vast majority of such pregnancies will result in normal children. Research has shown that the course of pregnancy and delivery is usually not impaired in women with Crohns disease.
Even so, women with Crohns disease should discuss the matter with their doctors before pregnancy. Most children born to women with Crohns disease are unaffected. Children who do get the disease are sometimes more severely affected than adults, with slowed growth and delayed sexual development in some cases. Women with ulcerative colitis have normal fertility.
In Crohns disease, fertility may be reduced when the disease is active. Sulphasalazine can cause men to become less fertile. Fertility usually returns to normal when the drug is stopped. If possible, women should try to get pregnant when the disease is in remission. Flare-ups can occur during pregnancy but they are usually mild and will respond to medical treatment. Clinical experience has shown that the risk from steroids and sulphasalazine to the baby is extremely low.
Some doctors advise women to avoid pregnancy while on azathioprine because of theoretical risks, though many successful pregnancies have been recorded while taking the drug. Some doctors would suggest that a woman with inactive Crohns disease should stop taking her medication(s) during pregnancy, resuming an appropriate regimen only if a flare-up occurs.
Others might have different advice. Any woman who has Crohns disease and wants to become pregnant should discuss the issue of treatment during pregnancy with her health-care providers, where her personal medical history and treatment requirements can be taken into account. Women with Crohns disease whose disease is in remission at the time they conceive may experience increased symptoms during their third trimester, if they have symptoms at all. Many women suffer flare-ups immediately after giving birth. Doctors believe this is due to the hormonal changes of the pregnancy and postpartum period. “If Crohns disease flares up during pregnancy, sulphasalazine and steroids are permitted. Azathioprine and metronidazole should be avoided unless advised by a specialist.
However, note that there is no convincing proof that azathioprine has been responsible for foetal abnormalities and many inflammatory bowel disease specialists now recommend continuing the drug for those patients in whom relapse would be a major problem.There is no predicatable pattern to inflammatory bowel disease in pregnancy. Patients with inflammatory bowel disease often seem to be healthier during pregnancy, but at a risk of a flare-up in the postpartum period. The chance of a flare-up is not increased by pregnancy however it is advised to wait until disease is inactive before conception.
If patients conceive during a flare of Crohns disease:
- about 1/3 get better, 1/3 get worse and 1/3 stay the same
Women with Crohns disease tend to have more preterm births and babies with lower birth weights ”