Posts Tagged ‘Inflammatory Bowel Disease’

Ulcerated Colitis

06.05.10

Ulcerative colitis is a chronic disease in which the large intestine becomes inflamed and ulcerated (pitted or eroded), leading to flare-ups (bouts or attacks) of bloody diarrhea, abdominal cramps, and fever. The long-term risk of colon cancer is increased. Ulcerative colitis may start at any age but usually begins between the ages of 15 and 30.

A small group of people have their first attack between the ages of 50 and 70.Ulcerative colitis usually does not affect the full thickness of the wall of the large intestine and hardly ever affects the small intestine. The disease usually begins in the rectum or the rectum and the sigmoid colon (the lower end of the large intestine) but may eventually spread along part or all of the large intestine.

Ulcerative proctitis, which is confined to the rectum, is a very common and relatively benign form of ulcerative colitis. In some people, most of the large intestine is affected early on.

The cause of ulcerative colitis is not known for certain, but heredity and an overactive immune response in the intestine seem to be contributing factors. Cigarette smoking, which is detrimental in Crohns disease, seems to decrease the risk of ulcerative colitis.

However, smoking in order to reduce the risk of ulcerative colitis is ill-advised in light of the many health problems that smoking can cause. Ulcerative colitis (Colitis ulcerosa, UC) is a form of inflammatory bowel disease (IBD).

Ulcerative colitis is a form of colitis, a disease of the intestine, specifically the large intestine or colon, that includes characteristic ulcers, or open sores, in the colon. The main symptom of active disease is usually diarrhea mixed with blood, of gradual onset. Ulcerative colitis is, however, a systemic disease that affects many parts of the body outside the intestine.

Because of the name, IBD is often confused with irritable bowel syndrome (“IBS”), a troublesome, but much less serious condition. Ulcerative colitis has similarities to Crohns disease, another form of IBD. Ulcerative colitis is an intermittent disease, with periods of exacerbated symptoms, and periods that are relatively symptom-free. Although the symptoms of ulcerative colitis can sometimes diminish on their own, the disease usually requires treatment to go into remission.

Ulcerative colitis is a rare disease, with an incidence of about one person per 10,000 in North America. The disease tends to be more common in northern areas. Although ulcerative colitis has no known cause, there is a presumed genetic component to susceptibility.

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Treatment for Crohns Disease

04.29.10

Crohns Disease treatment is a life-long commitment, as this chronic condition is marked by flare-ups and remission periods that sufferers will unfortunately be forced to deal. Crohns Disease symptoms, and possibly one or more stays in a hospital.

All of that works together with the general stress of life to affect the course of your disease. When it all combines together — you get fatigue. You feel tired, listless. I know. I’ve been there. Proper Crohns Disease treatment is crucial, and it is important to learn everything you can about this debilitating condition.

The goal of medical treatment is to reduce the inflammation that triggers your signs and symptoms. In the best cases, this may lead not only to symptom relief but also to long-term remission. Treatment for Crohns disease usually involves drug therapy or, in certain cases, surgery.

Doctors use several categories of drugs that control inflammation in different ways. But drugs that work well for some people may not work for others, so it may take time to find a medication that helps you.

In addition, because some drugs have serious side effects, you’ll need to weigh the benefits and risks of any treatment.
Anti-inflammatory drugs
Anti-inflammatory drugs are often the first step in the treatment of inflammatory bowel disease.

They include:
• Sulfasalazine (Azulfidine). Doctors have used this drug for many years to treat Crohns disease. Although it can be effective in reducing symptoms of the disease, it has a number of side effects, including nausea, vomiting, heartburn and headache. Don’t take this medication if you’re allergic to sulfa medications.
• Mesalamine (Asacol, Rowasa). This medication tends to have fewer side effects than sulfasalazine has. You take it in tablet form or use it rectally in the form of an enema or suppository, depending on which part of your colon is affected.
• Corticosteroids. Corticosteroids can help reduce inflammation anywhere in your body, but they have numerous side effects, including a puffy face, excessive facial hair, night sweats, insomnia and hyperactivity.

More serious side effects include high blood pressure, type 2 diabetes, osteoporosis, bone fractures, cataracts and an increased susceptibility to infections. Long-term use of corticosteroids in children can lead to stunted growth.

Also, these medications don’t work for everyone with Crohns disease. Doctors generally use corticosteroids only if you have moderate to severe inflammatory bowel disease that doesn’t respond to other treatments.

A newer type of corticosteroid, budesonide (Entocort EC), works faster than do traditional steroids and appears to produce fewer side effects. Entocort EC is effective only in Crohns disease that involves the lower small intestine and the first part of the large intestine (ileocolitis).

Corticosteroids aren’t for long-term use. They can be used for short-term symptom improvement for about three to four months. They’re also used in conjunction with other medications as a means to induce remission.

For example, corticosteroids may be used with an immune system suppressor — the corticosteroids can induce remission, while the immune system suppressors can help maintain remission.

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Pediatric Crohns Disease

04.08.10

Delayed growth is a well-established feature of pediatric Crohns disease. Several factors have been shown to affect growth, including disease location, severity, and treatment. The recently discovered NOD2 gene has been correlated to ileal location of Crohns disease and subsequently could affect growth through the resulting phenotype or as an independent risk factor.

The aim of our study was to determine if growth retardation is affected by genotype independently of disease location or severity. Crohns disease is an inflammatory bowel disease of the gastrointestinal tract.

Approximately 500,000 Americans suffer from Crohn’s, and it is estimated that at least 150,000 of them are children under age 17.  In children, the disease usually presents between 12 and 16 years of age; however, it has been detected in children as young as 7 years old.

Both adult and pediatric Crohn’s patients may experience a number of symptoms, including diarrhea, abdominal cramps and pain, fever, rectal bleeding, loss of appetite, and weight loss. However, each individual may experience symptoms differently. If your child has been diagnosed with pediatric Crohn’s disease, talk to your child’s doctor about treatment with REMICADE.

Individual results may vary. Talk to your child’s doctor to see if REMICADE is right for your child.REMICADE is for children (ages 6-17) with moderate to severe Crohns disease who haven’t responded well to other therapies.

REMICADE has been approved for the treatment of pediatric Crohns disease, based on clinical research. Children with pediatric Crohn’s disease may have to deal with things that other children don’t — painful and sometimes embarrassing physical symptoms, eating and treatment regimens, doctor visits, and even occasional hospital stays.

Pediatric Crohn’s can have an impact of all aspects of a child’s life, including school, relationships with friends and family, and self-esteem. But by learning how to cope with the disease, they can still lead an otherwise happy, productive life. If your child has been diagnosed with pediatric Crohn’s disease, it is only natural to feel overwhelmed and scared.

Since this is a chronic illness (meaning that it doesn’t go away) that can involve painful and sometimes embarrassing symptoms, you may have questions:
• How will pediatric Crohn’s disease affect my child’s health and well-being?  Will it affect me and the rest of my family as well?
• Will this disease change my child’s appearance or interfere with normal growth?
• Will my child have to go on a special diet?
• What treatment is available for pediatric Crohn’s disease?

Crohn’s disease can have physical, social, and emotional effects on a child.  Physical symptoms of pediatric Crohn’s disease include growth problems, frequent diarrhea, abdominal pain, loss of appetite, and weight loss.

Children and teenagers may find it especially hard to deal with a chronic disease like Crohn’s and its symptoms since they are already in the process of both physical and emotional development.
Because of the physical manifestations of pediatric Crohn’s, a child may face challenges both socially and emotionally. Below are some of the social and emotional challenges a child with pediatric Crohn’s may face.

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Living with Crohns Disease

03.30.10

Most people living with Crohns disease find that periods of remission (when they are free from symptoms) are longer and more frequent than periods of acute illness. This has never been truer than it is today, when doctors have large and growing arsenal of treatment options to prescribe.

The severity of Crohns disease can be measured objectively with indexes that chart symptoms, including:
•    The number of bowel movements per day
•    Appetite level
•    Fever
•    Number of days in a month when an individual must modify his or her work, home, or social schedule because of diarrhea, fatigue, fever, and other symptoms

Severity can also be measured subjectively, through a doctor’s assessment of an individual’s general state of being (such as whether he or she is angry, depressed, in pain, or embarrassed by needing to use the toilet frequently in social or business situations).There is considerable variation in how people with Crohns disease experience their illness.

An individual whose radiological examinations reveal an extent of disease that would seem to be debilitating may lead a relatively normal life, while a person with few objective signs of disease may find his or her symptoms totally debilitating, both physically and mentally.Although Crohns disease is a chronic (long-term) inflammatory bowel disease, it is not a constant disease.

That is, Crohns disease is characterized by acute flare-ups of symptoms followed by remissions that last for varying periods of time. Each individual’s pattern of symptoms is different, and conscientious doctors treat patients according to their reported symptoms rather than the results of laboratory tests or radiological exams. Diarrhea, pain, and fever-along with fatigue, chills, and possibly vomiting-come and go, sometimes in waves and sometimes in sharp bursts.

Flare-ups can occur out of the blue, following a viral illness such as a head cold, or during times of extreme personal, business, or social stress. People with Crohns disease may feel well and be free of symptoms for substantial spans of time when their disease is not active. Despite the need to take medication for long periods of time and occasional hospitalizations, most people with Crohns disease are able to hold jobs, raise families, and function successfully at home and in society.

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Crohns Disease Surgery

01.17.10

Crohns disease can cause a variety of symptoms of gastrointestinal distress.

The three classic (though not specific) symptoms of inflammatory bowel disease are:
•    Persistent or recurrent diarrhea (possibly with blood, mucus, or pus)
•    Abdominal pain
•    Fever

There also may be signs and symptoms unrelated to the gastrointestinal tract. A doctor will obtain a complete medical history and perform a thorough physical examination, along with laboratory and diagnostic tests, to diagnose Crohns disease. The examination and other tests are necessary to rule out a number of transient conditions, such as viral, bacterial, or parasitic infection, that cause symptoms similar to Crohns disease.

Diarrhea
In cases of Crohns disease, patients often experience frequent loose or watery bowel movements. The stool is occasionally accompanied by thick, dark blood (not bright red smears of blood, which usually result from a bleeding hemorrhoid). There is less mucus or pus in the stool than in cases of ulcerative colitis.

Pain
Patients may experience crampy, achy, or even sharp pain in the affected area. Most often, patients with Crohns disease feel pain on the lower right side of the abdomen (lower right quadrant) and just below the bellybutton. This is because the majority of cases of Crohns disease involve disease in the terminal ileum, where the small intestine meets the large intestine. The terminal ileum crosses from left to right just above the beltline, and joins the large intestine in the lower right quadrant. The type of pain associated with Crohns disease depends on what part of the GI tract is affected. Disease in the terminal ileum generally causes sharp pain, while disease in the colon causes more crampy pain, similar to that that of ulcerative colitis. Pain is sometimes relieved (temporarily) after a bowel movement.

Fever
Crohn’s is an inflammatory disease, and one of the key characteristics of the inflammatory process is fever. (The others are pain, swelling, and redness.) Some individuals with Crohns disease suffer a high fever, especially during the acute phase of a flare-up. Others run a persistent, low-grade fever. Fever may be accompanied by irritability and fatigue. Sometimes, the fever recurs each day, especially late in the day, then repeatedly breaks during sleep, causing night sweats.

Signs and Symptoms Unrelated To The GI Tract
A number of signs and symptoms that do not involve the gastrointestinal tract can occur with Crohns disease. These may occur at the same time as the intestinal symptoms, or may be experienced weeks or even months before any intestinal symptoms are noticed. If your doctor suspects inflammatory bowel disease, he or she will ask you detailed questions about whether or not these extra-intestinal symptoms have appeared:
•    Reddening and inflammation of the eye (iritis)
•    Joint pain (usually in the large joints of the knees, ankles, elbows, wrists, and shoulders), which sometimes migrates from one joint to another (migrating arthralgia)
•    Skin lesions, including tender red nodules on the shins or calves (erythema nodosum)
•    Sores inside the mouth (aphthous ulcers)

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Crohns Disease Statistics

12.31.09

Crohn’s Disease is a chronic inflammation of the digestive track.

The digestive track covers the following:
•    Mouth
•    Esophagus
•    Stomach
•    Small Intestine
•    Large Intestine
•    Rectum
•    Anus

Crohn’s can affect any of those areas, but most commonly attacks the ileum or the lower small intestine. The swelling of the affected area will cause pain and diarrhea.

Statistics
Crohn’s can be found in both men and women. It may run in families, 20% of people diagnosed with the disease have a blood relative with some form of inflammatory bowel disease. It is usually diagnosed between the ages of 20 to 30, although people of all ages can suffer from Crohn’s. People of Jewish heritage have a greater risk of developing the disease while people of African American heritage have less of a risk.

Prevalance of Crohn’s disease: 500,000 Americans

Prevalance Rate: approx 1 in 544 or 0.18% or 500,000 people in

Hospitalization statistics for Crohn’s disease: The following are statistics from various sources about hospitalizations and Crohn’s disease:
•    0.17% (21,634) of hospital consultant episodes were for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    82% of hospital consultant episodes for crohn’s disease required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    42% of hospital consultant episodes for crohn’s disease were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    58% of hospital consultant episodes for crohn’s disease were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    35% of hospital consultant episodes for crohn’s disease required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    9.6 days was the mean length of stay in hospitals for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    6 days was the median length of stay in hospitals for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    39 was the mean age of patients hospitalised for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    78% of hospital consultant episodes for crohn’s disease occurred in 15-59 year olds in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    5% of hospital consultant episodes for crohn’s disease occurred in people over 75 in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    36% of hospital consultant episodes for crohn’s disease were single day episodes in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    0.18% (93,538) of hospital bed days were for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)

New Treatment for Crohns Disease

11.21.09

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 in Children

10.31.09

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).

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Crohns Disease Diet

10.06.09

For those suffering from Crohns Disease diet and nutrition are of utmost concern. Although there is no evidence to show that the condition is caused by nutritional factors, the food you eat can affect the symptoms of the disorder.

Because inflammatory bowel disease manifests itself differently from patient to patient, and can affect so many different areas of the digestive tract, there is not one specific diet for Crohns Disease that works for everyone. Rather, it is an experimental process whereby the patient determines what foods tend to aggravate the condition, and makes dietary changes based on this determination.

As Crohns is marked by flareups, with good periods and bad periods, the Crohns Disease diet may have to be adjusted accordingly.Some patients follow the Specific Carbohydrate Diet, which entails curbing carbs that are difficult to digest. This may offer relief for certain symptoms, but has yet to be supported by clinical evidence.
The best diet for Crohns Disease is a healthy balanced one, including all of the food groups: fruits, vegetables, dairy, meats, whole grains, fats and protein should all be included daily, with those foods that may cause flare-ups eliminated or at least minimized.

One of the major concerns for patients is the strong possibility of malnutrition due to the inability of the impaired small intestine to properly digest and absorb nutrients from the food they eat.So even with a fully-balanced Crohns Disease diet, it is likely that you are not getting the nutrients you need. Add to that the common loss of appetite and the increased energy the body needs to combat the illness and many patients find themselves in a state of severe malnutrition.

This can and will lead to further health complications down the road. That is why many Crohns patients choose to take nutritional supplements to make sure they are getting the vitamins, minerals, amino acids and other important nutrients they may not be getting from their diet for Crohns disease.

High quality supplements can offer a full spectrum of vital ingredients, including B12, folic acid, Vitamin D, magnesium, potassium, trace elements and other specific nutrients that are often lacking in Crohns patients. One of the most complete nutritional supplements we have found is called Total Balance which is manufactured by a highly-regarded natural health company. It contains a wide variety of vitamins, minerals and nutrients in one comprehensive formula.

What separates this supplement from others is that it has an enteric coating which significantly increases the amount of nutrients that can be used by your cells and tissues, unlike others where a large percentage of nutrients get destroyed by stomach acids. Although some patients get adequate nourishment from a complete Crohns Disease diet, supplements are certainly worth consideration to ensure that your body gets what it needs.

As with all nutrition programs, a diet for Crohns Disease should be as well-balanced as possible, and include ample amounts of diverse foods. A nutritionist can offer diet help Crohns Disease patients can use to form the basis of their eating.

They can then tailor the regimen based on their specific needs. It’s important to check with your doctor to determine if supplementation might be right for you. In many cases, poor appetite, poor absorption and increased requirements may make you malnourished, and it might make sense to supplement these important nutrients to complement your Crohns diet.

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Crohns Disease and Complexion

09.25.09

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.

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