Crohns Disease and Ulcerative Colitis in Children

Children who suffer with these problems need lots of emotional support. These are “lonely” diseases, dealing with a sensitive part of a childs anatomy.

Crohns disease is an autoimmune disorder. It can be devastating to anyone, but especially children. This is not an easily diagnosed disease. Ulcerative Colitis is similar, but different in its symptoms. No one knows the cause of these disorders, though there is a theory that a virus may act as a trigger to the latent problem. Other studies cite certain medications or environmental factors. Psychologically, this is very, very difficult for children to deal with.

I developed Crohns Disease around the age of 7. It remained undiagnosed for many years. The onset involved sudden, severe bouts of intense abdominal pain, fever and diarrhea, so serious, I lost 40% of my body weight, ending up weighing 30 pounds. I stopped growing in height and couldn’t regain the lost weight. My joints would swell and redden, leading them to diagnose rheumatoid arthritis.

Fever remained, in spite of antibiotics, and truly world class medical care, at 100 degrees, for years. I was wheelchair bound for the entire 7th year of my life, due to pain and weakness. The symptoms continued off and on, until my 27th year, when I almost died from intestinal obstruction, and the diagnosis was made surgically. It’s taken 5 major surgeries and 2 prolonged bouts of chemotherapy to put me in semi-remission.

These are all classic worse case scenario Crohns symptoms. Any child who is experiencing the following cluster of symptoms needs to be followed closely by their pediatrician:

1. Abdominal pain and cramping
2. Recurring bouts of diarrhea, not related to flu or other viral illness
3. Unexplained low grade fever
4. Anemia
5. Joint pain with reddening
6. Iritis an eye inflammation, which left untreated can lead to blindness
7. Weight loss
8. Swelling of the abdomen, accompanied by pain
9. Sudden severe constipation, accompanied by the inability to pass gas
10. Fissures or openings on the skin, which have no other physical cause

Ulcerative colitis is similar in some ways to Crohns, but profoundly different in others. It is not an autoimmune disorder. The intestinal lesions, present in both are very different. In Crohns, the lesions skip , they don’t form a continuous line throughout, but skip, leaving healthy tissue in between.

The ulcerations penetrate all the way through the intestinal wall, whereas in ulcerative colitis, they remain on the outer layers of the intestinal wall, and rarely perforate. The fever is different too. In ulcerative colitis, a wildly swinging temperature is often seen. Diarrhea alternates with bouts of constipation, causing tremendous pain. There is no joint or systemic involvement, as with Crohns disease. In many ways, this is an easier disease to diagnose, because the symptoms can present so dramatically, especially in children.

Children who suffer with these problems need lots of emotional support. These are “lonely” diseases, dealing with a sensitive part of a childs anatomy. They are often embarrassed by the diarrhea, cramping, and sometimes incontinence. Medications like Prednisone can cause “moon” face, brittle bones and lowered resistance to infection.

Surgery for obstruction can be intensely painful and scarring. If you have a child with one of these diseases, reassure them that with good medical care and planning, they can often lead normal, productive lives. You can point out, that some early onset cases of Crohns, appear to burn themselves out, by a childs 18th birthday. Not often, but this can give the child some hope of future relief. Join a Crohns support group to get some help with your own feelings, and to keep up with the latest advances in treatment.

Finally, let your child become an active partner in treatment from a gastroenterologist. Encourage him to be frank about feelings and opinions on treatment options, and most of all, to ask as many questions as he needs to feel comfortable. After all, this is his life, his problem. Let his friends help if they want. Explain Crohns isn’t “catching”, and that he needs their friendship and support. All of this will help your child learn to live with his disease in a more balanced, comfortable way.

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GERD Gastroesophageal Reflux

It may first appear as a frequent tickle in the back of the throat, coughing that may last for weeks in the absence of known illness, hoarseness, even bad breath, or sour taste. Sometimes there may be mild or moderate back pain or chest pain that seems akin to a heart attack. The most common symptom is frequent heartburn. Millions of Americans, young and old, suffer daily with Gastroesophageal Reflux Disease or GERD. Untreated, GERD can be life threatening.

Gastric reflux occurs when stomach contents escape into the esophagus, the tube that carries food from the mouth to the stomach. The lining of the stomach protects it from digestive acids.

The lining of the esophagus does not provide the same protection. Stomach acid that enters the esophagus burns the lining and causes reversible changes called esophagitis. Continued acid assault of the esophageal lining may cause ulcers or even esophageal cancer.

The primary care physician often makes the diagnosis of GERD. A thorough medical history may reveal some of the symptoms in the above list. The physician will recommend treating the disease with dietary and lifestyle changes first. The dietary recommendations will include instructions to avoid foods that increase reflux such as fatty or fried foods, peppermint and spearmint, whole milk, oils, chocolate, creamed foods or soups, and most fast foods.

GERD sufferers should avoid foods that irritate the lower esophagus including coffee and black and green tea (regular or decaffeinated), citrus fruits and beverages including tomatoes and tomato products, carbonated beverages, spicy foods and alcohol. These restrictions only seem difficult until they bring relief. Then, they become a natural part of living pain free.

Recommended lifestyle changes include losing weight, not lying down right after a meal, cutting out late night snacks, avoiding tight fitting clothing, eating smaller meals and snacks, and elevating the head of the bed or sleeping on extra pillows. It is very important to quit smoking. Nicotine weakens the muscles of the lower esophagus causing or worsening reflux. Many GERD suffers find that dietary and lifestyle changes alone are enough to control their GERD.

When remedies that are more natural are not enough, many medications control or eliminate GERD. Liberal use of over the counter antacids decreases stomach acidity in the short term. Antacids such as Tums, Maalox, and Gaviscon, help people with occasional gastric reflux. Other medications such as Nexium, Prilosec, and Prevacid actually decrease acid production. If one of these medications does not work, another may. Together, antacid and acid reducing medications control more severe cases. Many GERD suffers find that they must continue taking these acid decreasing medications for the rest of their lives.

Please, do not treat frequent gastric reflux with over the counter remedies without consulting your physician. Just as gastric reflux pain may mimic pain caused by other conditions, another condition such as coronary artery disease, may feel like GERD.

Endoscopy is a visual examination of the esophagus. This exam is performed routinely for patients who have been diagnosed with GERD. Using an endoscope (a fiber optic camera) a physician may readily diagnose conditions such as esophagitis, ulcers, a pyloric valve that does not fully close (the valve that separates the stomach and the esophagus), and hiatal hernia (weakening of the diaphragm where the esophagus passes through). Patients are under general anesthesia during the procedure; it is quick, easy, and painless.

I write a column on dentistry, so there must be a dental connection to GERD. Here it is. In many cases of GERD, the acidic stomach contents regularly enter the mouth. Teeth are often affected. Dentists easily spot the dental effects of GERD – enamel erosion and a higher decay rate. Sometimes, dentists are the first to suspect that a patient has gastric reflux disease.

Erosion, the generalized loss of tooth enamel, may be caused by GERD, bulimia (the disorder of eating large amounts of food and then causing one’s self to vomit), even sucking lemons or limes. The pattern of erosion in cases of GERD and bulimia is similar, so the dentist must interview the patient carefully to differentiate the two.

Children with a high rate of tooth decay may be suffering with GERD. The dentist will need to know the facts of the child’s diet to differentiate between decay that is caused by diet and decay that may be due to reflux. If there is a question of the presence of gastric reflux, always consult thechild’s physician.

Dentists must treat patients afflicted by GERD in conjunction with treatment of GERD itself. The same acid that affects teeth will have a similar effect on the materials that dentists use to restore erosion and tooth decay. Patients with GERD often have a high rate of decay around fillings and caps or crowns.

Speak with the best medical doctor if you feel that you suffer with gastroesophageal reflux disease. If you believe that your teeth are extraordinarily sensitive, thin or very prone to decay, ask your dentist for their opinion.

 

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Hepatitis B: Risks, Treatment and Prevention

After an Assisted Living Center in Mount Olive, N.C., was fined $16,000 for causing the outbreak of Hepatitis B in which six of their patients died, the Obama administration has begun an intensive information drive to discuss the risks of Hepatitis B as well as prevention and treatment of the illness. His focus is on Asian-Americans and Pacific Islanders, because of the prevalence of the disease in those communities.

Here are the facts about Hepatitis B.

* Hepatitis B is an irritation and swelling of the liver due to an infection with the Hepatitis B virus. It is a contagious virus that can cause severe liver problems.

* The liver removes harmful chemicals from the blood, fights infection, digests food and stores energy, as well as vitamins and nutrients. Without the liver, you cannot exist.

* Hepatitis B can lead to liver failure, liver cancer or cirrhosis. Cirrhosis causes permanent scarring of the liver.

* There is no cure for Hepatitis B, though there is a vaccine to prevent the disease.

* Possible ways of spreading Hepatitis B include direct contact with blood in a hospital setting (such as what happened in the case in Mount Olive when medical technicians reused diabetes pens), sexual contact with a person that has the infection, tattoos or acupuncture that involve unclean needles, sharing needles during drug use, and sharing personal items that come in contact with bodily fluids of an infected person.

* Symptoms of the disease typically occur two to three months after becoming infected.

* Some of the signs and symptoms of the infection include abdominal pain, dark urine, appetite loss, nausea and vomiting, joint pain, weakness and fatigue, yellowing of the skin and the whites of your eyes that give an appearance of jaundice.

* Some infants as well as adults never experience the symptoms even if they are infected with the disease. If you think you have come in contact with the bodily fluids of someone who has the infection, it is important to contact your doctor immediately.

* Healthy people still may need to be screened for Hepatitis B if they fall under the following circumstances: people who are HIV-positive, immigrants from areas of the world where the disease is prevalent; such as, Asia, the Pacific Islands, Eastern Europe and Africa as well as children of parents from these areas.

* You should also be screened if you suspect a person you have had sex with has the infection, if you are an injection drug user or a prison inmate, a man who has had sex with a man, if you receive kidney dialysis or if you are a pregnant woman.

* Screening for Hepatitis B in Belle Glade is done via a blood test If it is determined that you have the infection, liver tests will be performed to gauge the damage that has been done to the organ.

* If you are diagnosed with the illness, you may receive antiviral medications to help prevent further damage to your liver. If your liver is already severely damaged, a liver transplant may be the only option.

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Irritable Bowel Syndrome: Bad but Not Serious

Irritable Bowel Syndrome, IBS, or spastic colon as my doctor referred to it, is a troublesome but not serious condition. It won’t turn into cancer, cause it or get worse. That’s good news. The bad news? Irritable Bowel Syndrome does make it’s presence know if you don’t take care of yourself. When? Usually during very stressful times in your life or after you’ve eaten certain foods that you will find out you really shouldn’t. if you’re a woman, Irritable Bowel Syndrome is worse right before or during your menstrual cycle. And more women are affected by IBS than men.

Irritable Bowel Syndrome is caused by your intestines squeezing too hard or not hard enough to expel the foods you might have consumed. In other words, the food may be going through your system more quickly or too slowly than what it should. That’s when the symptoms start to rear their ugly head. The cramping, the intermittent diarrhea for a few days then constipation the next. The bloating and gassy feelings like you’ve eaten five bowls of beans in one sitting.

Symptoms of Irritable Bowel Syndrome generally start out with abdominal cramping or more cramping during your menstrual cycle if you’re a woman. You may experience more gas and bloating after eating certain types of foods. The biggest and most telling symptoms of all and one that will be quite noticeable is the change in your bowel habits and the mucous that is more often than not mixed in with your stool.

If you notice this happening you should make an appointment with your doctor to be sure that this is Irritable Bowel Syndrome and not something else that is more serious. The doctor will ask you how long the symptoms have been going on and possibly if there were a pattern to these episodes. Were you under more stress than usual while these symptoms were occurring? Had you eaten certain foods that had caused these problems before? If so, then you more than likely have IBS.

If the symptoms have just started happening your doctor might want to run some blood tests, do a colonoscopy or a rectal exam to check for the presence of blood. If these tests come back negative, ruling out the more serious conditions the doctor will work with you on ways to keep these flare-ups from happening.

The doctor will try to work with you on how to figure out which foods are causing the episodes. They might suggest that you keep a diary of the foods you eat. When you start feeling badly, you can look back and see what you have eaten to try to narrow down the cause of the pain. If you are lactose intolerant, it could be milk, cheese or some other form of dairy product. Fats and caffeine are also catalysts for Irritable Bowel Syndrome so try to stay away from chocolate, lots of fried foods and coffee or soda. However, don’t stop eating a certain food the first time you eat it and it causes a flare-up. If this certain food has upset your stomach more than once, then it’s a good idea to shy away from whatever you are eating.

Most doctors from the best clinics in your area also prefer that a person with Irritable Bowel Syndrome add more fiber to their diet. Why? Because soluble fibers helps stop both the diarrhea and constipation. Insoluble fiber which is in foods such as wheat bread or many vegetables helps with constipation. Also, try drinking lots of water. Eat six small meals a day instead of three larger ones.

Your doctor will also try to help you with your stress levels. Most of the time, relaxation techniques like meditation or exercise will help. If your stress is more severe, a doctor might suggest trying relaxants of some kind or anti-depression medicine if you are going through a very rough time and are feeling emotionally drained and depressed.

There is no cure for Irritable Bowel Syndrome, but you can take over the counter medications such as Imodium AD for the diarrhea. Stay away from laxatives of any kind when constipated as they may weaken your intestines and make you dependent on them. If you are having lots of problems with constipation or diarrhea, your doctor will more than likely prescribe an antispasmodic medication that should help.

One of the worst things about having Irritable Bowel Syndrome besides the cramping and bloating is having your symptoms flare up at the worst possible times. During stressful situations such as when you have a loved one in the hospital or there is a death in the family. Irritable bowel syndrome can even make an appearance during typical daily happenings such as being stuck in traffic or traveling and having no bathroom in sight. But if you stay on a healthy diet, try to remain calm and stay away from any foods that might cause symptoms, you should have very few episodes and be able to live and function normally despite having Irritable Bowel Syndrome.

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A Possible Remedy for Hepatitis C

Presently, the treatment for hepatitis C, which is a liver disease, is a combination of an antiviral agent and another drug. Unfortunately, this type of treatment has a negative result. The side effect is very unpleasant for many people who are on this type of care. Because of this situation, patients are known to discontinue with their treatments.

The other negative fact regarding this drug is that even though patients who don’t get these disturbing side effects, there seems to be no indication that there is any improvement in the function of the liver for these people.

There is good news on the horizon, however. As reported in the U.S. News and World Report, Robert Lanford and his colleagues who are virologists from San Antonio, Texas, experimented with some chimpanzees who had been infected with hepatitis C. They injected these animals intravenously with what is known as SPC3649. The results were amazingly promising because it showed from the test that hepatitis C had been suppressed.

This was good news for me when I first heard about the results of this test because I knew of someone who had hepatitis C. This girl was a student of mine who had contacted this disease. I first realized that something was wrong with her one day, when I noticed that her face and the whites of her eyes were yellow. I didn’t know the cause of this unusual coloring, but I told her mother that she should take her daughter to the doctor. Later, I found out from this mother that her daughter had hepatitis C. Many teenagers get this disease through sexual intercourse which was believed to be the reason for this girl’s problem.

I later found out that this type of hepatitis could lead to cirrhosis of the liver which eventually could lead to the dreaded disease–cancer. I felt very concerned for this young girl and her parents. For their sake and for others who have this disease, I hope that this new experimental drug can soon be on the market.

The good news about this new drug, SPC3649, is that when it was first tested, it showed no toxic side effects. The other good news regarding the testing of this drug is that it showed no evidence that Hepatitis C was being resistant to it. This is extremely good news because in the past, scientists and best doctors have had problems with other drugs because these drugs allowed Hepatitis C to progress into further disaster. The other encouraging news about SPC3649 is that when treatment had stopped, it continued to be effective.

It is estimated that approximately 170 million people in the world have hepatitis C. It is also estimated that four million Americans are living with hepatitis C infection.

The results of this research is so promising that microbiologists are excited about what this new drug will lead to in the future.

 

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The Most Important Part of Crohn’s Disease and Relationships – Honesty

It was not only heartbreaking to my youngest son, who at the age of 17, was diagnosed with Crohn’s disease, but also for my whole family, as well. It was hard to watch me son, a high school student, who was very active in cross-country, stricken with a debilitating disease that would prevent him from competing in meets and events the rest of his high school years.

Another issue that concerned my son was his girlfriend. Would she still want to be his girlfriend knowing he had Crohn’s disease? Would any girl want anything to do with him? These were all real fears for my son and he had every right to have them, as people who are diagnosed with a specific disease are sometimes shunned by society.

When my son was first diagnosed, I tried to find a support group that he could join, with the thought that he might be able to relate to people affected with Crohn’s and to get some much-needed answers. I contacted the hospital where he was receiving treatments, but unfortunately, the only support groups for Crohn’s were for adults. I did take him to one and I think it helped, as he was made aware that he was not alone in the world; there were others like him, even if they were older.

My son kept his girlfriend up-to-date on his condition each time he went to the doctor, received a treatment, or found out any new information. I then contacted the CCFA (Crohn’s and Colitis Foundation of America) to see if they knew of any young adult support groups, and they informed me of a seminar being held for children near us. Although the seminar was for 16 year olds and younger, they allowed my son to register, after I explained how he needed some support from his peers. He also invited his girlfriend along, which proved to be an excellent decision.

I believe this to be one of the best seminars I have ever attended. There were children there of all ages, from different backgrounds, and there was even a set of twins, one diagnosed with Crohn’s, the other without. The children broke off in groups, attending different presentations, while the parents waited in an auditorium.

Later in the day, when I met up with my son and his girlfriend, they were both somewhat in awe of the information they had learned. It turned out that they were the ones in demand, as the other teenagers had question after question for them about their relationship and how they handled things, like dating. My son told them to be honest, and upfront about their condition. If your relationship becomes serious, keep your partner up-to-date on your treatments and medications with the best doctor, let them know what is going on with you, not just physically, but emotional as well.

Although he never found a support group to join, my son did very well adjusting to this disease, even though about a year after the CCFA seminar, my son’s condition worsened and he had to have a colostomy, which luckily was reversed 13 months later. All through his ordeal, he kept his girlfriend informed of his condition and she was right there by his side through everything, and instead of the relationship ending, it steadily grew through understanding, patience, and love. Today, they are both successful, have been married for five years, and are expecting their first child in September.

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Coping with Crohn’s Disease

Many people have probably not heard of Crohn’s disease. It is a chronic illness characterized by multiple symptoms which may include loss of appetite, vomiting, diarrhea, mild to severe abdominal pain, and sometimes intestinal bleeding. All of these symptoms can be part of inflammation in the intestines. There are possible complications but not everyone experiences them. It is not curable and can begin at any age, but most often is seen in teenagers and young adults. Inflammation can develop anywhere in the gastric system but generally affects the small intestine and the colon.

At the age of 9 my grand daughter, an active, vivacious child began to lose her appetite. We, her family, attributed her subsequent weight loss to the fact that she had changed schools. This may sound implausible but in the private grade school she attended she had a minimal structured physical education program and, with no real playground, her school day did not include strenuous play.

When she started attending her new school in fourth grade her physical activity level increased both in and out of school. She played outside with her friends in the neighborhood and at school she had a PE program that kept her active and in good physical condition. But then she started losing her appetite. She would be very hungry, start to eat, and suddenly lose interest. Sometimes she wouldn’t even be able to look at food without being nauseated. At her regular checkup that year her pediatrician expressed concern when she weighed in 20 pounds lighter than the year before. A gastric follow-through was scheduled which revealed the diagnosis of Crohn’s disease.

When Crohn’s is first diagnosed it is fair to say it is a shock to the patient and their family. Many who have it, when they learn the outcome of the tests, are completely overwhelmed. What could have caused it? How serious is it? Is normal life possible after this? Is it curable? What medications are available and what are the side effects? There are so many questions and, depending on whom you talk to, a lot of confusing answers.

I had heard of Crohn’s disease before my grand daughter got her diagnosis because one of my dear friends had it. Her disease course was horrible with ulcers from her mouth into her esophagus and throughout her entire gastric system. She started having major digestive problems in her twenties and didn’t understand the seriousness of her illness until her doctor told her she would likely die within a year if she did not have surgery. She underwent an ileostomy and learned to cope very well with the colostomy bag she has worn for many years. Aside from what I knew of her problems, my knowledge of the disease was limited and definitely skewed toward the negatives. I imagined the worst for my precious grand daughter.

I have always wanted to know as much as possible about any disease that affects me or my family so my first reaction involved looking on the internet. Big mistake! It only made matters worse. I got on a couple of informational forums with people who have Crohn’s and read about many of the worst case scenarios. It didn’t take long before I realized I needed some more objective information.

I found a website operated by the Crohn’s and Colitis Foundation of America, www.ccfa.org. Their approach is to educate patients about every aspect of the disease but to also offer hope. The information they provide is very straightforward. All the treatment alternatives are discussed, including support aimed at teaching about Crohn’s disease, helping a patient accept the diagnosis, guidance about being proactive in working with medical doctors, and encouragement as to prognosis. The website also discusses different types of Crohn’s disease, symptoms and causes, diagnostic tests, environmental factors, nutritional considerations, coping strategies, complications, and medications as well as surgical treatment options.

By the time I had read through this site I had a pretty thorough understanding of what my grand daughter could be facing. She went through several years of being afraid of what people would think if they knew she had Crohn’s disease and she hid the truth for some time, even from her friends. In time she trusted that people would not go away just because she had a chronic illness. She has had some periods of remission and a few flare-ups. She has managed, for the most part, to live a normal life with some bouts of pain and disruption. She has never been hospitalized and has not required surgical intervention.

Crohn’s disease, though undeniably serious, is not considered to be fatal. It is, however, a disease that must be coped with because unfortunately, though research is ongoing, there is no cure at this time. There are no guarantees that medication will work immediately and there may be periods of trial and error. The good news is that the likelihood of remission, for short periods or even for years, is possible. Everyone is different and there is no way to predict the disease course. That is one of the frustrations. As with all illnesses, the more educated you are, and the more compliant with treatment by the best gastroenterologist, the better your chances of leading a normal life.

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