DEAR DR. DONOHUE: I am a 28-year-old, single woman who has just been told that I have Crohn’s disease. For the past year or so I had constant diarrhea, but no doctor could figure out why. Then I began to lose a great deal of weight and have awful stomach pain. A gastroenterologist finally made the diagnosis. I’m on medicine, which has helped. Could I become immune to this medicine? Am I able to have children? I want to raise a family. – K.J.

ANSWER:
Crohn’s disease and ulcerative colitis are the two major inflammatory bowel diseases. Crohn’s frequently appears in late adolescence and early adulthood (15 to 30) or later in life, 60 to 80. Ulcerative colitis affects only the colon. Crohn’s can strike any part of the digestive tract, from mouth to rectum, but most frequently it’s found in the small intestine. With ulcerative colitis, the inflammation results in shallow surface ulcers in the colon. With Crohn’s, it disrupts the entire digestive tract wall, from the surface through its muscle layer. That, in turn, leads to fistula formation – tunnels that connect the intestine to other structures like the bladder, vagina and skin. Diarrhea is a feature of both illnesses. With ulcerative colitis, the diarrhea often is bloody. Crampy abdominal pain and weight loss are common to both.

Crohn’s and ulcerative colitis share some medicines. You don’t have to worry that the medicine you’re taking will lose its potency. There are many others to choose from, should that happen. The first medicine chosen for treatment usually is sulfasalazine or closely related drugs like Asacol, Pentasa or Dipentum. For more severe illness, cortisone drugs such as prednisone or budesonide come into play. A new treatment has been most effective in instances where the older medicines are not controlling symptoms. It is infliximab (Remicade), a drug that inactivates the inflammatory body chemicals responsible for changes of intestinal inflammation.

If the disease can be controlled – and it can be, in most cases – fertility is not affected. You can look forward to having a family.

DEAR DR. DONOHUE: Does ulcerative colitis always lead to colon cancer? I have a young adult nephew who has it. He is a hard worker and the father of two young boys. I just heard of the cancer connection with ulcerative colitis, and wonder if everyone with it gets cancer. – M.J.

ANSWER:
People with ulcerative colitis and Crohn’s disease have a higher incidence of colon cancer than does the general population. The cancer risk is greatest eight to 10 years after the diagnosis has been made. At that time, the doctor gives the patient a schedule for colonoscopies so that any suspicious changes can be detected early. The answer to your question is: no, not every person with ulcerative colitis or Crohn’s disease comes down with colon cancer. The booklet on colon cancer explains how this common cancer is detected and treated. Readers can obtain a copy by writing: Dr. Donohue – No. 505, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My husband claims he cannot eat turkey because it makes him groggy. Our entire family eats turkey at Thanksgiving and Christmas, but no one else complains of feeling groggy. I know he heard this on the radio because I heard the same thing. I can’t shake this out of his head. Can you? – R.D.

ANSWER:
Turkey has a good supply of the amino acid tryptophan. It’s a precursor of serotonin and melatonin. Serotonin is used in the treatment of depression. Melatonin is used for insomnia. That’s how this connection was made.

Only a very few people are affected this way by turkey. If your husband never suffered from turkey-related grogginess before he heard the radio information, then I would think his newfound grogginess is more the result of a powerful suggestion than an actual reaction to turkey.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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