Treatments for Crohn’s Disease are many
DEAR DR. DONOHUE: My 22-year-old nephew was diagnosed with Crohn’s disease about a year and a half ago. He has been on diets and medications with no remission. Can you suggest any herbal remedies or other alternatives? – C.H.
ANSWER: Crohn’s disease is one of the two inflammatory bowel diseases. The other is ulcerative colitis. Both are similar in inflammation of the digestive tract brought about by an assault from the immune system. In Crohn’s, the inflammation can be found in any part of the tract, from mouth to rectum, and the inflammation leaves the inflamed areas studded with deep sores (ulcerations). The small intestine and colon are the most frequent sites. In ulcerative colitis, it’s the colon – the large intestine – that’s the target of inflammation.
Crohn’s occurs mostly during two time spans: between the ages of 15 and 30 and again, later in life, between 60 and 80. Abdominal pain – often crampy and often relieved by a bowel movement – is one prominent symptom. Diarrhea is another. Because the small intestine is the site of food absorption, nutritional deficiencies and weight loss are common. Crohn’s can cause fistula formation. Fistulas are tunnels that burrow from the inflamed digestive tract to adjacent organs, like the urinary bladder.
A multitude of medicines exist for Crohn’s disease, some of which were unavailable only a few years ago. I don’t know of any herbal remedies. Quite often, doctors start Crohn’s patients on a medicine like Asacol, Pentasa or Dipentum. If they don’t control the illness, then drugs that target the immune system (azathioprine, cyclosporine and methotrexate) are prescribed. Should those medicines fail, newer medicines – Humira, Remicade and Cimzia – can be called into action. These medicines are called biologicals, and they inactivate TNF, tumor necrosis factor, a powerful inflammatory chemical produced by the immune system. TNF is the substance involved in creating the ulcerations of Crohn’s disease.
Probiotics – preparations of good bacteria – are sometimes helpful in restoring the tract’s harmony.
DEAR DR. DONOHUE: Can you clear the following problem? I am 77, and my wife is 71. We both had chickenpox. Our doctors in the North say we don’t need the shingles vaccine. Our doctor in the South says we do. Our Northern doctor gave us a blood test that shows we had chickenpox and that’s why he says we don’t need the vaccine. Kindly advise. – D.G.
ANSWER: Chickenpox, also called varicella, stays in the body for life after an infection. The chickenpox virus hides out in nerve cells. Later in life, the virus can creep out of its hiding place, travel down the nerve to the skin and produce the rash and pain of shingles (called zoster or herpes zoster). The names are confusing, but the same virus causes both chickenpox and shingles.
The blood test you had showed you were infected with the chickenpox virus at some time in the past. More than 90 percent of adults have been. These are the people – you and your wife included –who develop shingles. These are the people for whom the shingles vaccine was devised. It boosts your immunity to the virus when it creeps out of its nerve cell home. I side with the Southern doctor.
DEAR DR. DONOHUE: I am a 47-year-old African-American woman, mother of three. I am 5 feet 5 inches tall and weigh 125 pounds. I have been thin since I was a little girl. I worry about my weight because doctors say I am too thin. I have undergone many tests, but doctors find nothing wrong. Do I have an eating disorder? Please help. – M.F.
ANSWER: You’re not too thin. Your body mass index, BMI, is normal, and it’s a good indicator of health and body composition. You don’t have an eating disorder. If you want to gain weight for appearance’s sake, add 500 more calories a day and you’ll add a pound a week. Snack between meals. Increase the portions of food you eat. Eat some calorie-dense food, like a milkshake, which has about 380 calories. Two tablespoons of peanut butter has 190 calories. Dried fruit is another good choice for a snack food. It’s not hard to add an extra 500 calories a day.
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