Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Gastroenterology (Expert Forum)
Disease Overlap, Best Treatment Strategy?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Disease Overlap, Best Treatment Strategy?
by Carolina03, Mar 31, 2006 12:00AM
Hi, Dr. Pho.
Last week, I had a capsule endoscope revealing multiple ulcers throughout the small bowel, (thus explaining pain I've felt over the ileum for over a year). I'm also producing a high number of antibodies for Crohn's.
Three years ago, my GI doc performed a colonoscopy, taking a biopsy which revealed microscopic colitis. (I was having severe diarrhea). If I had to estimate, I’ve had the ileitis and diarrhea for 10-15 years but lived with it.
My GI doc said my case is rather odd: I’m dependent on synthroid after thyroiditis postpartum in 2003; asthmatic and dependent on Advair and periodic prednisone; and seeing a cardiologist every six months for chronic angina. An echo revealed a mildly dilated and dysfunctional RV. My diagnosis after an adenosine cath was a moderate coronary flow deficit (2.4) due to endothelial dysfunction. I take an ACE, statin and diuretic.
I can live with the colitis and deal with the asthma and bronchitis. I don’t even think about my thyroid … but I’m SCARED about the long-term impact on my heart, (not to mention my emotional health!)
I’m taking several medications pertaining to each disease and wondering … should I see an autoimmune specialist? Could you recommend someone? Or should being treated for Crohn’s with mesamaline resolve the systemic inflammation? Is there a “silver bullet” for multiple autoimmune diseases besides prednisone that I should bring up with my internist?
Thanks in advance for your time.
C
Last week, I had a capsule endoscope revealing multiple ulcers throughout the small bowel, (thus explaining pain I've felt over the ileum for over a year). I'm also producing a high number of antibodies for Crohn's.
Three years ago, my GI doc performed a colonoscopy, taking a biopsy which revealed microscopic colitis. (I was having severe diarrhea). If I had to estimate, I’ve had the ileitis and diarrhea for 10-15 years but lived with it.
My GI doc said my case is rather odd: I’m dependent on synthroid after thyroiditis postpartum in 2003; asthmatic and dependent on Advair and periodic prednisone; and seeing a cardiologist every six months for chronic angina. An echo revealed a mildly dilated and dysfunctional RV. My diagnosis after an adenosine cath was a moderate coronary flow deficit (2.4) due to endothelial dysfunction. I take an ACE, statin and diuretic.
I can live with the colitis and deal with the asthma and bronchitis. I don’t even think about my thyroid … but I’m SCARED about the long-term impact on my heart, (not to mention my emotional health!)
I’m taking several medications pertaining to each disease and wondering … should I see an autoimmune specialist? Could you recommend someone? Or should being treated for Crohn’s with mesamaline resolve the systemic inflammation? Is there a “silver bullet” for multiple autoimmune diseases besides prednisone that I should bring up with my internist?
Thanks in advance for your time.
C
Doctor's Answer
by Kevin Pho, MD, Apr 01, 2006 12:00AM
, Apr 01, 2006 12:00AM
Typically, a GI specialist would be appropriate to manage Crohn's disease. If there is concern about the management, another opinion can be considered - preferably at a major academic medical center. If there is further concern about the autoimmune aspects of the disease, a rheumatologist can be considered.
If prednisone or mesalamine isn't controlling the disease, one can consider medications that affect the immune system. This can include azathiorine and 6-MP. Methotrexate can also be considered.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
If prednisone or mesalamine isn't controlling the disease, one can consider medications that affect the immune system. This can include azathiorine and 6-MP. Methotrexate can also be considered.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
Member Comments (1)
by myproblem, Mar 31, 2006 12:00AM
If I were you, I would definately see a rheumatologist and get a full panel of autoimmune tests. Because Crohn's is an autoimmune disease, and they often overlap with each other, you are at risk for complications. There are better drugs available for most autoimmune disorders. These are in a class referred to as DMARD's (Disease Modifying Anti-rheumatic Drugs). If you visit RISG.org, and sign up for their newsletter, they send out news links every week on autoimmune diseases including Crohn's.
