5 Things I Wish My Patients Knew About Treating Crohn's Disease
Barry Levitt, MD
When I first diagnose patients with
Crohn’s disease, they tend to be concerned about how a chronic disease will
affect their lives. Most importantly, I want patients to know that Crohn’s
disease is treatable. You can manage it if you keep these key factors in mind.
Understanding Your Crohn’s Disease https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/582x389%2B2%2B0/resize/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F99%2F75%2F17ff2b4c4f36813cd2e5ccff0670%2Fsupport.jpg
My patients with Crohn’s disease are acutely aware of their bodies. They know what works for them and what doesn’t. I will help them find the right medicinal treatment–whether it’s mesalamine products, corticosteroids, immunomodulators, or biological therapies–but it’s important that they notice how their bodies react to different foods and triggers. I’ve seen patients benefit from probiotics, but there’s no research to support those as a recognized treatment for Crohn’s. And some people try a very low-carbohydrate diet called the Specific Carbohydrate Diet (SCD) but again, there’s no data on that. I tell my patients to listen to their bodies and find what works for them.
1. You’re the expert on your body. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F64%2Fd3%2F8517ac934505b63d329d104e2401%2Fimage-patient-in-counseling.jpg
Of all my patients with Crohn’s, 10 to 20% will go into complete remission after their first flare. However, the more common pattern of the disease is that patients have their initial flare, we get them on maintenance therapy, and then, depending on the severity of their disease, they might have a flare every couple years. For more severe cases, it could be a few times a year.
2. Crohn’s is a chronic disease. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/844x565%2B4%2B0/resize/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F98%2Fa6%2F5ea17e2140df8c4ae1bb84a3fce5%2Fimage-man-sitting-on-couch-sad.jpg
Thankfully, the way Crohn’s presents at first is usually the way it plays out for the duration of the disease. If, at the beginning, you have very mild to moderate disease, I’ll try to maintain you on the mesalamine products to limit your flares. You may need a course of steroids once a year or once every two years, and if it’s happening a lot, we may put you on biological therapy. If your disease is moderate to severe, I know you’re going to have a much rockier course, probably with a lot more flares and a lot more nutritional issues. If patients have obstructions, strictures, or fistulas when I see them initially, we know they’re going to have severe disease with a pretty rocky road ahead.
3. It’s possible to predict the course of the disease after diagnosis. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F80%2F71%2Fbbbc2d9f474ca8be7939ba0862ea%2Fresizes%2F1500%2Fimage-gettyimages-110883253.jpg
Most people can get their Crohn’s under control and avoid complications. Some people have severe disease that causes complications like obstructions, strictures, or fistulas to form. And if your Crohn’s affects your colon, you may be predisposed to colon cancer. We make sure these patients get tested regularly, and we pay special attention during colonoscopies to detect precancerous changes. Since Crohn’s is a systemic disease, it can also affect the eyes, lead to rashes, cause joint pain or arthritis, or manifest in other ways. Thankfully, if those complications develop, treating the underlying Crohn’s disease is usually enough to clear up any other systemic manifestations.
4. If untreated, Crohn’s can lead to serious complications. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F83%2Fa7%2Fc635de754c08be208d5f6bafe3b1%2Fvirtual.colonoscopy_738x399_S7_STK_124760452.jpg
I wish patients knew that in most cases, it’s treatable! Even though it’s a chronic disease, once you get it under control, you can go on with living a normal life. It’s something I stress to all my patients. Once I get them on the right regimen and they’re feeling good, they should be able to keep it under control with the therapy they’re on now.
5. Crohn’s disease is treatable. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/5382x3600%2B0%2B0/resize/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2Fc3%2F0d%2Faa216c49436cba67a9f5d885d95d%2Fimage-gettyimages-106510451.jpg