Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
191 Doctors are Online

Chron's disease, have blood in stools , taking Humira, remecade, iron shots to regain hemoglobin. Treatment options?

My grandson is diagonised to have crohn s for the last 5 yrs. He is having bloody stools several times a day and night also.Have tried lots of medicines like HUmira, remecade etc. Now & then he is given iron shots to bring back his haemoglobin etc. otherwise he is v. weak. lost weight . Do you have any suggestions which can be tried to bring this condition to remission?
Asked On : Sun, 15 Apr 2012
Answers:  1 Views:  72
Report Abuse
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
,   ,  
Medical Topics
General & Family Physician 's  Response
Hello and welcome to

There is no medication that can cure Crohn's disease. Patients with Crohn's disease typically will experience periods of relapse (worsening of inflammation) followed by periods of remission (lessening of inflammation) lasting months to years. During relapses, symptoms of abdominal pain, diarrhea, and rectal bleeding worsen. During remissions, these symptoms improve. Remissions usually occur because of treatment with medications or surgery, but occasionally they occur spontaneously without any treatment.

Since there is no cure for Crohn's disease, the goals of treatment are to 1) induce remissions, 2) maintain remissions, 3) minimize side effects of treatment, and 4) improve the quality of life. Treatment of Crohn's disease and ulcerative colitis with medications is similar though not always identical.

Medications for treating Crohn's disease include:
1. anti-inflammatory agents such as 5-ASA compounds and corticosteroids,
2. topical antibiotics, and
3. immuno-modulators.

Selection of treatment regimens depends on disease severity, disease location, and disease-associated complications. Various guidelines recommend that approaches be sequential - initially to induce clinical remission, and then to maintain remissions. Initial evidence of improvement should be seen within 2 to 4 weeks and maximal improvement should be seen in 12 to 16 weeks.

The classic approach to therapy in Crohn's disease has been a "step-up" approach starting with the least toxic agents for mild disease, and increasingly more aggressive treatment for more severe disease, or patients who have not responded to less toxic agents. More recently the field has been moving toward a "top-down" approach (early aggressive management) which might decrease exposure to anti-inflammatory agents and increase exposure to agents that enhance mucosal healing that might prevent future complications.

Dietary changes and supplementation that may help control Crohn's disease:
- Since fiber is poorly digestible, it can worsen the symptoms of intestinal obstruction. Hence, a low fiber diet may be recommended, especially in those patients with small intestinal disease.
- A liquid diet may be of benefit when symptoms are more severe.
- Intravenous nutrition or TPN (total parenteral nutrition) may be utilized when it is felt that the intestine needs to "rest."
- Supplementation of calcium, folate and vitamin B12 is helpful when malabsorption of these nutrients is apparent.
- The use of anti-diarrheal agents (diphenoxylate and atropine [Lomotil], loperamide [Imodium]) and antispasmotics also can help relieve symptoms of cramps and diarrhea.

You should contact your grandson's treating physician to advise him/her of ongoing symptoms and the need for additional or change in therapy. Due to his continuing bleeding, your grandson is probably experiencing the effects of anemia. Loss of weight is indicative of malabsorption of nutrients. You can try supplementing his nutrition with a high caloric drink such as Ensure. This will also help in giving his bowel time to heal.

Be well,
Dr. Kimberly
Answered: Sun, 15 Apr 2012
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer. For a more detailed, immediate answer, try our premium service [Sample answer]


Loading Online Doctors....
© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor