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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Ulcer in small intestine, stomach pain, occult blood issue. Done capsule endoscopy. Suggest treatment?

Kindly read them and inform what to do now. My case history: 1) 2 years back, in September 2010, a Capsule Endoscopy was done in Sahara hospital, Lucknow, which reported 6 places ulcers in small intestine . 2) Then Doctor advised me to took TB medicines (AKT-4 kit for 2 months, then Rcinex 750mg) for 1 & 1/4 year course. 3) During the course, the digestion was good & no occult blood was seen in stool but as the course was over, I still facing the same indignation, stomach pain after meal & occult blood problem. 4) I have to go for stool atleast 3-4 times in a day (with much smell). And also facing gas problem after 2-3 hours of meal. 5) Sometime gets stomach pain Net Result: Now, Doctor told me that you must be suffering from Crohn s disease, and it has no cure. Either go to Homeopathic or Aurvedic medicine. Other problem: I am also having Thyroid problem, so taking Thyronorm 50 mcg. Current medicine: Just now I started taking homeopathic medicines since 2 months, and experience no relief. Kindly Answers of my these Queries: 1. Please tell what type of treatment I have to take? 2. Please tell which produces some drugs/foods known as probiotic product can help me? Thanks & Regards Kishore Kushwaha A-1489/8, Indira Nagar, Lucknow-0000 +91-0000
Sat, 16 Feb 2013
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General & Family Physician 's  Response

Thank you for your query.

If a diagnosis of Crohn's disease has been made you need to first understand that Crohn's cannot be treated, we can only help in prevent the attacks, maintaining a state with the exclusion of attacks, reducing side-effects, symptomatic treatment and to improve quality of life. Thus, education on the disease is very important. The main treatment modalities that are used to achieve the above mentioned goals include:
-Anti-inflammatory drugs (eg. mesalamine, budesonide, etc.)
-Immuno-modulators (eg. azathioprine, infliximab, etc.)
-Antibiotics (eg. metronidazole, etc.)
-Anti-spasmodics (eg. mebeverine, etc.)
You should discuss the possibility of adding these drugs to your treatment regimen, with your doctor.

Lifestyle modifications play a vital role in preventing aggravation of the bowel. Most common aggravating factors can be: coffee or caffeinated drinks, tea, popcorn, red or raw meat, dairy products, hot beverages, oily, spicy, fried or fatty food, sugar containing drinks, smoking, alcohol, chocolates, poultry. You need to observe the food items that aggravate your condition and avoid them.

A liquid diet and otherwise a low fiber diet should be followed. Also calcium, vitamin B12, and folate supplements are contributory. You could continue ferrous sulphate (fefol-Z) in your treatment regimen due to the loss of blood in your stools.

Probiotics help in digestion and are found to contribute in individuals suffering from ulcerative colitis and Crohn's disease. Natural probiotics include: curd, yogurt, also available are probiotic drinks (Yakult in India), etc.

I hope I have succeeded in providing you with information you were seeking. Feel free to write back to me for any further clarifications. I would gladly help.

Wishing you a speedy recovery and a healthy life thereafter.
Best wishes.
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