Questions Answered By Expert
Sasha Taleban, MD
Arizona Health Sciences Center, Assistant Professor of Medicine, Director of IBD Program
A: Bloating can be a frustrating symptom. It sounds like you have gone through quite a few different treatments for it as well. Bloating is not something we typically see with vedolizumab. It may be time to sit down with your gastroenterologist and examine other causes for your bloating. hide answer
A: Thank you for your question. A bowel perforation and a new diagnosis of Crohn’s disease is a tough ordeal. By saying you are “trying to limit diet,” I imagine you mean that you are attempting to treat your Crohn’s disease by adjusting your diet. Unfortunately, no specific diets have been adequately evaluated to prevent or treat Crohn’s disease. I don’t know the exact circumstances of your case but if you were first diagnosed with Crohn’s disease after a bowel perforation, that may suggest that your disease needs to be closely monitored and possibly treated to prevent recurrence. I encourage you to speak to your gastroenterologist regarding testing that can be done to evaluate the activity of your Crohn’s disease at this point. This may include labs, imaging, and/or colonoscopy. A flare in Crohn’s disease may be associated with diarrhea, fever, abdominal pain, and/or nausea/vomiting. These symptoms will vary depending on the location of the Crohn’s disease in your intestine and the degree of inflammation. Ideally, remission is a combination of absence of symptoms and resolution of active intestinal inflammation. hide answer
A: The efficacy of alternative treatments in ulcerative colitis is a frequently asked question. Acupuncture may help patients better tolerate their ulcerative colitis symptoms, but at this point, there is no evidence that acupuncture helps decrease active intestinal inflammation. Since our goal with any treatment (i.e., remission) in ulcerative colitis is to decrease active intestinal inflammation in addition to eliminating symptoms, acupuncture on its own may not achieve the results we would like. However, if combined with other therapies that have been studied and found to cause remission in ulcerative colitis, acupuncture may be a better choice. hide answer
A: This is an interesting question. Medications such as infliximab (Remicade) are associated with a higher risk of bacterial infections like those that cause strep throat. As you suggested, this is because infliximab decreases the immune systems’ ability to fight off infections. If the diagnosis of strep throat has been made adequately on each occasion and you have been on appropriate antibiotics in each case, then it may be time to speak to your gastroenterologist about the role infliximab may be playing in the infections. At that point, your gastroenterologist can decide on the next best step for the treatment of the Crohn’s disease. hide answer
A: This is a good question. Medications like Pentasa generally are not effective for Crohn’s disease regardless of its location. The release mechanism of drugs like Pentasa seems to make little difference in its effectiveness. hide answer