Questions Answered By Expert
Sasha Taleban, MD
Arizona Health Sciences Center, Assistant Professor of Medicine, Director of IBD Program
A: There are reports of iritis occurring after IPAA surgery for UC but this not commonly. Iritis can occur with other medical conditions than UC so the eye doctor in collaboration with the primary care provider can decide on any further appropriate evaluation. If you are not having any gastrointestinal symptoms with the iritis, then the eye specialist (such as an ophthalmologist) is an appropriate person to address this issue. Otherwise, unless there are other symptoms after the IPAA for UC, you do not necessarily need another provider to manage your case. hide answer
A: I’m glad you asked this question. This is an important subject and probably does not get the attention it deserves. It’s not unusual for persistently active Crohn’s disease to have affects on intimacy and sex. Mood, self-consciousness, and illness perception are important determinants of sexual health and can also be adversely affected by Crohn’s disease. I would suggest a few different options. First, it’s important that your husband’s Crohn’s disease is evaluated and appropriately treated for any evidence of ongoing active disease by his gastroenterologist. If active Crohn’s is not causing his “flare-ups,” then his symptoms will need to be evaluated for other potential underlying causes. Second, it may be helpful to attend a support group (either an IBD or better yet, an ostomy support group) as this may be a common topic among other patients. Third, I believe it’s important to communicate your feelings and express your concerns to your husband. You may find that your relationship improves as a result. hide answer
A: Thank you for your question. This is a question that comes up often in different forms. Active disease refers to ongoing active inflammation of the intestinal lining, which can be detected by labs, imaging, and/or colonoscopic evaluation. These diagnostic tools often agree with one another but not always, and if the location of active disease is accessible by colonoscopy (i.e., in the colon or terminal ileum), this tool remains the gold standard for evaluation. Ideally, the definition of remission in Crohn’s disease is the combination of no active intestinal inflammation and an absence of disease-related symptoms. However, because symptoms associated with Crohn’s are also present in other hide answer
A: Immunoglobulins or Ig are not typically used in the diagnosis of Crohn’s disease. The three scenarios that this test may come up in the evaluation for IBD are: 1) Evaluation for celiac disease, which is associated with IBD, as celiac disease and IBD can have overlapping symptoms 2) Evaluation for common variable immune deficiency (CVID) which can have overlapping symptoms with IBD 3) As part of an antibody panel used by many providers (aka as the IBD-7 panel). These panels can include antibodies like ASCA, ANCA, Anti-ompC, etc, and are often associated with IgA or IgG. This antibody panel is rarely helpful for a diagnosis of IBD, especially when used alone. IBD is typically diagnosed based on a combination of clinical symptoms and history, endoscopic evaluation (with biopsies if needed), imaging, and labs. hide answer
A: Great question. There is some research on this topic but it depends on a couple different things. If before your total colectomy and end-ileostomy your disease was isolated to your colon, then the risk of recurrence with an end-ileostomy is low, about 10-20% over 5 years. If before surgery, the colon inflammation was associated with small bowel inflammation or inflammation around the anal area (i.e., abscesses or fistulas), the risk of Crohn’s disease recurrence would be higher. hide answer