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Eugene Yen, MD

Research Associate Professor, Gastroenterologist

Q: My daughter has had Crohns disease for almost 20 years. She has been having extreme bloating after meals no matter what she eats. She can look almost 7-8 month pregnant. What can we do?

A: Bloating can be a common symptom and it can happen for various reasons. We most commonly see bloating in patients with irritable bowel syndrome (IBS). The website can help you learn more about IBS, as we see IBS in a lot of our Crohn’s and colitis symptoms. These are essentially symptoms that may occur in the absence of actual Crohn’s inflammation. However, If she has a stricture (or narrowing) from having Crohn’s disease, sometimes certain foods, such as fibrous foods/roughage can cause bloating. With strictures—sometimes treatments are possible without the need for surgery. I would recommend follow up with your GI doctor to see if any further testing or treatments are needed. hide answer

Q: I have been taking Humira for 7 years with great response and no side effects. Recently I have had episodes of extreme fatigue with weak feeling and a shaky feeling the day after injection. My doctor ran a series of blood work which indicate a possible drug induced lupus. I have absolutely no other symptoms such as joint pain and such. I also take Synthroid 25 mcg and have for years. This level is checked every 6 months. Would switching to another medication end the lupus side effects?

A: It’s hard to know what you exactly had. Sometimes, people can have injection site reactions (the newer humira pens may be better for you), while others can be due to antibodies to humira (which you then need to switch off humira). It depends on what tests your doctors have checked, but if this has been deemed a lupus-like reaction to Humira, then you may have switch to a different therapy. The good news, however, is that you responded well to humira, then we now have lot of choices for you that you will likely also respond well. hide answer

Q: Does Stelara have less cancer potential than other biological as a treatment for Crohns?

A: Keep in mind that people with IBD are at increased risk for cancers, esp if their disease is not under control, so it’s often difficult to know based on the clinical trials whether a person got cancer because they were at higher risk for getting cancer vs whether the actual drug caused cancer. As a whole, we have data on all of the biologics, and none of them have been associated with increased cancers. This includes stelara, where we have not seen any increased risks of cancer. hide answer

Q: I was diagnosed 6 yrs ago with UC. It was a mild case. I took Lialda/Mesalamine, and it did the trick. I stopped taking it 6 months ago. A month ago, I had a mild flare up. My doctor wants to put me on Prednisone to bring down inflammation. I do not think my symptoms are bad enough for a steroid. If I take nothing, will the inflammation go down on its own? Is there a natural way to bring down the inflammation? Ginseng or Tumeric perhaps?

A: You probably don’t need prednisone if the flare is mild. We usually give people prednisone to make them feel better and to shorten time of suffering. Similarly, I think that mesalamine is a very good drug for mild disease. Tumeric has been studied as well, but I think that mesalamine is more effective. You can also probably tough this out, but you run the risk of it getting worse. Plus, you are almost guaranteed to extend your period of suffering. Don’t suffer. Take the mesalamine. hide answer

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