My 13 year old daughter has been diagnosed with Crohn's disease. The Dr. has prescribed prednisone, which is a steroid, and also 6-mp. I am not too thrilled about this radical approach. Today will be the first day she is taking the prednisone-30 mg. a day, hopefully not for more than a couple months. She will have to be weened off of this . I am worried about the side effects. Will these really work. Are side effects common-especially for someone her age. She will also have her blood monitored while she is taking the 6-mp, to keep track of her wbc. At present it is 4.5.
I would also like to know if a constricted bowel could also be a spastic bowel and not Crohn's. The Dr. diagnosed my daughter upon the first visit after viewing her barium x-rays -upper g.i. and small bowel follow through. There was 10 cm constriction of the proximal ileum. She has pain her naval area, and also on the left side. Most Crohn's cases are pain on the right. She also has a very healthy appetite- not symptomatic of Crohn's patients.She is 13 years old. She is on prednisone and 6-mp. Her wbc went from 4.5 to 11.1. What level of wbc is considered to be at risk? Many people have been telling me about herbs-particularly cats claw- uncaria tomentosa-which is supposed to cleanse the entire digestive tract. Any opinions on this. I would never stop her medication, but perhaps this could be given supplementary. And what role does diet play? The Dr. says she should eat what she wants, and if it bothers her--well then don't eat it!
REPLY:
I am sorry about the delay in answering your post but somehow it was not automatically forwarded from your Freenet to the national organization. OFCN then forwards it to the correct type of doctor and your question and his answer are then posted world-wide. You should not be able to see your question on your local Freenet system until it is answered. The Buffalo Freenet is looking into this problem.
The doctor who saw your daughter must have been fairly confident of the diagnosis if he started the treatment you have described. This treatment is reasonable for Crohn's disease although some physicians might have used only one drug initially. You are certainly entitled to a second opinion if you have any doubts about the correctness of either the diagnosis or treatment. Fortunately in your city there is an excellent Children's Hospital with a very active Crohn's and Inflammatory Bowel Disease Clinic. Unfortunately there is usually a slight delay for an appointment but your family doctor or pediatrician could call on your behalf to get you and your daughter an earlier appointment.
Side-effects from both prednisone and 6-mp are common but with careful monitoring they can be minimized. Your doctor should discuss these possible complications with you and your daughter. The benefits of treatment usually outweigh these side-effects however.
I would not give your daughter any treatments other than those prescribed at this point. She does not need any bowel cleansing and this could in fact be harmful to her.
In your area there is a very active patient society for people of all ages with Inflammatory Bowel Disease. It is called the CCFA which stands for Crohn's and Colitis Foundation of America. They sponsor educational meetings and support groups. I strongly suggest you contact them and get on their mailing list.
Given your daughter's healthy appetite the doctor's decision not to limit her diet except for foods which don't agree with her is not unreasonable at this time. The CCFA has a number of free pamphlets which deal with Crohn's disease in teenagers, the role of diet, issues of emotional factors, surgery, etc. all of which they will send to you if you give them a call.
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Bruce Sckolnick, M.D.
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