FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

NEW TREATMENTS FOR CROHN'S DISEASE MAY BE AVAILABLE SOON

Question: My father, who died 20 years ago, had Crohn's disease, and I've recently been having lots of stomach cramps and diarrhea. I'm worried that I might be developing Crohn's. If I do have Crohn's, can they treat it any better than when my father had it?

Answer: Crohn's disease is an inflammatory condition of unknown cause that may effect any portion of the digestive tract - from the mouth to the rectum, and all parts in-between. Simultaneous involvement of areas in both the large and small intestine occurs in about 50 percent of those who suffer from the disease.

Crohn's typically begins as a group of shallow sores, each one being much like a common mouth sore. These small ulcers increase in size and ultimately unite, forming larger areas of inflamed tissue. These areas may form scars or cause sufficient damage that infection starts, thereby causing an illness much like appendicitis. Typically, though, the symptoms of an episode of Crohn's disease just include diarrhea, fever, abdominal cramps, and weight loss.

Unfortunately, Crohn's Disease is a chronic condition, and there is no cure for it. That means people have to live with its discomfort their whole lives. Treatment for Crohn's Disease usually involves the use of medicines. Sulfasalazine, Asacol, Dipentum, Prednisone and other glucocorticoid steroid drugs have been the most frequently utilized. Unfortunately, these products, just like every other drug, can have side effects that limit their usefulness.

In recent years, immunosuppressant drugs have been utilized with fair success to treat individuals with severe flair-ups of Crohn's disease. This is a change from the time when your father had this disease. Azathioprine and 6-mercaptopurine are the most frequently employed members of this group.

Also, new anti-inflammatory medicines - currently awaiting government approval - will probably soon be on the market. These drugs are in the COX-2 family and will initially be marketed for the treatment of arthritis. In addition, they also hold promise for the treatment of Crohn's disease. The hope is that they will relieve the symptoms at least as well as currently available drugs and at the same time have more tolerable side effects.

Since you're suffering from diarrhea, abdominal pain and cramps, I'd recommend that you see your family doctor. Keep in mind that many other conditions can cause similar symptoms - most far less serious than Crohn's Disease. In fact, many people who develop these symptoms merely have irritable bowel syndrome, a common and less dangerous problem. Your family doctor can usually determine if you have irritable bowel by asking questions about your symptoms and conducting a few simple tests. After these tests, if he or she suspects Crohn's disease, you may be referred to a gastroenterologist, a specialist in digestive disorders.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.