Crohn's and Colitis For Dummies E-Book

Tauseef Ali

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 503

Veröffentlichungsjahr: 2013

Beschreibung

The ultimate reference for those with Crohn's and colitis and their family and friends Crohn's disease and colitis are frustrating, often debilitating gastrointestinal diseases that can have a severe impact on the overall health of those who suffer from them. According to the latest estimates, more than 600,000 patients in North America have Crohn's disease. Written by a physician specialising in the treatment of IBDs, Crohn's and Colitis For Dummies is a complete plain-English guide to understanding, treating, and living well with these diseases. * Helps readers actively recognize symptoms of Crohn's and colitis and explains the diagnostic procedures doctors use to identify these diseases * Outlines how the whole body is affected by Crohn's and colitis, and the potential hazards of letting the disease go untreated * Offers expert advice and guidance on controlling Crohn's and colitis with diet and outlines the treatment options of medicines and surgery, including the various risks and benefits of each * Provides practical advice for parents of children with Crohn's and colitis with insights into how children's treatment options can differ from those of adults

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Crohn’s & Colitis For Dummies®

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Library and Archives Canada Cataloguing in Publication Data

Ali, Tauseef

Crohn’s and colitis for dummies / Tauseef Ali.

Includes index.

ISBN 978-1-118-43959-3 (pbk); ISBN 978-1-118-43964-7 (ebk); ISBN 978-1-118-43966-1 (ebk); ISBN 978-1-118-43970-8 (ebk)

1. Crohn’s disease. 2. Colitis. I. Title.

RC862.E52A45 2013 616.3’44 C2013-901739-9

Printed in the United States

1 2 3 4 5 RRD 17 16 15 14 13

About the Author

Dr. Tauseef Ali serves as a faculty member in the Department of Medicine, Section of Digestive Diseases and Nutrition, at the University of Oklahoma College of Medicine. He is the director of the department’s comprehensive Inflammatory Bowel Disease Program and a staff gastroenterologist at OU Medical Center and St. Anthony Hospital, Oklahoma City. Dr. Ali graduated from Pakistan’s King Edward Medical University, one of the most prestigious medical universities in Asia, established in 1860. He finished his internal medicine residency and gastroenterology subspecialty fellowship at the OU College of Medicine. During his training, Dr. Ali spent some time at the University of Chicago to learn about inflammatory bowel disease and received direct mentoring from Dr. David T. Rubin, an internationally renowned authority in Crohn’s and colitis.

Dr. Ali has a great passion for inflammatory bowel disease and has presented many papers on the topic at the regional, national, and international levels. He has published many research and review articles on Crohn’s and colitis. His areas of interest include the effect of sleep problems on inflammatory bowel disease and the impact of health literacy on disease outcomes.

As a member of the American College of Physicians, the American College of Gastroenterology, the American Gastroenterology Association, the American Society of Parenteral and Enteral Nutrition, the Southern Society of Clinical Investigators, and the Crohn’s and Colitis Foundation of America, Dr. Ali is actively involved in many educational and scholarly activities. He has served as the academic editor-in-chief of World Journal of Gastroenterology and has been a reviewer in many gastroenterology journals.

Dr. Ali regularly tweets the latest research in Crohn's and colitis. You can find him at www.twitter.com/ibdtweets.

Dedication

To my wonderful parents, Rizwana and Asghar; my beautiful wife, Ammara; and my lovely kids, Mohid, Moiz, and Anaya, who were a constant support and source of fun and inspiration while I was working on this book.

Author’s Acknowledgments

First, I would like to thank God for giving me the capability to write this book. I would like to thank Anam Ahmad, my acquisitions editor, who thought I had what it takes to put Crohn’s and colitis in plain English. I thoroughly enjoyed working with Elizabeth Kuball, my project editor, who took great care of my words while patiently guiding me through the For Dummies process. I greatly appreciate the support of the entire editorial staff at John Wiley & Sons Canada, Ltd.; you were a great help in my endeavor to write this book. I also want to extend my thanks to Dr. Raymond Cross from the University of Maryland, who served as the book’s technical editor and provided valuable suggestions to make this book the best resource guide for patients, as well as their friends and family members.

I would like to specially acknowledge my mentor, Dr. David T. Rubin, who is a source of inspiration and motivation for me. I would like to thank Dr. William Tierney, who throughout my training and during my time as a faculty member, taught me the art of medical ethics. Special thanks go to Amber Crosby, Belinda Frost, and Theresa Rush, not only for their support and valuable suggestions, but also for the way that each, in her own way, encourage and inspire me. I would like to thank Sameera Omar for her comments and suggestions, especially on the chapters related to pregnancy and childhood issues. I also want to thank my brilliant medical student Joshua Wadlin, who helped me collect medical information that I drew upon in writing the book. A special feeling of gratitude to my loving parents, Muhammad Asghar and Rizwana Asghar, and to my parents-in-law, Dr. Janbaz Ahmad and Jawairia Ahmad, and other family members who have always supported and encouraged me. I would like to express extreme gratitude to my wife, Ammara, whose support and appreciation was more invaluable to me while I was writing this book than she could ever know.

Last but not least, I would like to extend my gratitude to all my patients, who in their efforts to find relief from their condition have given me the gift of learning.

Publisher’s Acknowledgments

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Some of the people who helped bring this book to market include the following:

Acquisitions and Editorial

Project Editor: Elizabeth Kuball

Acquiring Editor: Anam Ahmed

Copy Editor: Elizabeth Kuball

Technical Editor: Raymond Cross, MD

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Cover Photos: © luliya Sunagatova / iStockphoto

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Crohn's and Colitis For Dummies®

Visit www.dummies.com/cheatsheet/crohnscolitis to view this book's cheat sheet.

Table of Contents

Introduction

About This Book

Conventions Used in This Book

What You’re Not to Read

Foolish Assumptions

How This Book Is Organized

Part I: The Who, What, and Why of Crohn’s and Colitis

Part II: Getting Medical Help

Part III: Healing and Dealing with the Disease

Part IV: Living and Coping with Crohn’s and Colitis

Part V: Considering Special Populations with Crohn’s and Colitis

Part VI: The Part of Tens

Icons Used in This Book

Where to Go from Here

Part I: The Who, What, and Why of Crohn’s and Colitis

Chapter 1: Crohn’s and Colitis One Step at a Time

Knowing Crohn’s and Colitis

Getting the Treatment You Need

Recognizing That You’re Not Powerless

Living a Full Life with the Disease

Special Advice for Pregnant Women and Kids

Chapter 2: Defining Crohn’s and Colitis

What Crohn’s and Colitis Are

Looking at the big picture: Inflammatory bowel disease

Zeroing in on Crohn’s and colitis

The Signs and Symptoms

Blood in stool

Diarrhea

Abdominal pain

Urgency

Tenesmus

Other symptoms

Other Parts of the Body Involved in Crohn’s and Colitis

Bones and joints

Skin

Liver and gallbladder

Kidneys and bladder

Eyes

Complications of Crohn’s and Colitis

Intestinal complications

Nutritional complications

The cancer connection

Chapter 3: How the Digestive System Works

Tracking the Journey of Food inside the Gastrointestinal Tract

The oral cavity (or mouth)

The stomach

The small intestine

The large intestine

The anus

Getting Help from the Liver, Pancreas, and Gallbladder

Liver

Pancreas

Gallbladder

Understanding How Inflammation Affects the Digestive Process

Gastritis: Inflammation of the stomach

Enteritis: Inflammation of the small intestine

Colitis: Inflammation of the large intestine

Proctitis: Inflammation of the rectum

Chapter 4: Who Gets Crohn’s and Colitis and Why

Who Gets Crohn’s and Colitis

The Role of the Immune System in Crohn’s and Colitis

An immune system primer

When your gut’s immune system goes awry

Environmental Factors

Food

Air

Hygiene

Other environmental factors

Genes Gone Bad: The Role of Genetics

How genes work

The role of family history

Key genes for Crohn’s and colitis

Getting a genetic test

Part II: Getting Medical Help

Chapter 5: Assembling Your Healthcare Team

Finding the Right Doctor for You

Why you need a specialist

How to choose among the specialists in your area

Your first visit

Rounding Up Other Key Players

Your primary-care physician

Nurses

Physician assistants

Registered dietitians

Psychiatrists

Surgeons

Friends and family

Chapter 6: Getting a Diagnosis

Preparing for Your First Visit

Charting your signs and symptoms

Assembling your medical records

Talking to Your Doctor

Getting over the embarrassment

Communicating your symptoms

Being realistic about your expectations

Knowing What to Expect during a Physical Exam

General physical exam

Focused physical exam

Rectal exam

Being Poked and Prodded for Medical Tests

Blood tests

Stool tests

Scans

Endoscopy

Identifying Other Diseases That Mimic Crohn’s and Colitis

Chapter 7: Taking Medications for Crohn’s and Colitis

Steroids

Types of steroids

How steroids work

When steroids are used

Side effects of steroids

Aminosalicylates

Types of aminosalicylates

How aminosalicylates work

When aminosalicylates are used

Side effects of aminosalicylates

Immunomodulators

Types of immunomodulators

How immunomodulators work

When immunomodulators are used

Side effects of immunomodulators

Biologics

Types of biologics

How biologics work

When biologics are used

Side effects of biologics

Antibiotics

Types of antibiotics

How antibiotics work

When antibiotics are used

Side effects of antibiotics

Other Medications

Antidiarrheals

Bile salt binders

Analgesics

Iron

Calcium and vitamin D

Vitamin B12

Chapter 8: Considering Surgery

When You May Need Surgery

For Crohn’s disease

For ulcerative colitis

Types of Surgery

Resectioning the small intestine

Removing a stricture

Treating fistulas

Draining abscesses

Resecting the colon

Pouch surgery

Complications from Surgery

Short-term complications

Long-term complications

Ostomy: What It Is and How to Deal with It

Types of ostomy

When you may need ostomy

How to care for your stoma

Your ostomy pouch

Ostomy complications

Part III: Healing and Dealing with the Disease

Chapter 9: Paying Attention to What You Eat

Considering the Impact of Nutrition

The impact on your immune system

The impact on wound healing

Identifying the Nutrients You Need

Macronutrients

Micronutrients

Fiber or No Fiber? That Is the Question

Types of fiber

Why fiber matters

Fiber’s role in Crohn’s and colitis

Considering Specialized Diets for Crohn’s and Colitis

Liquid diets

Low-residue diets

Lactose-free diets

Elemental diets

Nutritional Support: When You Can’t Go It Alone

Enteral feeding: Feeding through a tube

Total parenteral nutrition: Feeding directly into your veins

Nutrition supplements: Boosting your diet

Chapter 10: Preventing Health Problems

Getting Vaccinated

Why vaccination matters

Which vaccines you need

Caring for Your Skin: It’s Not Just Cosmetic

Identifying the skin complications you may face

Recognizing and reducing your risk of skin cancer

Caring for your skin “down there”: Perianal skin care

Boning Up on Bone Health

Opening up about osteopenia and osteoporosis

Seeing what Crohn’s and colitis can do to your bones

Managing bone loss

Screening for Cancers

Colon cancer

Cervical cancer

Chapter 11: Alternative and Complementary Therapies

Let’s Get Physical: Exercise

Recognizing the health benefits of exercise

Looking at how exercise can help with Crohn’s and colitis

Gathering some useful exercise tips

Working Over-Thyme: Herbal Therapy

Healing with herbs

Identifying beneficial herbs for Crohn’s and colitis — and knowing which herbs to avoid

Homeopathy

Getting help from homeopathy?

Homeopathy and Crohn’s and colitis

Traditional Chinese Medicine

Understanding traditional Chinese medicine

Controlling Crohn’s and colitis with traditional Chinese medicine

Mind-Body Intervention

Aromatherapy

Hypnotherapy

Yoga and meditation

Music therapy

Support groups

T’ai chi

Worm Therapy

Putting worms to work for your health

Seeing how worms can help Crohn’s and colitis

Part IV: Living and Coping with Crohn’s and Colitis

Chapter 12: Living with Crohn’s and Colitis

Dealing with Your Diagnosis

Stage 1: Denial

Stage 2: Anger

Stage 3: Bargaining

Stage 4: Depression

Stage 5: Acceptance

People Who Need People . . .: Keeping Your Relationships Going Strong

So, what’s new with you? Telling people about your diagnosis

Come here often? Dating with Crohn’s and colitis

Like a horse and carriage: Keeping your marriage strong

Caring for a Loved One with Crohn’s or Colitis

Finding little things that help a lot

Helping during a flare

Helping after surgery

Getting the help you need for yourself

Chapter 13: Avoiding Triggers

Smoking: Why You Need to Quit

Drugs: Just Say No?

Non-steroidal anti-inflammatory drugs

Antibiotics

Stressing Out

Food, Glorious Food

Artificial sweeteners

High-fat foods

High-fiber foods

Caffeine

Dairy products

Alcohol

Mr. Sandman, Bring Me a Dream

What sleep does for your immune system

The effect of sleep on Crohn’s and colitis

How to get a good night’s sleep

Chapter 14: Working and Traveling with Crohn’s and Colitis

Working with Crohn’s and Colitis

Working your job hunt around your disease

Telling your employer and co-workers about your condition (or keeping it to yourself)

Starting your day off right

Planning your commute

Packing an emergency kit

Speed bumps ahead: Coping with job-related challenges

Taking advantage of the Family and Medical Leave Act

On the Road Again: Traveling with Crohn’s and Colitis

Assembling a vacation survival guide

Getting immunized before you travel abroad

Packing for your trip

Avoiding travelers’ diarrhea

Finding a bathroom . . . fast!

Part V: Considering Special Populations with Crohn’s and Colitis

Chapter 15: Kids with Crohn’s and Colitis

Identifying How Crohn’s and Colitis Are Different in Kids Than They Are in Adults

Gender

Symptoms

Effect on growth and development

Getting a Diagnosis

Managing Crohn’s and Colitis in Kids

Monitoring medications

Paying attention to nutrition

Vaccinating your child

Growing Up with Crohn’s and Colitis

Preschool: C is for Crohn’s and colitis

Surviving school

Turning 18: Adulthood begins (at least in theory)

Going off to college

Chapter 16: Having Sex and Getting Pregnant with Crohn’s and Colitis

Sex and Fertility

Sexual activity

Contraception

Your menstrual cycle

Fertility

Pregnancy

Pregnancy planning

While you’re pregnant

The big day and beyond

Part VI: The Part of Tens

Chapter 17: Ten Myths about Inflammatory Bowel Disease

Diet Is the Cure

Kids Get It from Their Parents

It’s Caused by Stress

You Can’t Get Pregnant if You Have It

Surgery Is Required

If You Have It, You’re Guaranteed to Get Cancer

You’re Responsible for Your Flares

Surgery Cures It

You Can Stop Taking Your Medications if You Feel Better

You Have to Stop Taking Your Medications during Pregnancy

Chapter 18: Ten Reliable Resources

The Crohn’s and Colitis Foundation of America

The United Ostomy Associations of America

You and IBD

MyIBD.org

WebMD

Mayo Clinic

The Culinary Couple’s Creative Colitis Cookbook

The International Association for Medical Assistance to Travelers

KidsHealth

IBD U

Appendix A: Glossary

Cheat Sheet

Foreword

When I started my training in gastroenterology, most people I met had never heard of Crohn’s disease or ulcerative colitis. Today, I rarely meet anyone who hasn’t heard of these conditions, and most people today know someone who suffers from them. This is due, in part, to the fact that the number of new cases of Crohn’s disease and ulcerative colitis is rising in North America and around the world, and we don’t yet know why. In addition, most inflammatory bowel disease (IBD) patients have no family history of IBD and no idea why this mysterious illness is affecting them. IBD is a substantial source of physical suffering and psychological distress, and until recently, it was often thought to be uncontrollable.

Today, we no longer think of IBD as uncontrollable. In the last decade, unprecedented advances have been made in the diagnosis and treatment of Crohn’s disease and ulcerative colitis. We have made substantial progress in the understanding of the genetic, environmental, and immunological causes of these conditions, have created new technologies that aid in accurate diagnosis and disease assessment, and most important, have developed many new therapies that are effective at controlling bowel inflammation and improving patients’ quality of life. In fact, IBD has moved from a dreaded and life-threatening disease of “crisis management” to a chronic, manageable condition whose management is now focused on prevention of complications and long-term, stable control.

Unfortunately, many patients are still misinformed or do not have access to expert care. The Internet is full of misinformation, and many physicians have had difficulty keeping up with the latest developments in the field. In Crohn’s & Colitis For Dummies, Dr. Tauseef Ali skillfully addresses these unmet needs. As an IBD expert, he provides some of the latest theories and advice about disease management. And as a caring and experienced physician, he addresses the educational needs of patients and their family members.

Dr. Ali applies the tried-and-true formula of the For Dummies series to Crohn’s disease and ulcerative colitis, and succeeds in breaking down complex and confusing symptoms and concepts into easy-to-understand chapters, well-defined terms, and myth-busting explanations. When you read this book, you feel Dr. Ali’s calming and compassionate presence, gently guiding you and providing straightforward advice and information. It’s obvious why having a dedicated physician like him in your corner can make a huge difference in your disease management and good health.

So, until we have cures for Crohn’s disease and ulcerative colitis, all patients and their family members should have a copy of Crohn’s & Colitis For Dummies!

David T. Rubin, MDProfessor of MedicineCo-Director, Inflammatory Bowel Disease CenterThe University of Chicago Medicine

Introduction

Millions of people suffer from inflammatory bowel disease (IBD) around the world: more than 1 million in the United States, nearly 200,000 in Canada, and approximately 2 million in Europe. The incidence of this disease is on the rise. Some recent studies suggest that more than 30,000 people are diagnosed with IBD every year in the United States alone. Crohn’s disease and ulcerative colitis, the two major types of IBD, are chronic inflammatory diseases of the intestine. They’re thought to occur because of a malfunctioning of the immune system, genetic defects, or exposure to certain environmental factors — or perhaps a combination of all three. Crohn’s disease and ulcerative colitis mostly affect younger people. There is no miracle drug to cure IBD, but many treatment options can provide relief.

About This Book

In this book, I don’t tell you everything there is to know about Crohn’s disease and ulcerative colitis. Instead, I give you the information you need in order to make the right decisions about your treatment. I’ve also made sure that the information I provide is clear and easy to understand — not a bunch of medical mumbo-jumbo. In this book, you find out what happens in Crohn’s disease and ulcerative colitis — the symptoms they can cause, how they can affect your life at home and at work, what you can do to feel good and function normally, and how you can protect yourself and your family against the long-term unpredictability of the disease. I also offer useful tips, introduce you to the members of your healthcare team, and point you in the direction of other useful resources.