Caring for Crohn's & UC

Final Installment of the ABC’s of Crohn’s & UC: “T,” “U,” “V,” “X,” & “Z”

January 16, 2013 at 9:09 pm Rebecca K. 2 comments

It’s hard to believe that we’ve come to the end of the alphabet and thus the end of my ABC’s of Crohn’s & UC series. After this post, I will compiled all of the previous ones into a page on the blog so you can easily access this glossary I’ve compiled about IBD. Additionally, if I’ve missed anything important for any letter, please let me know!!! I would love to keep adding to this list and eventually turn it into something to help explain these diseases to those who are unfamiliar.

That being said, here is the final installment: T, U, V, X & Z.

Toxic Megacolon: This is a life-threatening complication of IBD and infections of the colon. Toxic megacolon is the rapid widening/enlargement of the colon. It is commonly associated as a complication of ulcerative colitis. Symptoms of toxic megacolon include abdominal pain, distention and tenderness; fever; rapid heart rate; and shock.  A physical exam of someone with toxic megacolon may reveal signs of septic shock. Toxic megacolon is diagnosed through a physical exam, abdominal x-ray, blood electrolytes, and a complete blood count (CBC). According to the NY Times, patients with toxic megacolon will receive fluids and electrolytes to help prevent dehydration and shock and antibiotics to prevent sepsis. However, if the rapid widening continues, a perforation can form in the colon (which can lead to sepsis). Most cases of toxic megacolon will require surgery, such as a colectomy.

TPMT: According to CCFA, TPMT (thiopurine methyl transferase) is a laboratory blood test that checks for the activity of an enzyme that helps im breaking down 6MP and azathioprine (Imuran), which helps to establish proper dosing of these medications.

Turmeric: According to Everyday Health, turmeric is an herbal remedy that is good for your gut. Turmeric is the ingredient in curry that gives it their intense color. It is thought to be an anti-inflammatory. You can use it in your food but much of the clinical research surrounding turmeric is typically done using capsules containing curcumin (the clinical name for turmeric) because its a bit easier on the GI tract of those with Crohn’s.

Tysabri: An immunosuppressant used to treat Crohn’s Disease. Tysabri works by inhibiting integrins, certain immune cell molecules, from binding to other cells in your intestinal lining. It is thought that blocking these molecules reduces chronic inflammation that occurs when they bind to other cells. Tysabri is used for patients with moderate to severe Crohn’s with active inflammation who aren’t responding to other therapies. Tysabri isn’t widely used. According to the Mayo Clinic, “Because the drug is associated with a rare, but serious, risk of multifocal leukoencephalopathy — a brain infection that usually leads to death or severe disability — you must be enrolled in a special restricted distribution program to use it.”

Ulcerative Colitis: UC is an inflammatory bowel disease that causes long-lasting inflammation in the innermost lining of your large intestine and rectum. It occurs only through continuous stretches of your colon, unlike Crohn’s, which occurs anywhere in the digestive tract. UC can be debilitating and sometimes can lead to life-threatening complications like toxic megacolon. UC is a chronic condition and symptoms usually develop over time rather than suddenly. Like Crohn’s, there is no known cure for UC but there are therapies available that can reduce the signs and symptoms of the disease and bring about a long-term remission.

Ulcerative proctitis: A type of UC, ulcerative proctitis occurs in the area closest to the anus. Because of its location, rectal bleeding may be the only symptom of ulcerative proctitis. Others may have rectal pain and a feeling of urgency. Ulcerative proctitis tends to be the mildest form of UC.

Ulcers: Some patients with IBD may develop ulcers due to the chronic inflammation that occurs in the GI tract. Ulcers can develop anywhere in the digestive tract, including your mouth and anus, as well as in the genital area and anus.

Upper Endoscopy: According to Yale IBD (Dan’s doctor!), an upper endoscopy “is a diagnostic procedure that allows evaluation of the esophagus, stomach, and duodenum. In patients with inflammatory bowel disease, an upper endoscopy evaluates disease involvement in the upper region of the digestive tract.” An upper endoscopy is sometimes called an esophagogastroduodenoscopy or EGD.

Virtual colonoscopy: A procedure used to look for signs of pre-cancerous growths, cancer and other diseases of the large intestines. These are done by taking images of the large intestines through a CT scan or MRI. A computer then puts the images together to create an animated, 3D view of the inside of the large intestines. While this sounds awesome, according to CCFA, virtual colonoscopies are not recommended for suspected IBD because biopsies and direct viewing of the colon and small bowel are required.

Vitamins: Patients with IBD tend to have vitamin and mineral deficiencies due to inflammation, diet, and the therapies for IBD treatment. Common vitamin and mineral deficiencies include calcium, iron, Vitamin A, Vitamin D, Vitamin K, and Zinc. Your doctor will perform blood tests to check your vitamin and mineral levels. If they find you have deficiencies, they will recommend you take vitamins and will give you the correct dosage to take. Always consult with your doctor before you start taking a new vitamin.

X-ray: A barium X-ray is sometimes used to diagnose and check the prognosis of Crohn’s disease. A barium X-ray is also helpful for finding problems in parts of the small intestine that can’t be easily viewed by other techniques. According to WebMD, during a barium X-ray a chalky fluid containing barium is given by mouth (upper GI series) or through the rectum (barium enema). The barium fluid flows through the intestines and appears white on the X-ray film, making it easier to view problem areas. Barium X-rays allow doctors to see ulcers, strictures, fistulae, or other problems. If the X-ray shows signs of disease, your doctor may request additional X-rays or other imaging studies.

Zinc: A common nutritional deficiency in IBD patients.  Zinc plays a role in helping tissues heal and in building strong bones. However, according to Everyday Health, “studies are not clear about whether adding zinc to your Crohn’s diet has direct benefits if you already get enough.” Foods that contain zinc include oysters, dark chocolate, and fortified cereals, as well as certain seeds or foods containing seeds, like watermelon. However, some IBD patients, especially those with strictures, may have trouble digesting seeds, so exercise caution.

Well that’s everything from A to Z about IBD that I’ve been able to track down.

Again, if you have something that you want to add or think is missing, please email me at caringforcrohns@gmail.com.

And keep an eye out soon for the IBD glossary page on the blog!

Entry filed under: ABC Series. Tags: abcs, CCFA, crohn's, crohn's disease, Crohn's Sucks, Endoscopy, ibd, inflammatory bowel disease, Proctitis, Toxic Megacolon, uc, ulcerative colitis, Ulcers, Vitamins, X-ray.