Franciscan St. Francis

SPR 2016

Spirit of Women magazine is a national publication presented to women by hospitals and their physicians. The magazine provides up-to-date, evidence-based healthcare information and promotes our hospitals as leaders in women's health excellence.

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1 5 F r a n c i s c a n S t F r a n c i s . o r g S P R I N G 2 016 I N S P I R I N G W O M E N SHUTTERSTOCK G astrointestinal issues can be tough to talk about, but with Crohn's disease it's essential to open up to your health care professional early and often. One of a group of inflammatory bowel diseases (IBD), Crohn's disease is a systemic autoimmune disorder that can have life- threatening complications. The chronic inflammation can affect any part of the gastrointestinal tract and produce symptoms such as diarrhea, rectal bleeding, pain, weight loss and low energy. That's why working closely with your medical provider is crucial to managing flare-ups and symptoms. The good news is that there have been significant medication advances during the past decade or so that can greatly improve quality of life for Crohn's sufferers. A PROACTIVE APPROACH When Crohn's was less well- understood, it was treated in what physicians referred to as a "pyramid fashion" starting with the mildest but least effective medications, and then progressing to more radical treatments if needed. "But this approach didn't change the history of the disease," said Frederick R. Lane, MD, a board- certified colon and rectal surgeon with Kendrick Colon & Rectal Center in Mooresville, Indiana. "Many people still needed surgery in the end. Today, however, we have medications that reduce the inflammation caused by to the specific individual," said Dr. Nichols. "Since Crohn's is a complex disease that can target different sections of the gastro tract, being able to craft a medication in the lab specific to that patient's individual disease would hit all the end points of targeted treatment." Other areas of research include examining why Crohn's is more common in industrialized societies and less so in agrarian societies. "Interestingly, a big part of future areas of research is actually looking into the past to try to understand why these agrarian societies don't get these diseases," said Dr. Nichols. "We do know they have a more complex biome, whereas Westernized societies live more sterilized lives. It leads us to think that perhaps our internal biome is our buffer, so one of the futures of research is how we can establish good gut flora." Ryan McWilliams, MD, a gastroenterologist at North Colorado Medical Center, notes that because Crohn's disease can affect different parts of the body, therapies that target specific sites look very promising. And many of them are focused on the human microbiome as well. "For example, some small studies have shown a benefit to fecal microbiota transplants, which would apply to those with colonic-based symptoms," he said. "This type of research is a big area that's very well-funded because it does have so much promise. • Crohn's and can help patients avoid surgery." Much of the change in the medical community's approach to Crohn's is tied to the emergence of a new class of medications called biologic therapies, which are antibody-based therapies that help interrupt the pathways to inflammation. "These medications are highly effective in reducing the risk of inflammation and helping patients avoid surgery and hospitalization," said Dr. Lane. MANAGING CROHN'S WITH MEDICATION Unlike some other gastrointestinal disorders, Crohn's can be managed only with the proper medication; alternative therapies generally do not work and can lead to severe, lasting complications, said Dr. Lane. While there are side effects to biologic medicines that can be severe, these are extremely rare and the rewards usually far outweigh the risk. In addition, medical professionals can closely screen for these risks and follow their patients to catch any problems early, according to Dr. Lane. MORE IMPROVEMENTS ON THE HORIZON Research is ongoing to try to improve Crohn's outcomes even further, according to Matthew Nichols, MD, a gastroenterologist affiliated with Swedish Medical Center in Denver, Colorado. "One concept that's being looked at is tailoring the medications Unlike some other gastrointestinal disorders, Crohn's can be managed only with proper medication.

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