Crohn's disease side effects of steroids

Koch’s postulates have now been fulfilled proving that in a subset of patients the bacterium Mycobacterium Avium Paratuberculosis (MAP) is involved in the development and persistence of inflammation in Crohn’s Disease. Antimycobacterial agents specifically targeting this causative pathogen have shown success in inducing remission in severe disease and may even prove to be able to cure the disease in a subset of patients. The Centre for Digestive Diseases is a leader in this area of research and recently an Australia-wide trial has been completed against MAP, the results of which have shown that the highest reported remission can be achieved with anti-MAP therapy. Unfortunately, the trial used sub therapeutic doses, failed to test patients before they were treated for MAP presence and did not replace patients who were given non dissolving Clofazimine drugs so that the long term maintenance part of the trial cannot be currently accepted as having any clinical significance. Certain clinical trials have also shown that broad-spectrum antibiotics such as metronidazole and ciprofloxacin also have benefit in the treatment of Crohn’s Disease but need to be taken long term as they have known anti-MAP activity.

Selection of treatment regimens depends on disease severity, disease location, and disease-associated complications. Various guidelines recommend that approaches be sequential - initially to induce clinical remission, and then to maintain remissions. Initial evidence of improvement should be seen within 2 to 4 weeks and maximal improvement should be seen in 12 to 16 weeks 3 . The classic approach to therapy in Crohn's disease has been a "step-up" approach starting with the least toxic agents for mild disease, and increasingly more aggressive treatment for more severe disease, or patients who have not responded to less toxic agents. More recently the field has been moving toward a "top-down" approach (early aggressive management) which might decrease exposure to anti-inflammatory agents and increase exposure to agents that enhance mucosal healing that might prevent future complications 4 .

People with Crohn's disease often have anemia due to vitamin B 12 , folate , iron deficiency , or due to anemia of chronic disease . [39] [40] The most common is iron deficiency anemia [39] from chronic blood loss , reduced dietary intake, and persistent inflammation leading to increased hepcidin levels, restricting iron absorption in the duodenum. [40] As Crohn's disease most commonly affects the terminal ileum where the vitamin B12/ intrinsic factor complex is absorbed, B12 deficiency may be seen. [40] This is particularly common after surgery to remove the ileum. [39] Involvement of the duodenum and jejunum can impair the absorption of many other nutrients including folate. If Crohn's disease affects the stomach, production of intrinsic factor can be reduced.

Stress appears to play a role in the exacerbation of Crohn's disease. 32 While no adequate studies demonstrate the benefit of relaxation techniques for Crohn's disease, studies have been done assessing psychotherapy as treatment. One study 33 showed improvement in patients' coping ability and psychologic well-being. Low-impact exercise programs also have been shown to improve patients' quality of life and bone density, an important consideration with chronic steroid use. 34 , 35 Generally, patient education, relaxation techniques, simple exercise programs, and involvement in support groups may help improve quality of life for patients with Crohn's disease.

Crohn's disease side effects of steroids

crohn's disease side effects of steroids

Stress appears to play a role in the exacerbation of Crohn's disease. 32 While no adequate studies demonstrate the benefit of relaxation techniques for Crohn's disease, studies have been done assessing psychotherapy as treatment. One study 33 showed improvement in patients' coping ability and psychologic well-being. Low-impact exercise programs also have been shown to improve patients' quality of life and bone density, an important consideration with chronic steroid use. 34 , 35 Generally, patient education, relaxation techniques, simple exercise programs, and involvement in support groups may help improve quality of life for patients with Crohn's disease.

Media:

crohn's disease side effects of steroidscrohn's disease side effects of steroidscrohn's disease side effects of steroidscrohn's disease side effects of steroidscrohn's disease side effects of steroids

http://buy-steroids.org