Prompt diagnosis և appropriate therapy is extremely important in suppressing inflammation in the gastrointestinal tract, as delay can lead to scar tissue և stiffness that does not change with medication, said Dr. Feuerstein. Another possible serious complication is the development of a fistula. Abnormal connections to various organs, such as the large intestine or bladder, require surgical repair, which in turn can cause further damage to the intestines.
Understandably, significant stress, anxiety, depression can accompany illness, or even worsen symptoms. Last summer, when Mrs. Martin’s illness suddenly He lost control of his rage after being treated with drugs to keep breast cancer at bay, and a strong yoke tied him to the toilet in his Manhattan apartment. Dr. Lichtenstein said a class of drugs taken by Ms. Martin, called a checkpoint inhibitor, is especially difficult for Crohn’s patients, who may have to choose between preventing a recurrence of cancer and suppressing their bowel disease, as anti-cancer drugs can sometimes cause inflammation: colon.
If Crohn’s is diagnosed with severe inflammation or debilitating symptoms, patients are usually treated with steroids to control the disease before being placed on medication specific to the disease. “Steroids,” said Dr. Feuerstein, “are band-aids to stop the inflammatory process, but then we have to do something to suppress the disease, to heal the body.”
Sometimes patients are temporarily placed on a restricted fluid diet before starting medication to calm the bowel and allow it to heal. This is what Dr. Lichtenstein, author of the latest Crohn’s Disease Management Guide, developed by the American College of Gastroenterology, says.
There are now many medications available to treat Crohn’s, although keeping symptoms under control often involves trial and error. For example, five years after Ms. Martin was diagnosed, a specialist she referred to said there were four possible oral medications to try next. Each worked for several months, but the fourth drug, without further alleviating his symptoms, injected him with an injection called “Activio”, which, he said, “worked just like a miracle.”
“Activion”, the brand name for vedolizumab, is what is known as a biological, living cell drug, usually given by infusion or injection. Եւ One of several such drugs is now available to Crohn. It works on specific intestines to fight inflammation. Her colon is still inflamed, and Ms. Martins needs to be treated with medication every four weeks. If this one stops working, he can try one of the others.
Ms. Martin knows, however, that Crohn’s disease is not curable, and most patients have to stay on medication indefinitely. It can create a temptation. Biological materials are very expensive, averaging over $ 100,000 a year, and although they are usually covered by insurance, there is a sharp co-payment. To afford the therapy, many patients depend on co-payment support programs run by pharmaceutical companies, Dr. Fuerstein said.
However, as Ms. Martin recently learned, Medicare will cover the costs if she receives an infusion at the hospital or if her doctor can arrange for a nurse to come to her home to administer the medicine.