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Gastroenterology

A patient with Crohn’s disease.

Sean: Good evening, everyone. I hope you are all well. Let’s get ready for our next installment of Hansons weekly oral English lecture, sponsored by MedEditing. It’s now time to begin.

P: Hello doctor. Recently I've been really tired, losing weight, feeling painful stomach cramps quite often, experiencing diarrhea and there's even been some blood present. I'm starting to worry about this. I'm hoping you can help me shed some light on this.

D: Hello Mrs Wilson. That sounds like an awful ordeal you are experiencing. Let's get started on diagnosing and trying to resolve this problem for you. Is the pain in the lower right side of your tummy?

P: Yes it is, what does that mean?

D: There is an illness called Crohn's disease, and everything you are experiencing at the moment are the most common symptoms of this disease. Most patients with Crohn's disease feel the pain in the lower right side of there tummy, so that's why I asked this. I suspect you may have Crohn's disease, but first, I need to ask some questions to rule out other possibilities. Have you been abroad recently?

P: Nope, I've been here since last December.

D: Does your diet contain lot's of junk food or spicy food's?

P: Barely any at all.

D: Are you taking any medication at the moment? and does anyone in your family have Crohn's disease?

P: No to both questions doctor.

D: Okay Mrs Wilson, I am going to need a blood and stool sample to test for inflammation which could be caused by Crohn's disease or an infection. We are very busy right now, so it may take 2-3 days for me to get the results back unfortunately.

P: That's okay doctor, I can handle that. I'm just glad we are making headway now. If the results show I have inflammation what will happen then?

D: I will refer you to see a Gastroenterologist to have a specific type of check. Most probably a colonoscopy to check the inside of your bowels.

P: If I have Crohn's disease, can I cure it?

D: As things stand, to the best of our knowledge there is no known cure for this disease, but we do have effective methods which help to control symptoms such as a taking a steroid called prednisolone from time to time, or a liquid diet which contains all of the nutrients you need, but we usually only recommend this for kid's and young adults so we do not stunt their growth with steroids, but it's definitely an option if it would interest you.

P: A liquid diet? I didn't even know people do that. Is it possible to survive like that?

D: Yes it is, you would be surprised to know what our bodies are capable of. We can survive in so many different conditions.

Oh, before I forget, sometimes you might also need to take medicines called immunosuppressants to reduce the activity of your immune system. If other medicines are not helping, stronger medicines called biological medicines may be needed. We may recommend surgery if we think the benefits outweigh the risks or that medicines are unlikely to work.

Surgery can relieve your symptoms and help stop them coming back for a while, although they'll usually return eventually.

P: Well, I mean no disrespect here doctor, but surgery sounds pointless if my symptoms are probably going to come back.

D: I understand why you feel that way. I don't like to recommend surgery with this disease or ones like it.

Some people find that certain foods seem to make their symptoms worse.