gastroduodenal Crohn's

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itainteasy
Regular Member


Date Joined Mar 2009
Total Posts : 46
   Posted 3/27/2009 9:33 PM (GMT -7)   
My 14 yr old daughter was diagnosed with gastroduodenal Crohn's about a month ago. She has been stepping down from 40 mg of prednisone and is on 20 mg now. She is also taking pentasa and one prevacid in the morning. Things were going fine until this past few days when she started getting bloated and having acid reflux type issues. She says it's not quite the same as she felt when she was first diagnosed. She says it is that she has to burp a lot and she burps up acid. Is this a result of stepping down and not responding to her meds? I am having a difficult time finding any information on this type of Crohn's. I have started her on probiotics. Is that a possible problem? I am struggling to know what to feed her and how to handle all of the basic information on Crohn's, let alone this type. Any recommendations? Thanks in advance.

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 3/27/2009 11:43 PM (GMT -7)   
This is the info I found on gastroduodenal crohn's....

Symptomatic gastroduodenal manifestations of Crohn's disease (CD) are rare, with less than 4% of patients being clinically symptomatic. Gastroduodenal involvement may, however, be found endoscopically in 20% and in up to 40% of cases histologically, most frequently as Helicobacter pylori-negative focal gastritis, usually in patients with concomitant distal ileal disease. In practice, the activity of concomitant distal CD usually determines the indication for therapy, except in the presence of obstructive gastroduodenal symptoms. With the few data available, it seems correct to say that localized gastroduodenal disease should be treated with standard medical therapy used for more distal disease, with the exception of sulfasalazine and mesalanine with pH-dependent release. Presence of symptoms of obstruction needs aggressive therapy. If medical therapy with steroids and immunomodulatory drugs does not alleviate the symptoms, balloon dilation and surgery are the options to consider.

Hope this helps some :)
My bum is broken....there's a big crack down the middle of it! LOL :)


itainteasy
Regular Member


Date Joined Mar 2009
Total Posts : 46
   Posted 3/28/2009 7:14 AM (GMT -7)   
So according to what you are saying pb4, she should not be on Pentasa since it is pH dependent?

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 3/28/2009 7:20 AM (GMT -7)   
I take Proton Pump inhibitors myself (Prilosec). I am wondering if the Pred is aggravating her GERD, it is very common for this to happen. Pred is very hard on the stomach. I am wondering if she might need to increase her Prevacid or try a different PPI. She may need to increase or change until she gets off the Pred.

Good luck,
Gail *Nanners*
Gail*Nanners* Co-Moderator for Anxiety/Panic Forum
Been living with Crohn's Disease for 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia and Osteoarthritis and Anxiety. Currently my Crohns is in remission.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 3/28/2009 7:21 AM (GMT -7)   
By the way I wouldn't stop the Pentasa. I think the culprit is the Pred. JMHO
Gail*Nanners* Co-Moderator for Anxiety/Panic Forum
Been living with Crohn's Disease for 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia and Osteoarthritis and Anxiety. Currently my Crohns is in remission.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

itainteasy
Regular Member


Date Joined Mar 2009
Total Posts : 46
   Posted 3/28/2009 7:39 AM (GMT -7)   
I talked with her GI and he suggested another Prevacid daily for a few days to see if it helps. Crossing my fingers and hope it helps.

itainteasy
Regular Member


Date Joined Mar 2009
Total Posts : 46
   Posted 3/28/2009 2:02 PM (GMT -7)   
One more question I have. I forgot to mention she is taking MiraLAX. She has never had any problems with her bowel movements, but he has her taking it once a day. Does this cause any problems?

randynoguts
Veteran Member


Date Joined Jan 2003
Total Posts : 6049
   Posted 3/28/2009 8:57 PM (GMT -7)   
i have similar problems now and then, such as ulcerations causing large bleeds in the duodenum, i use 2 PPI'S each night before bed, when the acid reflux is the worst for me. maybe her dr would try 1 evry 12 hours to spread the dose ?
randynoguts 



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