• Title/Summary/Keyword: Crohn's disease

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A Case Study of a Crohn's Disease Patient Treated with Oriental Medical Treatment (한방 치료로 호전된 크론병 치험 1예)

  • Kim, Seon-Wook;Lee, Ook-Jae;Shin, Jeong-Cheol
    • Korean Journal of Acupuncture
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    • v.31 no.4
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    • pp.247-252
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    • 2014
  • Objectives : The purpose of this study is to report the effect of Oriental medical treatment on a patient with Crohn's disease. Methods : The patient was treated with acupuncture, herb remedy and moxibustion for about 2 weeks. We evaluated the results of the treatment by observing the patient's symptoms and through the Crohn's disease activity index(CDAI) score. Results : After Oriental medical treatment the patient's symptoms such as emesis, heartburn and abdominal pain considerably reduced. The patients CDAI score decreased from 190.8 to 134.2. Conclusions : These results support that Oriental medical treatment can be a help in relieving symptoms of Crohn's disease.

Topical Tacrolimus Resulting in a Marked Resolution of Perianal Crohn's Disease (Tacrolimus 연고제로 호전을 보인 항문 주위 크론병 3례)

  • Park, Moon Ho;Choi, Won Joung;Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.70-75
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    • 2005
  • Crohn's disease of the perineum is notably resistant to treatment. We describe our experiences of tacrolimus ointment application in three patients with intractable perianal Crohn's disease. At the time of diagnosis patients showed anal fissure with ulcer, anal fistula, or perianal abscess, respectively. These lesions did not respond to steroid, metronidazole, mesalazine, or azathioprine, though the pediatric Crohn's disease activity index was markedly improved during the treatment period (4 to 12 months). Topical tacrolimus was applied and resulted in marked healing and a rapid granulation of cavity edges within 6 weeks to 3 months. Topical tacrolimus at a low dose shows a promise for the management of childhood perianal Crohn's disease. Further controlled studies are required to assess the efficacy and safety of this treatment.

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Body Image, Self Esteem, and Health related Quality of Life in Patients with Crohn's Disease (크론병 환자의 신체상, 자아존중감 및 건강 관련 삶의 질)

  • Lee, Young Jin;Oh, Eui Geum
    • Korean Journal of Adult Nursing
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    • v.26 no.4
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    • pp.383-392
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    • 2014
  • Purpose: The purpose of this study was to describe the degrees of body image, self esteem and Health Related Quality Of Life (HRQOL), and to identify factors related to these variables in patients with Crohn's disease. Methods: A descriptive cross sectional survey design was used. The 148 participants were the patients with Crohn's disease, recruited conveniently from one metropolitan hospital located in Seoul, Korea. The collected data were analyzed with SPSS/WIN program. Results: Patients with severe illness activity reported significantly lower body images than those of the others. Education levels and working states affected self-esteem positively, while the number of operations and illness activity affected self-esteem negatively. Hospitalization and illness activity affected HRQOL negatively. Body image, self esteem, and HRQOL were positively correlated to each other with statistical significance. Illness activity was a common factor to affect body image, self esteem, and HRQOL. Body image was an influential factor on HRQOL as well as illness activity in patients with Crohn's disease. Conclusion: As a result, this study suggested a necessity for developing an intervention study to lower the illness activity and heighten the body image among the patients with Crohn's disease.

The Effect of Oriental Medical Treatment on Crohn's disease; 1 Case Report (항통을 주소로 내원(來院)한 크론병(Chron's disease) 호전 1례)

  • Park, Jong-Min;Kim, Ho-Jun;Keum, Dong-Ho;Park, Young-Hoi;Lee, Myeong-Jong
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.1
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    • pp.57-66
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    • 2010
  • Objective: This study evaluated the effects of Oriental treatments on one patient who was diagnosed to Crohn's disease. Methods: One patient was diagnosed as Crohn's disease by physician. We used acupuncture and moxibustion at 曲池(LI11), 天樞(S25), 足三里(ST36), 合谷(LI4) and (GL25), 2 times per week about one month. We analyzed the change symptom by Crohn's disease activity index(Harvey-Bradshaw index) before and after treatment. Results: After treating acupuncture and moxibustion in the case, We found out that the Crohn's disease activity index score was significantly improved after treatment. First the number of liquid or very soft stool was decreased to 2 times a day and the stools became more solid condition. The abdominal pain and use of anti-diarrhea medication score came to none. The well being score set slightly below poor condition. Conclusions: These result suggest acupuncture, moxibustion were effective to Crohn's disease clinical symptom. These could help patient ordinary life by reducing abdominal pain and diarrhea.

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Early Biologic Treatment in Pediatric Crohn's Disease: Catching the Therapeutic Window of Opportunity in Early Disease by Treat-to-Target

  • Kang, Ben;Choe, Yon Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.1
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    • pp.1-11
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    • 2018
  • The emergence of mucosal healing as a treatment goal that could modify the natural course of Crohn's disease and the accumulating evidence showing that biologics are most effective in achieving mucosal healing, along with the success of early treatment regimens for rheumatoid arthritis, have led to the identification of early Crohn's disease and development of the concept of catching the therapeutic window during the early disease course. Thus, an increasing number of pediatric gastroenterologists are adopting an early biologic treatment strategy with or without an immunomodulator. Although early biologic treatment is effective, cost and overtreatment are issues that limit its early use. Currently, there are insufficient data on who will benefit most from early biologics, as well as on who will not need early or even any biologics. For now, top-down biologics should be considered for patients with currently known high-risk factors of poor outcomes. For other patients, close, objective monitoring and accelerating the step-up process by means of a treat-to-target approach seems the best way to catch the therapeutic window in early pediatric Crohn's disease. The individual benefits of immunomodulator addition during early biologic treatment should be weighed against its risks and decision on early combination treatment should be made after comprehensive discussion with each patient and guardian.

Imaging Techniques and Differential Diagnosis for Inflammatory Bowel Disease (염증성 장질환의 영상기법 및 감별진단)

  • Kyoung Doo Song
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.536-549
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    • 2023
  • The two main types of inflammatory bowel disease (IBD) are Crohn's disease and ulcerative colitis. Currently, when IBD is suspected, CT enterography is widely used as an initial imaging test because it can evaluate both the bowel wall and the outside of the bowel, helping to differentiate IBD from other diseases. When IBD is suspected, it is necessary to distinguish between Crohn's disease and ulcerative colitis. In most cases this is not difficult; however, in some cases, it is difficult and such cases are called IBD-unclassified. CT findings are often non-specific for ulcerative colitis, making it difficult to differentiate it from other diseases using imaging alone. In contrast, characteristic CT findings for Crohn's disease are often helpful in diagnosis, although diseases, such as tuberculous enteritis can mimic Crohn's disease. Recently, mutations in the gene encoding a prostaglandin transporter called SLCO2A1 have been discovered as the cause of the disease in some patients with multiple ulcers and strictures, similar to Crohn's disease. Therefore, genetic testing is being used to make a differential diagnosis.

Steroid-induced Psychosis in Adolescent Patient with Crohn's Disease

  • Kim, Jin Woo;Kang, Ki Soo;Kang, Na Ri
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.3
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    • pp.161-164
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    • 2020
  • Crohn's disease is a chronic inflammatory disease that involves the upper and lower gastrointestinal tracts, including the oral cavity. For the conventional treatment of inflammatory bowel diseases, steroids are usually used as induction therapy, and azathioprine is used as maintenance therapy. Steroids are associated with various side effects. Under rare circumstances, they can even cause psychotic symptoms, and reports on steroid-induced psychosis in the pediatric population are few. Here, we report the first case of steroid-induced psychosis in a 16-year-old female with Crohn's disease administered with steroids as induction therapy in South Korea. She showed psychotic symptoms, including auditory hallucination, loosening of association, and idea of reference, after 2 weeks of administering prednisolone 60 mg/day. One week after steroid discontinuation, the patient gradually recovered and was treated with quetiapine. Therefore, pediatricians should be aware of serious psychiatric adverse effects when administering corticosteroids for various indications.

Life-Threatening Lower Gastrointestinal Hemorrhage in Pediatric Crohn's Disease

  • Kim, Earl;Kang, Yunkoo;Lee, Mi Jung;Park, Young Nyun;Koh, Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.1
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    • pp.53-60
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    • 2013
  • In Crohn's disease, mild gastrointestinal bleeding often occurs; however massive gastrointestinal hemorrhage, which can have a dramatic effect on a patient's vital sign, is rare. This could result in potentially life-threatening complications, which can lead to death. Massive hemorrhagic Crohn's disease is not well known and for this reason, they are a diagnostic and therapeutic challenge. Various diagnostic and therapeutic methods are currently being developed and used. The surgical method is often used only as a last measure since this approach has the risk of serious complications that may endanger patients. However, if massive bleeding continues even after all therapeutic methods are used, the surgical method must be implemented. In this case, all therapeutic methods were found to be ineffective; therefore, surgery was used as a last option. Ultimately, the surgical method was found to be successfully used to treat life-threatening hemorrhagic Crohn's disease.

A Case Study of a Soyangin Patient with Crohn's Disease who Reported Symptomatic Improvement after Being Treated with Dojeokgangki-tang (도적강기탕(導赤降氣湯)으로 호전된 크론병 환자 1례)

  • Lee, Mi-Suk;Hwang, Mim-Woo;Kim, Yun-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.24 no.2
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    • pp.61-70
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    • 2012
  • 1. Objectives : The aim of this study was to report significant improvement of chronic diarrhea and hematochezia after treatment with Dojeokgangki-tang in a Soyangin Patient with Crohn's Disease. 2. Methods : The patient's subjective and objective symptoms were observed daily throughout the hospitalization period, and the Crohn's disease activity index(CDAI) was calculated to gauge the progress or lack of progress. 3. Results : The symptoms of diarrhea and hematochezia disappeared by the end of the hospitalization period without recurrence, and the CDAI score dropped from 92.5 to 47. 4. Conclusions : A patient with Crohn's disease, who was in the state of repetitive relapse and remission after long term clinical courses was treated with Dojeokgangki-tang in a short period and the the symptoms of diarrhea and hematochezia disappeared without recurrence. Then the patient could stop taking corticosteriods and taper off immune-suppressing drugs.

Depression and Risk Factors in Patients with Crohn's Disease (크론병 환자의 우울과 위험요인)

  • Cho, Ok-Hee;Yoo, Yang-Sook;Yang, Suk-Kyun
    • Journal of Korean Academy of Nursing
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    • v.42 no.2
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    • pp.207-216
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    • 2012
  • Purpose: This study was conducted to determine the risk factors among patients with depression with Crohn's disease. Methods: Data were collected by questionnaire from 276 patients who were diagnosed with Crohn's disease at a tertiary hospital located in Seoul. Measurements included patients' demographic characteristics, clinical characteristics, depression level, and health-related quality of life. Data were analyzed using t-test, $X^2$-test, Wilcoxon rank sum test, and logistic regression analyses. Results: The incidence rate of depression (BDI-II${\geq}$14scores) was 31.9% (n=88). Univariate analysis revealed that being a woman, school graduation status, economic status (low), BMI(<$18.5Kg/m^2$), disease duration (${\geq}3$ years), CDAI (${\geq}150$ scores), frequency of hospital admission (${\geq}2$), extra-intestinal manifestation (arthralgia, stomatitis), administration of 5-aminosalicylic acid, and disease related quality of life (SIBDQ<50 scores) were associated with depression. Multivariate analysis revealed that economic status (low), school graduation status, and quality of life (SIBDQ<50 scores) were more likely to report high level of depression. Conclusion: Future research should consider managing depression as an essential component of comprehensive care for patients with Crohn's disease. In addition, further research is needed to develop strategies to better improve quality of life among patients with Crohn's disease who are depressed.