Crohn's and Colitis For Dummies

Tauseef Ali, MD, is a consultant gastroenterologist and inflammatory bowel disease specialist. He is an assistant clinical professor at University of Oklahoma and Oklahoma State University. He is recognized internationally for his clinical work in the field of Crohn’s and colitis. You can find him on social media with twitter handle @ibdtweets.

• Foreword xiiiIntroduction 1About This Book 1Foolish Assumptions 2Icons Used in This Book 2Beyond the Book 3Where to Go from Here 3Part 1: The Who, What, and Why of Crohn’s and Colitis 5Chapter 1: Crohn’s and Colitis One Step at a Time 7Defining Crohn’s and Colitis 8Getting the Treatment You Need 9Recognizing That You’re Not Powerless 9Living a Full Life with the Disease 10Managing Special Cases: Advice for Pregnant Women and Kids 11Chapter 2: Defining Crohn’s and Colitis 13Figuring Out What Crohn’s and Colitis Are 13Looking at the big picture: Inflammatory bowel disease 14Zeroing in on Crohn’s and colitis 15Noticing the Signs and Symptoms 20Blood in stool 22Diarrhea 23Abdominal pain 24Urgency 24Tenesmus 24Other symptoms 24Identifying Other Parts of the Body Involved in Crohn’s and Colitis 25Bones 25Joints 26Skin 28Liver and gallbladder 28Kidneys and bladder 30Eyes 30Complicating Things 31Intestinal complications 31Nutritional complications 35The cancer connection 38Chapter 3: How the Digestive System Works 41Tracking the Journey of Food inside the Gastrointestinal Tract 42The oral cavity (or mouth) 42The esophagus 44The stomach 44The small intestine 45The large intestine 46The anus 46Getting Help from the Liver, Pancreas, and Gallbladder 46Liver 46Pancreas 47Gallbladder 47Understanding How Inflammation Affects the Digestive Process 48Gastritis: Inflammation of the stomach 48Enteritis: Inflammation of the small intestine 49Colitis: Inflammation of the large intestine 50Proctitis: Inflammation of the rectum 51Chapter 4: Who Gets Crohn’s and Colitis and Why 53Who Gets Crohn’s and Colitis 54The Role of the Immune System in Crohn’s and Colitis 54An immune system primer 55When your gut’s immune system goes awry 57Environmental Factors 58Food 59Air 60Hygiene 60Other environmental factors 61Genes Gone Bad: The Role of Genetics 63Considering family history 64Calling out key genes for Crohn’s and colitis 64Getting a genetic test 65Part 2: Getting Medical Help 67Chapter 5: Assembling Your Healthcare Team 69Finding the Right Doctor for You 69Why you need a specialist 70How to choose among the specialists in your area 70When you get to your first visit 71Rounding Up Other Key Players 73Your primary care physician 73Nurses 74Physician assistants 75Registered dietitians 76Psychiatrists 76Surgeons 77Friends and family 77Chapter 6: Getting a Diagnosis 79Preparing for Your First Visit 79Charting your signs and symptoms 80Assembling your medical records 84Talking to Your Doctor 85Getting over the embarrassment 85Communicating your symptoms 85Being realistic about your expectations 86Knowing What to Expect during a Physical Exam 86General physical exam 87Focused physical exam 87Rectal exam 87Being Poked and Prodded for Medical Tests 88Blood tests 88Stool tests 89Scans 91Endoscopy 92Identifying Other Diseases That Mimic Crohn’s and Colitis 93Chapter 7: Achieving Remission with Medications 95Rejoicing for Remission 96Types of Remission 96The role of symptom control 97Using Steroids 98Types of steroids 99Side effects of steroids 100Turning to Aminosalicylates 101Types of aminosalicylates 102Side effects of aminosalicylates 104Getting Involved with Immunomodulators 104Types of immunomodulators 105Side effects of immunomodulators 105Battling Your Disease with Biologics 107Types of biologics 107Side effects of biologics 109Loss of response to anti-TNF therapy 110Benefits of biologics 111Targeting Crohn’s and Colitis with Small Molecules 112Types of small molecules 112Side effects of small molecules 113Attacking Your Illness with Antibiotics 113Types of antibiotics 113Side effects of antibiotics 114Considering Other Medications 114Antidiarrheals 115Bile salt binders 116Analgesics 116Iron 117Calcium and vitamin D 117Vitamin B12 118Chapter 8: Considering Surgery 119Determining When You May Need Surgery 119For Crohn’s disease 120For ulcerative colitis 121Understanding the Types of Surgery 121Resectioning the small intestine 121Repairing a stricture 123Treating fistulas 123Draining abscesses 124Resecting the colon 126Pouch surgery 128Considering Complications from Surgery 130Short-term complications 130Long-term complications 132Defining Ostomy: What It Is and How to Deal with It 135Types of ostomy 135When you may need ostomy 136How to care for your stoma 137Your ostomy pouch 137Coming to terms with Ostomy complications 139Listing Some Ostomy Resources 140Part 3: Healing and Dealing with the Disease 143Chapter 9: Paying Attention to hat You Eat 145Considering the Impact of Nutrition 146The impact on your immune system 146The impact on wound healing 147Identifying the Nutrients You Need 147Macronutrients 148Micronutrients 152Wondering about Fiber 156Types of fiber 156Why fiber matters 157Fiber’s role in Crohn’s and colitis 158Considering Specialized Diets for Crohn’s and Colitis 159Liquid diets 159Low-residue diets 160Lactose-free diets 162Elemental diets 163Specific Carbohydrate Diet 163Mediterranean diet 164Low FODMAP diet 164Choosing a diet that suits your body’s needs 165Getting Nutritional Support: When You Can’t Go It Alone 166Feeding through a tube 166Feeding directly into your veins 167Boosting your diet with supplements 168Chapter 10: Preventing Health Problems 171Getting Vaccinated 172Why vaccination matters 172Which vaccines you need 172Caring for Your Skin: It’s Not Just Cosmetic 176Identifying the skin complications you may face 177Recognizing and reducing your risk of skin cancer 178Caring for your skin “down there”: Perianal skin care 179Boning Up on Bone Health 180Opening up about osteopenia and osteoporosis 181Seeing what Crohn’s and colitis can do to your bones 182Managing bone loss 183Screening for Cancers 184Colon cancer 184Cervical cancer 186Chapter 11: Alternative and Complementary Therapies 187Let’s Get Physical: Exercise 188Looking at how exercise can help with Crohn’s and colitis 188Gathering some useful exercise tips 190Working Over-Thyme: Herbal Therapy 191Healing with herbs 191Identifying beneficial herbs for Crohn’s and colitis — and knowing which herbs to avoid 192Homing in on Homeopathy 194Exploring the pros and cons of homeopathy 195Using homeopathic remedies for Crohn’s and colitis 195Tapping into Traditional Chinese Medicine 196Understanding traditional Chinese medicine 196Controlling Crohn’s and colitis with traditional Chinese medicine 196Mulling over Mind-Body Intervention 197Cognitive behavioral therapy 198Aromatherapy 198Yoga and meditation 199Support groups 199T’ai chi and Qigong 199Wondering about Worm Therapy 199Putting worms to work for your health 200Seeing how worms can help Crohn’s and colitis 200Part 4: Living and Coping With Crohn’s and Colitis 203Chapter 12: Living with Crohn’s and Colitis 205Dealing with Your Diagnosis 205Stage 1: Denial 206Stage 2: Anger 207Stage 3: Bargaining 209Stage 4: Depression 209Stage 5: Acceptance 210Keeping Your Relationships Going Strong 211So, what’s new with you? Telling people about your diagnosis 211Come here often? Dating with Crohn’s and colitis 213Like a horse and carriage: Keeping your marriage strong 214Caring for a Loved One with Crohn’s or Colitis 216Finding little things that help a lot 216Helping during a flare 216Helping after surgery 217Getting the help you need for yourself 218Chapter 13: Avoiding Triggers 219Quitting Smoking 220Deciding to Medicate 222Non-steroidal anti-inflammatory drugs 222Antibiotics 223Stressing Out 223Craving the culprit: Food, Glorious Food 225Artificial sweeteners 225High-fat foods 226High-fiber foods 226Caffeine 227Dairy products 227Alcohol 229Inviting the Sandman 229What sleep does for your immune system 229The effect of sleep on Crohn’s and colitis 230How to get a good night’s sleep 230Traveling at High Altitudes 232Chapter 14: Working and Traveling with Crohn’s and Colitis 233Work It Out: Doing your job When You Have Crohn’s or Colitis 233Coordinating your job hunt around your disease 234Telling your employer and coworkers about your condition (or keeping it to yourself) 235Starting your day off right 235Planning your commute 236Packing an emergency kit 237Speed Bumps Ahead: Coping with Job-related Challenges 238Responding to symptoms when they get in the way 238Handling your coworkers’ less-than-understanding attitudes 238Taking advantage of the Family and Medical Leave Act 239On the Road Again: Traveling with Crohn’s and Colitis 240Assembling a vacation survival guide 240Getting immunized before you travel abroad 241Packing for your trip 241Avoiding traveler’s diarrhea 242Finding a bathroom — fast! 244Part 5: Considering Special Populations with Crohn’s and Colitis 245Chapter 15: Kids with Crohn’s and Colitis 247Identifying How Crohn’s and Colitis Are Different in Kids than they are in Adults 248Sex 248Symptoms 248The impact on growth and development 249Getting a Diagnosis 251Managing Crohn’s and Colitis in Kids 252Monitoring medications 252Paying attention to nutrition 257Vaccinating your child 257Growing Up with Crohn’s and Colitis 259Surviving school 259Turning 18: Adulthood begins (at least in theory) 261Going off to college 262Chapter 16: Having Sex and Getting Pregnant with Crohn’s and Colitis 265Sex and Fertility 266Sexual activity 266Contraception 267Your menstrual cycle 269Fertility 270Pregnancy 271Pregnancy planning 271While you’re pregnant 273The big day and beyond 277Part 6: The Part of Tens 281Chapter 17: Ten Myths about Inflammatory Bowel Disease 283Myth#1: Diet Is the Cure 284Myth#2: Kids Get It from Their Parents 284Myth#3: It’s Caused by Stress 285Myth#4: You Can’t Get Pregnant if You Have It 285Myth#5: Steroids Are a Magic Potion 286Myth#6: If You Have It, You’re Guaranteed to Get Cancer 286Myth#7: You’re Responsible for Your Flares 287Myth#8: Surgery Cures It All 287Myth#9: You Can Stop Taking Your Medications if You Feel Better 288Myth#10: You Have to Stop Taking Your Medications during Pregnancy 289Chapter 18: Ten Reliable Resources 291The Crohn’s and Colitis Foundation 291The United Ostomy Associations of America 292WebMD 292Mayo Clinic 293About IBD 294IBD Passport 294IBD School Videos 295Nutritional Therapy for IBD 295South Asian IBD Alliance (SAIA) 295Trustworthy Twitter accounts 296Index 297