It is basic medical information of Crohn's disease and Ulcerative colitis.

What's Crohn's Disease？                　　　　　　　2002.12.21　

　Crohn's disease comes from a name of the doctor who reported it first.　It is called "CD" for short.　It is disease to produce inflammation with digestive organs from a mouth to an anus.　There may be many people who were troubled when patients explain about crohn's disease to someone else.Because crohn's disease is imaged with the "clone" which is famous for a clone sheep, the person who does not know disease seems to misunderstand it.

If you explain disease to someone else for the first time, you had better answer "disease that inflammation happens in the intestines".　If you have a little more time, you had better explain the following things as a symptom, which inflammation of the intestines, anemia, bellyache, diarrhea, fever.　Will not they understand what kind of disease it is somehow?
You had better add that you say that "a meal limit is severe, and there are a lot of things which are not eaten" to a partner confided a condition to a little more.

Crohn's disease patients are 21,061 in Japan, however, it is said that there are about 267,000 patients in America, and there are 437,000 patients in the world. ^*1

*1.Human　Genome Sciences Repifermin Background より

I will write things what we will must know.

A cause is indistinct, and this disease is watched in the young generation .This disease may become sick digestive organs anywhere and produces a granulomatous inflammation (the state that it is red and shows a rash as a swelling, and produce inflammation.) physical change caused by a disease tissue is tense, and to be accompanied with an ulcer.

There are the following symptoms.
Fervescence, Weight decrease by nutritional disorder, Anemia, Joint pain, Crimson rainbow flame, A liver handicap, I have loose bowels, An anal fistula.

For crohn's disease, a positive surgery treatment is not done currently.
This disease is surgical operation adaptation when not effective by an internal medicine treatment.
Many person who operated already receive medical examination in surgery for a followup.　There is the following reason in what do not do an operation immediately.　There are many cases which skipping, show lesions as a characteristic. Therefore parts to extract by an operation increase. A part making you join it together (anastomotic part) by an operation tends to have relapse. In addition, an anastomotic stricture happens at a high rate. An accumulation operation percentage after 5 years is 30%, and the rate becomes high with 70% after ten years. The reason is because it may be operated on for more than one time after all. In addition, an intestinal tract adheres when I operate (celiotomy) once. Time becomes necessary to remove the adhesion if you operated repeated. As the result an operation becomes terrible.

It is an operation adaptation example absolutely

Relative operation adaptation

1.	Absecc, Internal fistula , External fistula ("Deep cleft" and "ulcer split in lengthwise" occur from the ulcer that was possible to intestine.　More serious ulcer moves, and a fistula is formed at last.　85% of an external fistula are anal fistulas As for the internal fistula, there are ileum - intestinal fistula, ileum - ileum fistula, ileum - vesicl fistula, large intestine - vaginal fistula.
2.	A null and void example of internal medicine treatment
3.	Being hard to cure stenosis
4.	An anus part circumference lesion
5.	Developmental disability（(An infant needs an operation before growth of a bone is limited to expecting it for the case that developmental disability is advanced.)
6.	Parenreral complication	Produce by Shingo

About internal medicine treatment
1.About medical therapy
Pentasa （5-ASA）
　5-ASA which separated the component that Pentasa produces a side effect of Salazosulfapyridine is medicine of a component. Originally Salazosulfapyridine is medicine of rheumatism.　Because Salazosulfapyridine was effective against a patient of inflammatory bowel disease, it was prescribed, but a side effect was pointed out.
A component of side effect was removed, but Pentasa was authorized and gets possible to increase a quantity of clothes.　As for 1 tablet, the dosage to 12 tablets became possible by 250mg for one day.　A quantity of maximum dosage on 1 day becomes 3,000mg.It is made so that medicine melts by degrees, and it is expected whether you are not effective for a person of small intestine type either.Prescription is possible for 4 weeks.
 
Daikenchutou(Chinese medicine)
　This is a Chinese medicine released by Tsumura Inc.　It is said that an effect of this medicine may remove a belly turgescence.　In addition, there is effective literature to prevent intestinal obstruction.
This medicine may be accumulate gas in the intestines, and to ease a painful state. A quantity of maximum dosage on 1 day becomes 6 pack. Prescription is possible for 2 weeks.
A component : Korea carrot3.0g, Japanese pepper 2.0g , Kankyo 5.0g

Flagyl oral tablets (Metronidazole)

Originally this medicine is medicine of Toriko muslin colpitis. It is prescribed with gynecology, but there is action to kill enterobacterium the time when I expect it to this medicine. It is used as being antimicrobial medicine, and there is the report that a person having a complication of anal fistula in particular is effective for. However, an effect of the medicine is said with dosage start around 3 months. Medicine tolerance is on afterwards, and an effect seems to be reduced to half. A quantity of use of 1 day is 2 tablets. (250mg x 2) A side effect becomes the state that moss grew with a tongue. It does not seem to be medicine to take for a long term.　There is overseas report that there is not an effect that you do not take it more than 750mg in a day. 

Lacb-R （Antibiotics-resistant lactic acid bacteriae）
　This medicine is a lactobacillus drug. It is medicine for intestinal disorders.This medicine cannot hope to be effective.It may be soothing degree.In a case using being antimicrobial medicine and an antibiotic of Flagyl together, a lactobacillus has been killed.You had better use "Lacb-R" when you used being antimicrobial medicine.This medicine is prescribed until only 2 weeks.

Predonine (Predonisolone)
These are medicine called steroid.There is an immediate effect, and steroid is good medicine of terrible sharpness, but does not use mainly, because of many side effects in the long term.You may use it in order to improve the state that turned bad (increase of inflammation value of CRP) temporarily. When this sick mechanism was not solved, there was a selected case, but the first is not medicine of the mainstream with medical therapy of current crohn's disease.There is the possibility that a fistula part turns bad when I use steroid when in other words infection is doubted when there are it and a fistula.

Treatment medicine of Hemorrhoids

These are suppository and ointment to ease a pain of hemorrhoids by diarrhea.
Rinderon (Betametazone)is steroid, but others drug include some surface steroid and anesthetics besides it, but think that quantity does not need to worry about a few side effects.

２．About Nutrition therapy
As nutrition medicine used with crohn's disease, there are "Elental" and "Entelued." Elental is released by Ajinomoto falma Co., Ltd. You dissolve powder of 80g with 1 kcal per 1cc with 300kcal .Entelued is released by Terumo Co., Ltd. You dissolve powder of 100g with 1 kcal per 1cc with 400kcal. Flavor for nutrition medicine is prepared
Taste is good, too, and flavor of Terumo is full. Elental is well used for a patient of crohn's disease with a few contents of fat.Peristalsis exercise of the intestines with a little fat does not happen and can keep the state that is rest .It seems to be severe to take from a mouth that you do not devise taste badly. A patient inserts a tube from a nose, and a method a stomach or keeps hold to the duodenum, and to pour nutrition medicine into is general. Enteral nutrition pump is used in order to regulate injection speed.These nutrition medicine is made to be easy to digest it very much.As for the Elental, an elemental diet "Elental", Entelued are called peptide nutrition medicine.A problem of osmotic pressure occurs both so that absorption is too good .Patients can prevent osmotic pressure characteristic diarrhea by dropping it using a pump with sutra nose injection method slowly than they take it from a mouth.

It is hard to become a remainder thing than a meal, and there is " Ensure Liquid" (Dinabot Inc.) in meaning with a few charges of the intestine when prescribed .As for the "Ensure Liquid", contents of fat increase than "elemental diet" and " peptide nutrition".However, with getting a calorie by a small quantity, I seem to attract it that taste is good. 1can 250ml =250 kcal. As for the taste, there are vanilla, a strawberry, coffee.

Because I have had loose bowels when I take Ensure Liquid, I am no good.
Nutrition advice is different, but a quantity of fat intake to patient of crohn's disease is said with less than 20-30g on 1 day by each hospital."Ensure Liquid" is insurance adaptation. But I advise you, and it is not possible when I think about this fact.
As for the nutrition treatment, it is assumed that it is effective than medical therapy in crohn's disease currently in Japan.