Dear Dr. SerVaas: I have a 24-year-old grandson with Crohn's disease. He has had surgery and is on medication but has no idea about other treatments. Other family members keep telling him it is emotional, so he depends on medication, especially prednisone, which can cause many problems. He may have even been misdiagnosed.
Betty Lyson
Waukegan, Illinois
Dear Reader: I would urge you to have your grandson seen by Dr. Stephen Hanauer, director of the section of gastroenterology/nutrition at the University of Chicago. He would be my choice if my grandson had Crohn's or even thought he did. They have at this hospital a very fine pathologist who would be able to make a definitive diagnosis. His name is Dr. John Hart, and he specializes in differentiating Crohn's from ulcerative colitis and other lesions of the colon. A specialized pathologist is useful for getting the patient the proper diagnosis at the onset.
If your grandson can't get to Chicago for a second opinion, it might be possible for his gastroenterologist to send laboratory slides to Dr. Hart at the University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637.
Even experts don't always read biopsy slides in the same way, and early in the disease, the diagnosis isn't always clear-cut.
Thank you for your confidence in writing to the Post, and I hope he does well.
The fundamental cause of Crohn's disease is still unknown. About one in six patients has at least one first-degree relative with the same disease or with ulcerative colitis. Cigarette smoking seems to contribute to the development or worsening of Crohn's symptoms. Most cases begin in patients aged 14 to 24 years.
The drugs sulfasalazine or mesalamine may be prescribed to help induce and maintain remission of Crohn's disease. Azathioprine or 6-mercaptopurine are often effective as long-term therapy. Surgery may improve symptoms but does not cure the disease.
A 200-page coffee-table book about digestive diseases, including Crohn's disease, is available from The American Foundation for Preventive Medicine and might be a good gift for your grandson. To order, send $49.95 to AFPM, P.O. Box 130, Fishers, IN 46038.
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