Crohn's disease: why is it important to follow the recommendations?
NewsPatient A., 44 years old, was diagnosed with Crohn's disease with lesions of the small and large intestine for the first time in 2018. He was prescribed treatment with hormonal drugs (systemic glucocorticosteroids) with a gradual dose reduction until complete withdrawal. Additionally, permanent immunosuppressive therapy with azathioprine is recommended. The man complied with the appointment.
In November 2019, a comprehensive diagnosis was carried out during the planned hospitalization:
- Ultrasound of the abdominal cavity;
- esophagogastroduodenoscopy;
- colonoscopy;
- computed tomography of the abdominal cavity and intestines.
According to its results, minimal activity of Crohn's disease was noted, it was recommended to continue taking azathioprine to maintain remission.
The patient felt well, and therefore decided to cancel the medication. Subsequently, he did not seek medical help.
In December 2020, there were complaints about:
- abdominal pain;
- an increase in body temperature to 39 C;
- loose stools up to 4 times a day without pathological impurities.
In the clinic, the patient was consulted by a gastroenterologist, who prescribed treatment with mesalazine and paracetamol. Against the background of therapy, the general condition improved, body temperature returned to normal, but loose stools persisted.
In December 2020, the patient was hospitalized in the department of treatment of inflammatory bowel diseases of the MCSC named after A.S. Loginov. During the ultrasound examination of the abdominal organs, a small intestine seal was revealed.
At a consultation with the participation of a coloproctologist surgeon, a decision was made on surgical treatment - removal of the generated part of the intestine with its simultaneous connection. The postoperative period proceeded without complications, and the patient was discharged home with improvements.
The described case demonstrates the importance of following the doctor's recommendations, the need for annual examinations.
In the IBD department of MCSC, a comprehensive examination of patients with ulcerative colitis and Crohn's disease is carried out. These are severe incurable immunoinflammatory diseases, the therapy of which is aimed at achieving and maintaining remission (healing of erosions and ulcers of the intestinal mucosa), prevention of surgical complications.
Immunosuppressive drugs such as azathioprine are used to achieve these goals. Given such a surgical complication, the patient was prescribed genetically engineered biological therapy, which he receives to this day in combination with azathioprine. Against the background of treatment, it was possible to achieve remission of Crohn's disease.
