
Suffering From Crohns Disease. What Treatment Should Be Done?

my brother having a crohn deisaea..I have the reports and looking for your assistance on how it can be treated if it is applicable and i prefer to have a full medical report about the case.
i am panning to travel to Germany..is there any good hospital there or contact?
Thanks for contacting Healthcare Magic.
I have gone through the Medical records, lab tests and CT scans of your brother. I am also of the opinion that he is suffering from Crohn's disease. The treatment started at your hospital is the standard one, that would have been given anywhere in the world.
I will advise you to collect the report of MT-PCR and culture for the ileal biopsy and let me know, as I could not find this report in your papers. This is important to rule out ileal tuberculosis as treatment for this condition is totally different.
I am not aware of any particular hospital to see in Germany. I presume any big hospital should be fine. In anycase the treatment being administered at your hospital in Saudia seems fine.
Best wishes,
Dr Dinesh Singal


thnks for your email..can U send to me pls one page medical report about the case and best way from your opinion to be treated?
i would appreciate that report..since it will help me to make many final decision.
XXXXXX
Thanks for contacting again.
In my opinion the discharge summary made by your doctor in Saudi Hospital is good and explains everything about the patient, except the biopsy report which is available separately. As I have already said the MT-PCR and culture report is not available in your papers and needs to be collected from your hospital.
Regarding treatment, all the medicines that are needed have been given by your doctor. The main medicines are Pentasa, Imuran and Prednisalone. Dose of Imuran needs to be increased to about 150 mg (2 mg / kg body weight), while dose of prednisolone needs to be tapered gradually and stopped over next 2 to 3 months. You need to follow side effects of Imuran by doing Haemogram and Liver function tests from the lab on a monthly or two monthly basis. In case the symptoms do not get controlled or there is a relapse then medicine like Infliximab will need to be considered.
Crohn's disease is a chronic disease which can cause mild symptoms to severe incapacitating symptoms. There is no cure, it can only be controlled with medications. There is no way to know how the disease course will evolve in a given case. Hence I can not predict what problems your brother might face in future. But usual problems can be in form of intestinal strictures and obstruction, diarrhea, bacterial overgrowth, fistula and sinus formation, joint pains and swelling etc.
Best wishes,
Dr Dinesh Singal

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