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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Lyme Disease Along With Ulcerative Colitis Be Treated?

I was diagnosed with Lyme Dis about 6 weeks ago. I finished a 3 week course of antibiotics (doxycycline) about 2 weeks ago. About 4 days ago I started with fever, chills, joint pain, body aches, fatigue, weakness, tingling/numbness in bottom of feet and fingers and difficulty falling asleep. I m on another round of doxy which I started two days ago. I also have Ulcerative colitis and currently get IV infusions of remicade about every 6-8 weeks. I ve had 5 treatments to date. During the last infusion, I developed hives, rash, swelling and itching. I was given IV Benadryl and prednisone. I m not sure if the symptoms I have are related to the Lyme disease or side effects of the remicade. There are days I can t even get up and out. Other days I feel like I m turning a corner and then the pain comes back and other symptoms. Not sure what to do. All of my recent labs have been negative. I was hospitalized 2.5 yrs ago in near renal failure post op sinus surgery. I was treated with steroids and antibiotics and did fully recover renal function. thank you.
Tue, 14 Aug 2018
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General & Family Physician 's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

Psoriasis and psoriasiform skin lesions can be due to side effect of Remicade which you are using. But the doctor has prescribed you this as the benefits of the drug outweighs the risk. If still you are having problems which is affecting your daily routine you can discuss with your doctor who may think of putting you on an alternative drug.

I will tell you separately about the treatment of Lyme's disease and ulcerative colitis.

Lyme's disease: Antibiotics are used to treat early stage Lyme infection. Patients typically take Doxycycline or Amoxicillin and Cefuroxime. In up to 90% of cases, the antibiotic cures the infection. If it doesn’t, patients might get other antibiotics either by mouth or intravenously.

For early disseminated Lyme's disease, which may happen when a Lyme infection goes untreated, oral antibiotics are recommended for symptoms such as facial palsy and abnormal heart rhythm. Intravenous antibiotics are recommended if a person has meningitis, inflammation of the lining of the brain and spinal cord, or more severe heart problems.

In late-stage Lyme, a patient may receive oral or intravenous antibiotics. Patients with lingering arthritis would receive standard arthritis treatment.

Ulcerative colitis: UC treatment has two main goals. The first is to ease your symptoms and give your colon a chance to heal. The second is to prevent more flare-ups. You may need a mix of diet changes, medication, or surgery to reach those goals.

Diet. Food doesn’t cause ulcerative colitis, but some types can make your symptoms worse. You might find that soft, bland food doesn’t bother you as much as spicy or high-fiber dishes. If you can’t digest the sugar in milk called lactose (meaning you’re lactose intolerant), your doctor may tell you to avoid dairy products. To make sure you get enough vitamins and nutrients from your meals and snacks, your doctor may recommend a high-protein, high-calorie eating plan that is low in fiber.

Medicine. Your doctor may prescribe a few different kinds of drugs, including:
1. Antibiotics to fight infections and let your large intestine heal
2. Medicine to lower inflammation in your colon and control your symptoms. You may start by taking one type, called aminosalicylates. If those don’t work or your symptoms are more severe, your doctor may prescribe another type of anti-inflammatory drug, a corticosteroid.
3. Medication to help stop your immune system’s attack on your colon
4. Biologics are drugs made from proteins in living cells instead of chemicals. They are for people with more severe ulcerative colitis.

Regards
Dr Sanjay Kini
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How Can Lyme Disease Along With Ulcerative Colitis Be Treated?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Psoriasis and psoriasiform skin lesions can be due to side effect of Remicade which you are using. But the doctor has prescribed you this as the benefits of the drug outweighs the risk. If still you are having problems which is affecting your daily routine you can discuss with your doctor who may think of putting you on an alternative drug. I will tell you separately about the treatment of Lyme s disease and ulcerative colitis. Lyme s disease: Antibiotics are used to treat early stage Lyme infection. Patients typically take Doxycycline or Amoxicillin and Cefuroxime. In up to 90% of cases, the antibiotic cures the infection. If it doesn’t, patients might get other antibiotics either by mouth or intravenously. For early disseminated Lyme s disease, which may happen when a Lyme infection goes untreated, oral antibiotics are recommended for symptoms such as facial palsy and abnormal heart rhythm. Intravenous antibiotics are recommended if a person has meningitis, inflammation of the lining of the brain and spinal cord, or more severe heart problems. In late-stage Lyme, a patient may receive oral or intravenous antibiotics. Patients with lingering arthritis would receive standard arthritis treatment. Ulcerative colitis: UC treatment has two main goals. The first is to ease your symptoms and give your colon a chance to heal. The second is to prevent more flare-ups. You may need a mix of diet changes, medication, or surgery to reach those goals. Diet. Food doesn’t cause ulcerative colitis, but some types can make your symptoms worse. You might find that soft, bland food doesn’t bother you as much as spicy or high-fiber dishes. If you can’t digest the sugar in milk called lactose (meaning you’re lactose intolerant), your doctor may tell you to avoid dairy products. To make sure you get enough vitamins and nutrients from your meals and snacks, your doctor may recommend a high-protein, high-calorie eating plan that is low in fiber. Medicine. Your doctor may prescribe a few different kinds of drugs, including: 1. Antibiotics to fight infections and let your large intestine heal 2. Medicine to lower inflammation in your colon and control your symptoms. You may start by taking one type, called aminosalicylates. If those don’t work or your symptoms are more severe, your doctor may prescribe another type of anti-inflammatory drug, a corticosteroid. 3. Medication to help stop your immune system’s attack on your colon 4. Biologics are drugs made from proteins in living cells instead of chemicals. They are for people with more severe ulcerative colitis. Regards Dr Sanjay Kini