Tokushukai Medical Group

Treatment of disorder

Treatment of disorder

Gastroenterological Medicine: Clone Disease

Pathogeny Age lowering is advanced

In clone disease, inflammation can be produced at anywhere, from mouth to anus, but it is common to be produced at small intestine and large intestine. Puffiness or erosion (erosion, ulceration) is produced at remoted point to point. Vertically long ulcer (longitudinal ulcer) is easy to be produced along the gut tract. And as it’s characteristics, gut tract becomes narrower because of when ulcer is being cured, it twitches away. The peak pathogeny is around age of 20, but nowadays pathogeny age is getting younger to even among elementary or junior high school student. Because the symptom itself is hard to recognize, it sometimes diagnosed as clone disease after longer period has passed.

May associate with canker sore, inflammation of skin, or aching joint.

Crohn disease is considered as pathogenies when immunity burden status, like extreme fatigue, lack of sleep, food antigenic agent, and communicable disease, are overlapped, but epidemic reason are unknown. Its symptoms are mainly, like stomachache, diarrhea, fever, merely melena, which is hard to distinguish from normal infectious enteritis. But it is suspicious as clone disease when these symptoms continue for longer period or symptom is repeated. Also, there are many cases where it is noticed by anal fistula or perianal ulcer, and there is a case where canker sore, inflammation of skin, or aching joint are associated.

Grouped in three categories depend on inflamed part.

As inflammation is produced anywhere in alimentary tract, clone disease is diagnosed with several checks, such as, esophagus, belly, and duodenum are checked by upper endoscopy, and large intestine or exit area of small intestine is checked by large intestine endoscopy to identify erosion or longitudinal ulcer, or biopsy pathology test. Small intestine test is commonly conducted by Arteriography using barium but recently small intestine capsule endoscopy, balloon assisted small intestine endoscopy, CT or MRI diagnoses can be done depend on hospital. Disease is categorized, by the position of primary inflammation, small intestine type, small and large intestine type and large intestine type. (Fig.1)

Fig. 1: Category of Clone Disease

Continuous medicine treatment is necessary for permanent cure.

5- Amino Salicylic acid preparation (Pentasa) and elemental diet treatment are the basic treatment. Recently, new steroid drug Budesonide (Zenter Coat Capsule) dosage becomes the subject to Health Insurance. For the case where these treatments have less or no effect, or inflammation is too strong, or patient is young, or anal pathological abnormality inflammation is too strong, and disease has a strong progress so that damage to gut tract, such as stenosis or fistula is possibly produced, dosage of biological drug (Remi Cade, Humira, etc.) may start earlier. Furthermore, there may be the case to dose immune-regulating drug Thioprine Formulation (Imran, Azanine, Leukerin) together. In case there is a stenosis, expansion treatment by endoscope using balloon may possibly perform under the right circumstances. But when medicine treatment is difficult, surgical treatment is possibly performed. Provided that the clone disease cannot be permanently cured completely, continued medicine treatment is necessary after the surgery.

Fig.2 Treatment of Clone Disease

Cure effect is practically judged by medical exam

Although it takes several years for inflammation to settle down, if inflammation is difficult to control in the meantime, intestinal damage such as relapse, stenosis, fistula formation may progress. Because inflammation does not advance, it is required to continue treatment properly.Because the subjective symptoms are difficult to understand, the diagnosis may be delayed and it may be difficult to judge during the treatment, so be careful. Please consult with your doctor carefully and judge treatment effect by objective inspection.

Burden-free meal for intestine is a basic.

It is expected that the Burden-free meal for intestine makes symptom hard to appear. However, it is also important not to be deficiency of nutrition with limiting the meal amount too much. In case there already exist a stenosis, select less-fiber food and make devisal not to take too much food at once, to prevent transit disorder like bowel atresia. Having a nutritional consultation to select meals fit to your symptom.

Reference
“For Clone Disease Patient: Fundamental Knowledge Need-to-Know for the Treatment (Research group (Suzuki Team) for Refractory Inflammation Bowel Disturbance), 2nd edition” (Ministry of Health, Labor and Welfare “Research Study for Refractory Inflammation Bowel Disturbance” group home page, Patient/Family information ( http://ibdjapan.org/patient/ )

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