One piece of advice that I've picked up from the DD forum that I can pass along is that this disease may not get worse with age. It may actually become more tolerable with age. There is some evidence that the routine gets easier to deal with with every bout. Look into this.

You have to find what works for you and, more importantly, what triggers your attacks. Keep a food diary and keep more than just food. Keep your weight, your condition, your BM movements, everything. This will help you determine (hopefully) what isn't working for you.

I think this disease is hereditary much of the time. Many people diagnosed at a young age also had parents who were afflicted.

If you had an attack 3 years ago and it went away, that is a good sign that this one may too. If the oral medications (awful as they are) work for you, you shouldn't have to have surgery.

Just keep in mind that if you ever spike a pretty decent fever with pain, please go to the ER immediately.

I hope your GI problems calm down for you. They're no fun.

hi jmartin - i just switched over to the "advice" page...i hope that you've been reading the discussions about mesalizine in many of the posts especially from 4 strikes. because your div. is in two ends of your colon, surgery doesn't seem reasonable at this point (to me - not a doc!), but i do know that some people have had their entire sigmoid colons removed and been fine - not a great option but one that could save your life. if it is possible for you to convince a doc to get you into a study on mesalizine or simply prescribe it for you, that may be just what you need. 4 strikes has done so much research and it does seem to confirm that div. does not necessarily mean surgery. check it out. i hope that you get well and feel more optomistic. this is a great place for questions (and answers!) and lots and lots of support.
best to you,
sally

I have a 29 year old son just out of the hospital with colon bleeding and other health issues. He has DD as do I. He was adopted with a serious facial deformity and has always been on a liquid diet through a g-tube. He also has GERD which is pretty weird. He is very sick and was on meds to help but now his heart and lungs have been affected. There is no easy answer to your questions as we are all different. I have no family history, high fiber diet, excercise etc. There are vegetarians, over eaters, non drinkers, drinkers etc. You just follow what you feel is the way to regain your health. We are here for you.

I have had 2 colectomies and doing ok.

Joanne

Hello JMartin,

All good info above.

You certainly have a lot to deal with at your young age. I have some understanding of diverticulitis, but your 13 ulcers may be a clue to your condition. Something seems to be attacking your gastro linings.

Have you been checked for H-pilori? Have you been on NSAIDs alot - asprin, Advil, Motrin, etc.

If you have not been to several Docs, you should seek other expert opinions. If I were you, I would think all ARE related until I exhausted several resources. What do I know? Not much!

Fiber does not stop attacks IMO. It is a myth that it does. I could not find a diet that would stop my attacks - and I tried hard.

Best Wishes,

John

Good general info that may not apply, but can't hurt.

http://www.medicinenet.com/nonsteroidal_anti-inflammatory_drugs_and_ulcers/index.htm

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed medications for the inflammation of arthritis and other body tissues, such as in tendinitis and bursitis. Examples of NSAIDs include aspirin, indomethacin (Indocin), ibuprofen (Motrin), naproxen (Naprosyn), piroxicam (Feldene), and nabumetone (Relafen).

NSAIDs are taken regularly by approximately 33 million Americans!

What are side effects of NSAIDs?

The major side effects of NSAIDs are related to their effects on the stomach and bowels (gastrointestinal system). Some 10%-50% of patients are unable to tolerate NSAID treatment because of side effects, including abdominal pain, diarrhea, and upset stomach. Approximately 15% of patients on long-term NSAID treatment develop ulceration of the stomach and duodenum. Even though many of these patients with ulcers do not have symptoms and are unaware of their ulcers, they are at risk of developing serious ulcer complications such as bleeding or perforation of the stomach.

The annual risk of serious complications is 1%-4% with chronic NSAID treatment. The risk of complications is higher in elderly patients, in those with rheumatoid arthritis, patients taking blood thinning medications (anticoagulants such as Coumadin and heparin) or cotisone-containing medications (e.g., prednisone), and patients with heart disease or a prior history of bleeding ulcers.

How do NSAIDs work and how do they cause stomach problems?

Prostaglandins are natural chemicals that serve as messengers to promote inflammation. By inhibiting the body's production of prostaglandins, NSAIDs decrease inflammation. However, certain prostaglandins also are important in protecting the stomach lining from the corrosive effects of stomach acid as well as playing a role in maintaining the natural, healthy condition of the stomach lining. These protective prostaglandins are produced by an enzyme called Cox-1. By blocking the Cox-1 enzyme and disrupting the production of prostaglandins in the stomach, NSAIDs can cause ulcers and bleeding. Some NSAIDs have less effect prostaglandins in the stomach than others, and, therefore, have a lower risk of causing ulcers.

If a stomach ulcer is detected, how is it treated?

Treatment of NSAID-induced ulcers involves discontinuing the NSAID, reducing stomach acid with H2-blockers (e.g.Zantac, Tagamet, Pepcid, Axid) or, more effectively, with proton pump inhibitors, such as omeprazole (Prilosec) or synthetic prostaglandins (misoprostil or Cytotec). Since H. pylori bacteria is a common cause of ulcers, eradication of the bacteria with a combination of antibiotics may also promote ulcer healing.

Can NSAID-related ulcers and complications be prevented?

NSAIDs are valuable medications for patients with inflammatory arthritis and other inflammation of body tissues. For patients who need long-term NSAID treatment, several steps can be taken to decrease NSAID-related ulcers and complications. The risk of ulcers and complications tend to be dose related. Therefore, the smallest effective dose of NSAIDs is taken to minimize the risk. NSAIDs might be selected that have less effect on the stomach production of prostaglandins. Some of these NSAIDs are called selective Cox-2 inhibitors. Cox-2 inhibitors block the Cox-2 enzyme that produces prostaglandins of inflammation without blocking the natural prostaglandin production of Cox-1 in the stomach. Taking NSAIDs with meals may minimize stomach upset with NSAIDs but not ulcerations.

A synthetic prostaglandin, misoprostol (Cytotec), can be administered orally along with NSAIDs. Misoprostol has been shown to decrease NSAID-induced ulcers and their complications. The side effects of misoprostol include abdominal cramps and diarrhea.Misoprostol is also avoided in childbearing women because it can cause uterine muscle contractions and miscarriage. H2-blockers and proton pump inhibitors have sometimes been used in reducing the risk of NSAID-induced ulcers. Their effectiveness is still under study.

Scientists are actively searching for safer NSAIDs that are effective anti-inflammatory agents but are not ulcer producing. In the meantime, patients who need long term NSAID treatment should be closely supervised by a doctor. Patients at risk of NSAID-induced ulcers and complications should consider preventive measures, such as using NSAIDs with less stomach prostaglandin disrupting effects, or misoprostol. Stopping smoking, and eradicating H. pylori may also be helpful. A variety of safer and more effective NSAIDs are available.


Last Editorial Review: 1/30/2007