Talk:Crohn's disease/Archive 1

Gross Images

Can someone remove some of the most gross/offensive images in the article? I have CD, and like to read the contents on this article, but the images stress me. Particulary the red colon image, and the cancer image. Thanks.

I'm sorry, but generally we don't remove otherwise informative images because they cause offence. However, if they do distress you, why don't you browse the article with image downloading disabled on your browser?

In my personal opinion, as a sufferer of Crohn's disease, I find the images in the article extremely informative and useful, and not gross at all. For me at least, the human body is a fascinating mechanism, even the icky parts. --Robert Merkel 01:32, 5 June 2006 (UTC)

First let me say this is my first edit, I'm new, very new, so please forgive me if I am doing this wrong and let me know. I think the images should stay. The reason is it tells the story in a way what crohn's can do to the body, damage, kill and maim it. I have crohn's and three surgeries. I never heard of IBD before so this will help people understand, at least it did me. Thank you for your time. --Crohnie 13:57, 22 January 2007 (UTC)

Diet Changes

Diet changes? I've suffered Crohn's since I was a teenager, and as far as I can tell diet makes absolutely no difference to my symptoms. I'm told my experience is reasonably typical in that sense (though people who've had surgery are often a little restricted in what they can eat). --Robert Merkel 12:22 Jan 24, 2003 (UTC)

Hmm. You mean to tell me you can eat lots and lots of fiber and roughage, including things like corn on the cob, broccoli, mushrooms, etc. without a worsening of symptoms? I think that would be pretty atypical. Chadloder 12:24 Jan 24, 2003 (UTC)

My symptoms get worse with some foods, but I don't always care. Some things are worth it :).

Aren't Asacol and Pentasa different brand names for the same stuff? I remember, back when Asacol was somewhat efficacious, being curious as to why Pentasa made me throw up and Asacol didn't when according to the labels on the bottles they're both mesalamine. --Calieber 20:12, 29 Sep 2003 (UTC)

I've had Crohn's for five years now and have been lucky in some areas, and not so in others.

I've never had anything really serious like fistula but did have extensive ulceration and bleeding, along with something which feels vaguely like a cross between Flu and a really early morning all day and every day.

My diet restrictions are quite severe as a great many things have an adverse effect, basically anything with and abundance of fibre (fruit, veg, wholemeal breads, nuts etc...) or anything containing chilli, much to my sadness.

I can pretty much eat as much junk as i can handle with no noticeable effects, and strangely i can drink wine & spirits with no problems, but beer has the predictable undesired effects.

Currently I consume vast quantities of Balsalazide and Azathioprine which keep things under control most of the time, but when I need a little bit of extra oomph to keep on top of things I've found that combining any over-the-counter products containing Loperamide and Codeine is very effective in stopping things short.

Grey Area 12:16, 30 March 2006 (UTC)

I too have Crohn's, and I eat pretty much anything. Never had another outbreak. Have broccoli almost every night

I'm surprised no-one has mentioned the infamous SCD (Specific Carbohydrate Diet ) that was being plugged around the forum boards a while back. My recommendation is to try different foods, and delete the ones that give you trouble, and know your safe ones in case of attacks.

Dairy is often mentioned as a problem in Crohns, however one of my safe foods is cheese on toast. GO figure

I can't believe I'm saying it, but SCD is popular enough that it should probably be mentioned in the article as an alternative treatment -- Samir धर्म 05:25, 3 June 2006 (UTC)

I am a medical doctor from India and am 48 years old. I had been suffering from Crohn's disease from 1982. It was a rollercoaster ride for me and it finally landed me with surgery and I was minus 100 cms. of ileum from 2001. Afterwards also I was not free from other problems and I suffered from TB pleural effusion. But with time I learnt that milk products, refined sugar products, wheat and especially tamarind donot agree with me. I excluded these from my diet and I am happy now.[drmallik@hotmail.com-India]

I know this is anecdotal, but SCD has worked for me for the past 2 years. This after major gut pain, diarrhea, fistula, and abcesses. When I was clinically diagnosed, the Dr. said diet makes no difference. For those interested, you don't have to buy the book to see what is included in the diet. http://www.breakingtheviciouscycle.info I agree, SCD should be added to the "Alternative" section.

I have been diagnosed with Crohn's for almost 2 years now, and at the start of my recovery following diagnosis, I was advised to follow a low fiber diet which saw me living off chicken, rice, mashed potato and fish. For a 21 year old university student this was boring and hard to follow! I followed this for 6 months, until i had finished taking steroids, and now eat pretty much anything I was, and almost everything I ate before diagnosis. I havnt ventured far enough to try corn on the cob, peas, cabbage or a raw carrot which I love, but so long as eaten moderately, I can now eat red meat, most veg, chips, baked beans and all fruit, even strawberries with no adverse effect. As mentioned by someone else, I advise sufferers to try a different food each week, if you have discomfort remove it from your diet, if not continue and add another food. Also, I ahve no adverse effects from consuming dairy products.

I suggest trying a food diary. I have had Crohn's for 7 years, though I am pretty sure I was born with it and the problems. A food diary comes in handy to help know what you ate and the effects you experienced. Remember though, your diet of acceptable foods will change. Everyone is different, which makes diet very difficult to get a handle on. Have you had any surgeries? --Crohnie 12:14, 26 April 2007 (UTC)

List of sufferers

Most illnesses and conditions on this site have a list of famous sufferers. It might be worth having one for Crohn's. The only one I know of is the English snooker player Allister Carter. --MartinUK 17:34, 2 May 2006 (UTC)

These lists are evil. I reckon Allister doesn't tell the whole world about this condition, and the same applies to many other public figures with such conditions. One can make exceptions for people known independently because of their disease (e.g. Michael J. Fox and Parkinson's, Kylie Minogue and breast cancer). The one Crohn's patient I can think of who has made the condition more or less part of her public persona is the singer Anastacia. JFW | T@lk 23:08, 2 May 2006 (UTC)

Carrie Grant (famous UK vocal coach/tv personality) is fairly prominent; she receives cheques from fundraisers on behalf of the NACC (UK charity for the disease), and so on. I think if we can find more sufferers, as long as they aren't private about it then it'd be nice to have a list. -- Dandelions 17:22, 9 May 2006 (UTC)

Two suffers that spring instantly to mind are Mike McCready (guitarist of Pearl Jam and Daryl Palumbo (frontman of Glassjaw). Both McCready and Palumbo's entries on here mention their suffering of the illness, and more lately McCready has played in several benefit shows for the CCFA. McCready's suffering was also mentioned on the BBC news site too. -- Lugnuts 14:56, 14 May 2006 (BST)

I am against any list of sufferers because it doesn't seem to serve a purpose in the article unless they are a willing spokesman for the disease. BTW, Eisenhower had it. --Ignignot 16:28, 15 May 2006 (UTC)

That's the whole point - Mike McCready is a spokesman and does lots of benefit gigs for chairty. -- Lugnuts 18:04, 15 May 2006 (BST)

Singers Beth Orton and Anastasia have both mentioned their Crohn's Disease in interviews. M Halton

If the purpose is to highlight "spokespeople" with the dissease, I would suggest a different name than "List of sufferers"

I am for lists such as these. Knowing famous people suffer from this disease can encourage sufferers and show that the fact that they have a chronic disease doesn't mean they cannot make it! Just another way to show that our world is not 'only for healthy people'--Noy Halevy 10:37, 14 December 2006 (UTC)

Clarification

Somebody needs to clarify this, from para. 1:

It typically affects the terminal ileum and well demarcated areas of large bowel with relatively normal bowel.

What is "large bowel with relatively normal bowel"? I don't know the subject so I can't fix it, but this needs clarification. —Tkinias 18:56, 10 Dec 2004 (UTC)

I've made a stab at clarifying that sentence... (I have it) CJewell (talk) 20:59, 4 Apr 2005 (UTC)

It means that you can have normal intestinal mucosa next to inflamatory mucosa

Pentasa vs Asacol

Both Pentasa and Asacol contain the same drug -- mesalamine -- which acts asprin-like and antibotic-like. The difference is the coating the drug comes in. These coatings act as a delay mechanism. Pentasa's coating dissolves in the last couple feet of the small intestine, while Asacol's coating dissolves and releases the mesalamine in the colon. [Full details: http://www.gihealth.com/html/education/drugs/pentasa.html ]

Although sulfasalazine may have an antibiotic effect, I don't think the same is true for mesalazine, which has only the aspirin like effect.M dorothy 03:41, 9 June 2006 (UTC)

Brain damage?

I've read many things on crohn's disease but have never read anything other than this article that mentions indirect brain damage. What supporting evidence is there for this? Is it simply a result of the low grade fever that often accompanies the disease? Or is it just unsubstantiated guesswork?

Low-grade fever does not cause brain damage. There is an increased incidence in white-matter lesions of unknown significance, and an increased incidence of multiple sclerosis. If in doubt, have a look on Google or Pubmed, and if this does not satisfy you, please feel free to rephrase or remove the contentious paragraph. JFW | T@lk 18:41, 8 Jun 2005 (UTC)

I have never read anything by any major Crohn's disease researcher or organization that cites minor brain damage as a symptom of Crohn's disease. There is a higher incidence of other autoimmune disorders, including MS, in anyone with an autoimmune disorder, not just Crohn's, but this is not directly related to having Crohn's disease itself. I think this should be removed from the list of symptoms or reworded to include a reference or two. --Kerry 17:45, 24 August 2005 (UTC)

I suspect that the general poor nutritional status of your average sufferer, is more likely to cause brain effects rather than the disease directly. Especially if its topped off with a nice bit of aneamia and some of the meds we have to take

I believe here is a study supporting this... Add if you would like. [1] Josh --68.82.65.116 20:46, 24 September 2006 (UTC)

Sorry, I may have added some brain damage claims while I was in a very bad CD episode. I had a lot of hallucinations, lasting memory problems, probably malnourishment, anger and stress issues probably from the prednisone, etc. My bad. -Kristan Wifler

Dietary aids

I was diagnosed with Crohns disease and now suffer from None of the sypmtoms I feel fine. 2 times a week I take a stomach enzyme called Azeo Pangen and Acidopholus. All my symptoms went away within a month and now I often forget im afflicted.

If you think this is significant, do you have any references (web or medical journal) that support this approach? JFW | T@lk 06:46, 3 August 2005 (UTC)

Wait a few years then come back here. The seriousness of Crohn's varies greatly. I was diagnosed at 10 and didnt have another inflammation until 17. Since then I've had one serious case of Crohn's symptoms every 6 months (I'm now 20).

Ive had it for 4 years now and taking those named above enzymes my stomach problems have ceased

The problem i had was my sugars were not getting digested properly they would decend to my intestines and begin to ferment causing horrible gas problems Shortly after starting my gas problems went away and my stomach pains stopped I would also get spasms in my stomach thru my back that would make me curl into a ball it would hurt violently for up to 5 minutes and then just Stop My doctor prescribed me with Lactaid and i asked him if i could take the said medications prescribed by my dietary aid and he said Absolutely not i now realized he said No because he cant make money off of it. Try eating more Yogurt that may help you if it seems to do any good try Acidopholus two a day if that seems to help a little but it doesnt seem to completely remove the problem i take one teaspoon of Colidol Silver twice a week for 2 weeks 2 Acidopholus 2 Omega Three Fatty Acids 1 azeo pangen every other day and that seems to do the trick 100% My stomach doctor didnt believe me that it helped me and shortly after i told him he moved away still in disbleief

I dont think its necessarily that you have a malfunction Maybe its that we've all come to the convenience of fast foods and Pop Our ancestors didnt have any of those and supposedly its more prevelant in Industrialized nations 1 in 300 in the US Try eating more fishes and Yogurts and cheeses Stop drinking pop its one of the worst things for your stomach out there

In my region I have heard from many supposedly 'cured' people who were diagnosed with Crohn's disease after only a few months of suffering. They changed their dietary habits and the disease completely went away. The meaty detail here is that their doctors changed their diagnosis effectively erasing them from the list of Crohn's sufferers. My theory is NOT that Crohn's is curable but that there are several causes of the symptoms, and that the treatment should affect the specifics of the diagnosis, perhaps this has been addressed in the medical world? I wish I was better at sticking to a dietary change. -Kristan Wifler

Naming convention

I am annoyed by leaving the possessive standalone. I think all instances of "Crohn's" standalone should be replaced with "Crohn's disease".

This is an extremely common form and used by patients as well as doctors. It would be overkill to mention "disease" in every instance. JFW | T@lk 00:40, 18 August 2005 (UTC)

I have Crohn's disease, and, most of the time, I refer to it as Crohn's. Once the proper name is used in the introduction, I think it's okay to just refer to it as Crohn's. -- Kerry 17:47, 24 August 2005 (UTC)

Marshall Protocol for Crohn's Disease

Dr. Trevor Marshall, a medical research scientist, developed a treatment for all TH1 type diseases, such as Crohn's disease, based on the concept that the root cause of these diseases is infection with intercellular bacteria (L-forms or cell wall deficient forms). Doctors around the World have been trying this treatment on their patients with TH1 type diseases with great success. He and others involved in this treatment are looking for funds to support clinical studies to bring this treatment into the mainstream.

For more information see www.marshallprotocol.com.

Has this been published in a peer-reviewed publication? Are there prospective clinical trials? What does the treatment entail? JFW | T@lk 16:17, 30 August 2005 (UTC)

Current Research

I think there ought to be a section on current research in this article. I saw an article in Wired 2-3 months ago that described a number of them. Some added detail about Remicade should also be added, its association with arthritis and its effects on the disease. Dguido

Remicade is not research anymore. It is used when DMARDs fail or in fistulating disease. JFW | T@lk 08:57, 9 October 2005 (UTC)

I dropped the comment on Ashkenazi jews. Interesting notion, but there is not difference in port consumption between Ashkenazi and other jewish groups. The parenthetical comment was thus an interesting quip, but not supported. Still a good idea! Steve Kd4ttc 23:24, 3 February 2006 (UTC)

Obviously never heard about CARD15. JFW | T@lk 05:58, 5 February 2006 (UTC)

Thanks for pointing out the linkage disequilibrium research on NOD2 and Ashkenazi jews! Kd4ttc 18:07, 5 February 2006 (UTC)

Research methods...

I've been doing some research, and it seems that there are some "undergrounders" that say the Crohn's comes from cow's milk...

http://www.nomilk.com/crohns.shtml

very riteting article.

Also have read that it's the "myco-bacterium" found in cows (and goats) milk that cause the Crohn's, and oddly enough a similar type of 'disease' can be found in some cows and goats intestinal tracts!

I've also read about something called "Helminthic therapy (Current research)", which sounds a little weird for those who have weak stomachs...but it sounds promising.

What you guys have said about the Azeo Pangen, and the Lactobacillis Acidopholus...I'm going to give them a try (the Acidopholus first, because I already have some in the fridge!).

Food for thought...The Food Pyramid (developed by the US Department of Agriculture (USDA)). Can anyone say wholly conspiracy?! We all know you don't need dairy to be healthy (as long as you get your calcium, and your vit. D, etc.)...it's kind of funny that dairy is second on the list...

Anyways...happy hunting, and I'll be back to post my progress with the two afformentioned...one question:

1. I know that I avoid red meat (and pork)...and I noticed that Azeo Pangen... http://www.metagenics.com/products/catalog/detail.asp?pid=143 comes from Porcine Pancreas (for those of you who don't know: Pig Pancreas)!

---

Even ignoring sites such as "nomilk.com" linked by the previous poster, which sound a little less then objective, there does some to be some credible research on pubmed implicating infection (possibly from Cows) as a factor in Crohn's.

http://www.blackwell-synergy.com/doi/full/10.1111/j.1365-2672.2005.02598.x?cookieSet=1

This study also detected Mycobacterium avium in people suffering from Crohn's. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15380962&query_hl=3&itool=pubmed_docsum

Can anyone comment on this? I'm not too informed about current research in the area beyond what I've seen on pubmed.

152.3.198.219 00:48, 30 September 2006 (UTC)

-- It's true that in some studies, [MAP | http://en.wikipedia.org/wiki/Mycobacterium_avium_subspecies_paratuberculosis] has been cultured from people who have Crohn's disease. However, it seems most likely that MAP is just one of several pathogenic organisms that capitalize on a patient's damaged mucosal layer and inability to clear microbial infections properly. For more information, see this current review paper by Sartor: Link Spin2cool 23:12, 30 September 2006 (UTC)

Here's an interesting read!

http://www.biblelife.org/bowel.htm

This is an awesome site guys, a diet regimen, pro-biotics are recommended, it's a long read, but well worth it.

Wait! There's more

http://www.vsl3.com/VSL3/default.asp

My mother in law says that there's a gentleman that comes into her pharmacy who picks this probiotic up on a regular basis for his son. She asked him, and he says it helps to keep things under control. Not exactly sure what that means, but if he keeps dumping money into it...

While VSL3 has been shown in randomized controlled trial to be useful for pouchitis treatment, my understanding is that it has not shown a similar benefit for CD -- Samir धर्म 07:03, 27 January 2006 (UTC)

References

129.143.100.146 added a huge list of references, but it is unclear which reference refers to which factoid in the text. I've asked the contributor to improve this, but if this doesn't happen it may need to be deleted. JFW | T@lk 17:58, 10 January 2006 (UTC)

New Research

http://news.bbc.co.uk/1/hi/health/4740632.stm

The article's lead in: A weakened immune system - not an over-active one as had been suspected - may cause the intestinal disorder Crohn's disease, research suggests.

The main page needs a lot more research information: right now it reads like a booklet from your local public health nurse. I added one or two items taken from previous versions, but frankly the previous versions were a lot better.

Wikification

I began to wikify the article, but it needs a bit more tweaking by someone who knows about the subject. Foxjwill 01:04, 12 May 2006 (UTC)

• I have also made a (hopefully) bold attempt to wikify this; however, as I went through it I could see that it needs a serious copy-edit. I had only intended to do a wikification and light copy edit, but as I got familiar with the text I began to notice the excessive redundancies and disorganization of the article. That's not to be critical, but its to say that I (not very) soon realized that I had bit off more than I could chew and this topic deserves a lot better attention than I could provide at one sitting. Someone who knows the topic could improve it that much more. Fluit 05:21, 12 May 2006 (UTC)

Another suggestion for wiki-fying the article well: have the entries for Crohn's ileitis and ileitis redirect to this article.

Material copied from Mayoclinic.com

I just noticed that a huge swath of text was copied from Mayoclinic.com. The edits replacing original content with Mayoclinic's text can be seen at [2]. --Uthbrian (talk) 07:18, 30 May 2006 (UTC)

Agree with reversion of copyvio info -- Samir धर्म 08:20, 31 May 2006 (UTC)

NPOV on stress section

Not referenced, and POV against medical therapy for CD. Please cite literature that hypnosis helps with CD symptoms -- Samir धर्म 09:31, 31 May 2006 (UTC)

Couple of things for this article

Rash

A few things; if anyone has them, it would be great:

• Picture of erythema nodosum
• Pathology slides of Crohn's disease, preferably showing granulomata (I think I have some but they are low resolution)

-- Samir धर्म 09:45, 3 June 2006 (UTC)

I have a nice jpg of what might be erythema nodosum. It hasn't been biopsied or officially pronounced, but I would email it if you wanted to look at it.M dorothy 03:12, 26 June 2006 (UTC)

Sure, send it over. -- Samir धर्म 06:21, 26 June 2006 (UTC)

This is not diagnosed. I could probably figure out how to rotate the image & upload again, if it was worth it. It looks more like a shin rotated.M dorothy 03:22, 13 July 2006 (UTC)

• Doesn't really look like EN to me on first glance... was it palpable? -- Samir धर्म 03:21, 13 July 2006 (UTC)
  • This is on the shin, where there is little skin. There is very slight swellling, and the surface of the skin has a slightly different texture. No itch, no pain. Came suddenly about 3 years ago. Smaller rash on other shin.M dorothy 03:32, 13 July 2006 (UTC)
    • It probably is an EN-like panniculitis, but it doesn't classically look like EN... looks more like macules that are discrete (aren't large and coalescent like EN usually is). But it's the best EN picture we have so far... -- Samir धर्म 03:41, 13 July 2006 (UTC)
      • Have you clicked on the image to look at it enlarged? Assuming this started as isolated red dots, they must have merged in the central area.M dorothy 03:50, 13 July 2006 (UTC)
        • I have. EN usually isn't red dots though, it's usually palpable plaques that coalesce. -- Samir धर्म 07:20, 13 July 2006 (UTC)
• Andrew47 edited to describe EN as "exquisitly painful" instead of "painless". I have removed this, since I can't find any ref either way.M dorothy 15:14, 30 July 2006 (UTC)
  • The classic textbook definition is painful, but I must say that most EN I've seen is painless -- Samir धर्म 08:18, 15 August 2006 (UTC)

Smoking

Most sources seem to suggest smoking increases the risk for Crohn's (and decreases for UC). Is this valid? should it be mentioned?M dorothy

You're absolutely right... typo that was my fault in the article. I've changed it back. -- Samir धर्म 13:20, 5 June 2006 (UTC)

Er, kind of not relevant but in an episode of "House" the Doctor advised a CD sufferer to smoke two cigarettes a day to help with loose stools. I find that smoking two cigarettes a day helps to solidify my stools, when i'm not smoking I pass far more fluid. Anyway, thought i'd add this. M Halton

I am having trouble sorting out the differential between UC and Crohn's. I have been told one or the other since my twenties. At age fifty-eight I was told I had BOTH. My Medical Gastroenterologist diagnosed me with "steroid-dependent Crohn's Ulcerative Colitis" two years ago. About smoking--When I mentioned that I was flaring up as I stopped tobacco, my GI physician prescribed Bentyl(R), dicyclonine HCl 20 mg.,T.I.D.User:W8IMP 06:31, 7 December 2006 (UTC)

Jargon report

As requested by User:Samir (The Scope)

Jargon can be treated in three ways:

• By linking to a pertinent article (e.g. "systemic disease", "uveitis")
  • Sometimes the article is not quite at the same location (e.g. small bowel obstruction → bowel obstruction)
• By defining the term (e.g. "Ileitis(inflamation of the ileum)")
• by replacing the term with a simpler one (e.g. "stool" → "feces", )

• augmentation of the Th1 system of cytokine response in inflammation.
  • Can this be made more detailed, or more links added to make it clearer? It is compeltely impossible to understand as is to the layman.
• usually the area overlying lymphoid aggregates
• They typically preent with fevers
  • Typo?
• evacuate the infected focus.

other

• Testing for anti-Saccharomyces cerevisiae antibodies (ASCA) and anti-neutrophil cytoplasmic antibodies (ANCA) has been evaluated to identify inflammatory diseases of the intestine and to differentiate Crohn's disease from ulcerative colitis, but are not routinely used in practice.
  • It has been evaluated: were the results conclusive?
• and with susceptibility to certain phenotypes of disease location and activity.
  • Could this be develloped a bit, with examples?
• Oral contraceptives have shown an association with the development of Crohn's disease.
  • Specific examples would be a very pertinent adition here. There is quite a range of formulations.
• and metaplasia or change in the tissue type
  • What does the tissue than becomes?
• The splitting of treatments alongmedications is a poor organization, and contains too much subsections. Organizing it by uses, and then giving each medication a quick description, or inversely, would probably be a better idea.
• Oddly enough, the statement Similarly, stress can worsen symptoms of Crohn's disease. Patients with Crohn's disease can find that their symptoms improve if they control the stress in their lives. is unsourced
• how Crohn's Disease can cause several complications (Fistulas, abscesses, anal fissures, osteoporosis...) is not discussed
• The history section is very sketchy: how has treatment and understanding of the disease changed in the last 70 years?

Circeus 19:19, 6 June 2006 (UTC)

I have tried to fix most of these comments, so they no longer relate to anything in the article. I have therefore removed what has been addressed.M dorothy 01:59, 13 July 2006 (UTC)

To answer one part of this, I'd call Crohn's a TYPE of ileitis, as far as small intestine involvemant is concerned. (It isn't the only type, as far as I understand. I could be wrong, however.) I've heard of "small intestine only" Crohn's called "Crohn's ileitis", just as "large intestine only" Crohn's is called "Crohn's colitis". — CJewell (talk to me) 06:40, 7 June 2006 (UTC)

Yup, ileitis is a generic term for any inflammation of the ileum, and as such, Crohn's involving the ileum is "Crohn's ileitis"

For information about the different types of surgeries, http://www.ccfa.org/info/surgery/surgerycd is a good page to look at. To answer your direct questions, the first part I'd answer using what's already in the (Wikipedia) article, as for the removal question, sometimes they take the affected part out (resection), while other times strictures are expanded using a proceedure that sounds similiar to balloon angioplasty (called strictureplasty), and as for transplants, I remember hearing that small intestine transplant is experimental and done only in extremely severe cases where repeated resections have been previously done and the patient is running out of small intestine. [I'm a patient, not a doctor. I could be wrong.] — CJewell (talk to me) 06:53, 7 June 2006 (UTC)

SB transplant! Forgot to add it completely, and I work at the largest SB transplant centre in North America. David Grant would kill me! -- Samir धर्म 07:00, 7 June 2006 (UTC)

• By the way, thanks immensely, Circeus. This was very useful -- Samir धर्म 09:24, 7 June 2006 (UTC)\

Length

One complaint is that the article is too long. I could address that by moving the details about drugs and treatment to a new article, and writing a summary in the main article. Any votes on this?M dorothy 03:37, 13 July 2006 (UTC)

Good Article

The article seems to be relatively well-written, (The vocabulary is very high, but I don't think its prohibitive, wikilinks should suffice) NPOV, (Though that might just because the symptoms of this disease creeped me out so much I might of missed it heh) Stable, the pictures are nice, (Though creepy) and the best part to me was the extensive references. If there is any way you can somehow lower the vocabulary level without getting the article off-topic i'd recommend it, and also, a few sections read sort of like lists, outlines, or outlines progressing through to some idea, I think one or two of those should be converted to paragraphs. Homestarmy 03:42, 17 June 2006 (UTC)

Whipworm emphasis?

I'm wondering if there should be greater emphasis on the roles of hygiene and the immune system and treatment using pig whipworms.

There is a line of thought out there that because the disorder is largely Western (where people rarely suffer from intestinal parasites, as opposed to the developing world), and because whipworms have had such a dramatic effect in treating Crohn's sufferers, that perhaps much of Crohn's is an auto-immune disease. The whipworms, in essence, serve to recalibrate an otherwise wayward immune system.

One poor study in Gut on the therapy. We should probably expand a bit on the hygiene hypothesis though. -- Samir धर्म 04:00, 20 June 2006 (UTC)

What's left for FAC

As I see it the following:

1. Prose: Point form looks like it is frowned upon
2. Referencing the lead (which is quite well written)
3. Reference for SB transplant (I need to pull up the Grant paper)
4. Referencing table of comparison
5. Referencing initial part of clinical manifestation (Podolsky or Hanauer reviews should suffice)
6. A statement on prognosis
7. Jargon as above; almost done

-- Samir धर्म 09:14, 25 July 2006 (UTC)

I think that references in the lead are unnecessary, and detract from it. Everything stated in the lead should be expanded upon in the article, and referenced there. The point of the lead is to try to get a one-screen summary that people can read and decide whether they want to read the entire article. Is there any official guidance on notes in the lead?

I put the comparison table in based on suggestions. If people like that version better, I would remove the pointy version.M dorothy 03:26, 30 July 2006 (UTC)

Table is good. Not sure about refs in lead (my bias would be to add refs, as introductions are done in scientific reviews). I'll check WP:MOS. -- Samir धर्म 03:55, 30 July 2006 (UTC)

Comparison text

Here is the comparison pointy text in case anybody wants to preserve it.

• Crohn's disease:
  • Can occur anywhere in the gastrointestinal tract but commonly involves the terminal ileum
  • Has a patchy distribution in the intestine.
  • Has transmural inflammation where it spreads deep into the layers of affected tissues.
  • Can have granulomata on biopsy
  • May spare the rectum on endoscopy
  • Has characteristic features on endoscopy including deep, linear and serpiginous (or snake-like) ulcers
  • Can be associated with fistulae, abnormal connections or passageways between the intestine and organs or vessels that normally do not connect.
  • Can exhibit peri-anal symptoms around the anus.
  • Often returns following surgical removal of the affected part of the intestine.

• Ulcerative colitis:
  • Usually affects only the large intestine and rectum
  • Usually exhibits inflammation in a single area in a continuous fashion.
  • Usually affects the only the mucosa, or the innermost lining of tissues.
  • Has characteristic features on endoscopy including shallow, continuous ulcers and involvement of the rectum.
  • Does not usually exhibit peri-anal involvement.
  • Not usually associated with fistulae.
  • Has a higher rate of primary sclerosing cholangitis
  • Can usually be cured by surgical removal of the large intestine.M dorothy 04:45, 30 July 2006 (UTC)

Famous sufferers

To include them? I think not. Need solid references if they are to be included. Personally, I think it's unencyclopedic. Other medical articles seem to have followed suit in removing them. See relevant section above at Talk:Crohn's disease#List of sufferers -- Samir धर्म 17:45, 30 July 2006 (UTC)

If it has become a problem, I typically create a list of famous sufferers page. InvictaHOG 17:59, 30 July 2006 (UTC)

Good idea for this one. I deleted these as they are unreferenced, but if there are credible references, it can go to List of individuals with Crohn's disease or somewhere similar. -- Samir धर्म 18:40, 30 July 2006 (UTC)

• I have created the page per List of notable people diagnosed with dyslexia. Philip Stevens 19:01, 30 July 2006 (UTC)

• I disagree about this omission- there are some high profile Crohn's sufferers in the UK who have done public interviews about Crohn's which can easily be found, referenced and quoted. It humanises the condition, and you'd be surprised at how often it comes up in conversation amongst IBD sufferers so is very relevant. They include Carrie Grant (BBC's Fame Academy) actor Jeff Hordely (ITV's Emerdale star Cain Dingle), actor Ken Stott and singer-songwriter Beth Orton. In the US, Pearl Jam's guitarist Mike McCready & sports star Ralph Benirshke (sp?).

Kez- 31 July 2006

• • I think the spin off article is the way to go as long as its referenced. -- Samir धर्म 01:05, 31 July 2006 (UTC)

An addition (suggestion)

• Can you add a bit about Metastatic Crohn's Disease (also called Cutaneous Crohn's disease). It's very rare but worth a mention as the only stuff on the net seems to be tiny pieces about it or medical abstracts. I would do it but find it difficult to reference things properly. Metastatic Crohn's Disease is very rare- it's where Crohn's affects other parts of the body.. not the bowel. It is significantly different from secondary extraintestinal symptoms in that it is primary Crohn's disease in itself.Hope that makes sense.

Thanks, Kez 31 July 2006

• • I have a picture somewhere. It would make a good article. -- Samir धर्म 01:38, 31 July 2006 (UTC)

• I found a lot on Google. Crohn's disease has extra-intestinal manifestations, such a EN. Why is this regarded as "Cutaneous Crohn's", as opposed to a really bad case of EN? If it really is different from EN, this rarer condition may be telling us something profound about the disease.M dorothy 05:31, 3 August 2006 (UTC)

• EN is not Crohn's - EN is a secondary condition that can be associated with Crohn's and occurs as an extraintestinal associated symptom in less than 2% of Crohn's patients. It is a condition in its own right and can also be caused by streptococcus virus or more rarely, tuberculoisis as well as other causal conditions. Not to be confused with Crohn's disease of the skin which has a completely different pathology and does not cause the distinctive sub-cuteneous lesions indicative of EN. Kez 17th Aug 2006

• • I need to find that picture and I think I have pathology specimens also -- Samir धर्म 21:06, 17 August 2006 (UTC)

Featured article candidacy

I took a look at the article today because I know that a lot of great work had been ongoing to get this to FAC. I liked what I saw and think that this is a wonderfully written, well-referenced, nicely laid-out article. My only concern is that the reliance on lists will really attract negative votes at FAC. I like them in this setting and think that they work well; however, sections such as the extraintestinal manifestations, pathology, and drugs used will most likely be targeted. The desire is always to convert to a paragraph style. The extraintestinal manifestations would not be hard. Pathology is practically there and might slide by as is since it's well done. The drugs I don't know what to do with. It will be interesting to see what a peer review would come up with. I'll try to add more later, but won't change any of the formatting until everyone adds their thoughts! InvictaHOG 17:03, 31 July 2006 (UTC)

Lead or Lede

Please try to avoid adding details to the lead. Eventually the entire article will wind up in the lead.

One thing that the lead is supposed to do is to tell what the words mean. It is not obvious to all readers what a "Crohn" is. Is it a body part? No, it's just a person's name. If you want to find out more, read the article. But, we don't want you to get three pages in before you figure out what a Crohn is.M dorothy 03:17, 1 August 2006 (UTC)

Burrill Bernard Crohn should be linked to. --WS 09:02, 1 August 2006 (UTC)

The link is present in the history sectionM dorothy 05:05, 2 August 2006 (UTC)

I don't think that adding the full name of the physician who is responsible for the eponym should raise the fear of a slippery slope of information moving into the lead. I don't personally think that the first sentence of the article should discuss where the name came from, however. I think that the most important things in the first paragraph are 1)What symptoms does Crohn's disease cause 2) What is Crohn's disease and 3) How serious is Crohn's disease. Right now, reading the first sentence, I bet most people would not know anything about Crohn's disease other than who named it. It's a minor point, I know, but I think that the first paragraph is the most important part of an article and that it should be as perfect as possible. I would like to rewrite the first sentence to attempt to capture the chronicity, severity, and nature of Crohn's disease but sense that I should allow some time for consensus to build as to what is most important here. I'll ask those who have spent a lot of time editing this article to let me know what you think. InvictaHOG 11:33, 1 August 2006 (UTC)

See Wikipedia: Lead Section. The initial task is to define the term "Crohn's".M dorothy 05:05, 2 August 2006 (UTC)

Actually, the initial task is to define or clearly describe the condition. I personally feel that a description is more helpful than explanation of the etiology of the name. I'm sure that a sentence could be found which captures both... InvictaHOG 15:25, 2 August 2006 (UTC)

No. We want to start by explaining what we are talking about, and not talking about. It is a "disease". It is named afer a man, not some characteristic of the disease. It is a type of IBD. It is like UC, but different. It's not the same as IBS. And, we have to explain the Crohn's illeitis and colitis refs into the article.M dorothy 05:09, 3 August 2006 (UTC)

How about this or a similar lead sentence "Crohn's disease is a common, chronic, episodic disease affecting the gastrointestinal tract which was named for Burrill Bernard Crohn, the physician who first described it as a distinct type of inflammatory bowel disease." It would be difficult to be more specific about the type of disease and how it may affect the rest of the body in this setting. However, I think that it covers a lot and summarizes the name as well as the disease. Let me know what you think! The rest of the lead article could easily be rewritten to accomodate it. InvictaHOG 03:18, 3 August 2006 (UTC)

Crohn's is not common: it is, indeed, a "rare" disease. Dr. Crohn was not in fact the first to characterize the disease, his name was just earlier in the alphabet. If we lead with him, the supporters of the earlier discoverers may demand equal space. There are at least 100 factoids that are more important than the ref to Dr. Crohn, but the lead is already long enough. The important point is just that the disease is named after a person, so the unfamiliar reader doesn't have to wonder what a "Crohn" is.

Was the concept of IBD actually developed prior to Dr. Crohn's time, or did that concept develop subsequently? If the concept of IBD, or UC, were around prior to the characterization of Crohn's, that would be a new fact worthy of mention, but not in the lead, please.

I agree that the common symptoms of the disease may belong in the lead, if we can be brief about it.M dorothy 05:09, 3 August 2006 (UTC)

Crohn's is a rare disease. I've also just read through Sleisenger's chapter, Yamada's chapter, Podolsky's review, and the 1986 Britannica article. None of the mention Crohn's name in the intro. Regardless, I do think it belongs in the lead to contextualize the name, but you need to define the symptoms and the like first. Mentioning in the latter part of the lead that the disease was named after Burrill Crohn is more than adequate. -- Samir धर्म 09:40, 3 August 2006 (UTC)

I concur on the common part - I didn't think that it qualifies as rare, but it appears that it does indeed. Just seems like everyone has it! As to why Crohn's name is attached to the disease - I think that the submitted lead sentence candidate adequately describes his contribution - he first characterized the pathology of Crohn's as distinct from that of other forms of IBD (as far as my understanding goes, I haven't read his original article, to be honest). The submitted lead sentence (with rare in place of common!) seems to characterize the disease broadly and to address what a "Crohn" is. Would it work as a compromise or are there other proposals? InvictaHOG 11:38, 3 August 2006 (UTC)

Dr. Crohn was the third to characterize the disease. The desase was named after him because "C" came earlier in the alphabet. I still think the lead is long enough. What do you propose to delete?M dorothy 01:53, 7 August 2006 (UTC)

I have put together a lead section which actually cuts down significantly on the length while I hope increasing some of the things I felt was missing. To explain, I don't think that the different categories of Crohn's is important to have in the lead, especially since they are in the first paragraph after the lead. All of the categories were not included and, frankly, I'm not sure how helpful the categories actually are in clinical practice other than shorthand to describe where the disease is. Especially since the idea of fistulizing Crohn's is not developed - I would love to learn if there are any data about these categories and outcome measures, etc. An additional discussion I excised dealt with the idea that diet and bacteria are not thought to play a role in the development of CD. There are a lot of things which could be discussed as not causing CD. Are these two more important that others for a reason that I am not aware of? I didn't think that they added much. Things that I felt could be added (and were) was a little more of the epidemiology. I included age, but was surprised to find that the article as a whole did not discuss whether there were sex differences (at least to my eye!). I also added the most common synonyms. Anyway, give it a read and give me some feedback! InvictaHOG 03:44, 7 August 2006 (UTC)

The refs to Crohn's ileitis and colitis are obligatory, since those terms link into the article. These were added in response to specific criticism of an earlier version.

The refs to IBS and ulcerative colitis are important to help the reader that doesn't know much about the subject to know whether they are reading the right article. The confusion with IBS is real among the typical readers.

The fact that Crohn's is not caused by diet is important to negative a common misconception.

Proposed lead paragraph

Crohn's disease (also known as regional enteritis or CD) is a rare, chronic, incurable, episodic disease affecting the gastrointestinal tract which was named for Burrill Bernard Crohn, one of the physicians who first described it as a distinct type of inflammatory bowel disease. Crohn's disease can affect the entire gastrointestinal tract from mouth to anus. Because it is a systemic disease, it can also cause complications outside of the gastrointestinal tract. The main gastrointestinal symptoms are abdominal pain and diarrhea, which may be bloody. Symptoms outside the gastrointestinal tract include skin diseases, arthritis, and ulcers in the mouth.

Crohn's disease is a type of inflammatory bowel disease (IBD). IBD occurs when the immune system contributes to damage of the gastrointestinal tract by causing inflammation. Crohn's disease can be difficult to distinguish from other forms of IBD such as ulcerative colitis. Because of the name, IBD can be confused with irritable bowel syndrome (IBS), an annoying but much less serious condition.

Crohn's disease is a rare disease, affecting fewer than one person in 10,000 in Europe and North America. The disease is believed to be even less common in the rest of the world. Crohn's disease often develops in the teenage years, though individuals in their 60s and 70s are also at increased risk.

Although the cause of Crohn's disease is not known, it is widely believed to be an autoimmune disease. There is a genetic component to susceptibility, and the disease may be triggered in a susceptible person by environmental factors. Unlike the other major type of IBD, ulcerative colitis, there is no known medical or surgical cure for Crohn's disease. Many medical treatments are however available for Crohn's disease with a goal of keeping the disease in remission.

InvictaHOG 03:44, 7 August 2006 (UTC)

Historically, did the concept of IBD exist before the characterization of Crohn's disease, or were several diseases subsequently linked together to form this category?

Although the disease is "incurable", it often goes away after a single attack.

The second paragraph appears to be making a definitive statement that all forms of IBD are autoimmune diseases. There is no consensus on this. This statement is probably too strong even with respect to Crohn's, where some people claim it is a bacterial infectionM dorothy 04:17, 7 August 2006 (UTC)

The concept of IBD existed - the pathology of Crohn's (and apparently its treatment effects) were not distinguished. Incurable can be moved out of the first sentence (as below). The second paragraph was attempting to highlight the role of inflammation in the disease - it states that the immune response contributes to the damage, which is certainly true no matter the initial trigger. I'm sure the language can be improved to make it more clear, though! InvictaHOG 05:38, 7 August 2006 (UTC)

These articles are weak on history. If Crohn was working against a backdrop in which IBD and UC were already known, this is significant, and should be discussed in the history section. Please provide foot notes, however.M dorothy 02:31, 8 August 2006 (UTC)

I agree that a lot of the medical pages are weak on history - a lot of the historical summaries are not available on-line and, though fascinating, are less well-known than the pathology, epidemiology, etc. of the disease. That said, this article does discuss the early work on IBD and, in fact, lists three people who contributed to the early understanding of IBD. This information is referenced with the abstract freely available through pubmed. InvictaHOG 02:41, 8 August 2006 (UTC)

Samir's version

I like InvictaHOG's version a lot. I would tweak as such:
Crohn's disease (also known as regional enteritis or CD) is a rare, chronic, episodic disease which can affect any part of the gastrointestinal tract from mouth to anus. Because it is a systemic disease, it can also cause complications outside of the gastrointestinal tract. The main gastrointestinal symptoms are abdominal pain and diarrhea, which may be bloody. Symptoms outside the gastrointestinal tract include skin rashes, arthritis, and ulcers in the mouth.

Crohn's disease is a type of inflammatory bowel disease (IBD). IBD occurs when the immune system contributes to damage of the gastrointestinal tract by causing inflammation. Crohn's disease can be difficult to distinguish from other forms of IBD such as ulcerative colitis. Because of the name, IBD can be confused with irritable bowel syndrome (IBS), an annoying but much less serious condition.

Crohn's disease is a rare disease, affecting fewer than one person in 10,000 in Europe and North America. The disease is believed to be even less common in the rest of the world. Crohn's disease often develops in the teenage years, though individuals in their 60s and 70s are also at increased risk.

Although the cause of Crohn's disease is not known, it is widely believed to be an autoimmune disease. There is a genetic component to susceptibility, and the disease may be triggered in a susceptible person by environmental factors. Unlike the other major type of IBD, ulcerative colitis, there is no known medical or surgical cure for Crohn's disease. Many medical treatments are however available for Crohn's disease with a goal of keeping the disease in remission.

The disease was named for Burrill Bernard Crohn, an American gastroenterologist who, in 1932, first described a series of patients with inflammation of the terminal ileum, which we now know is one of the most common areas affected in patients with Crohn's disease.

BTW: The classic teaching is that Crohn, Ginzburg and Oppenheimer's work was novel in that they described terminal ileitis that did not respond to anti-TB therapy (i.e. streptomycin) but responded to steroids instead.

-- Samir धर्म 05:29, 7 August 2006 (UTC)

I like the changes made to the proposed version. The last paragraph is a single sentence, but could easily be changed, such as "The disease was named for Burrill Bernard Crohn, an American gastroenterologist.In 1932, he and two other physicians described a group of patients with inflammation of the terminal ileum, which we now know is one of the most common areas affected in patients with Crohn's disease." InvictaHOG 05:40, 7 August 2006 (UTC)

SCD etc

This article, while informative, still reads like a page from a national Crohn's group with the heavy bias from the medical experts. Diet certainly makes a major difference. Also disappointing to see no mention of the SCD - it saved my life after I was diagnosed with CD and I can attest to the theory that sugars play an important part in this disease. There also needs to be a mention of the research showing that it is a depressed immune system that is an aggrevating factor (see reference to BBC article above). I believe all these things carry equal weight and should not be dismissed just because a bunch of doctors think they should be stuffing Asacol into people and that "diet makes no difference" - after all, none of these self-professed experts can say what causes CD, let alone cure it. Their opinions are no more valid than those who have the disease and have found out by experiment what cures them or alleviates the symptoms.

What makes me angry is that I could have saved myself 6 months worth of misery, hospital visits, and useless drug taking if I'd been told other than "diet makes little or no difference". I'd like to see others spared this by being given all of the information, not just the medically politically correct information. —The preceding unsigned comment was added by David Digi (talk • contribs) .

• I agree that SCD should be mentioned in the article, as there is some basic science evidence to its effectiveness as put together by Elaine Gottschall. Please feel free to add it in. But, you are only one person, and I am happy that the diet worked for you. I can tell you of hundreds dozens of my patients who threw Breaking the Vicious Cycle into the garbage in tears when it didn't work for them -- Samir धर्म 10:44, 29 August 2006 (UTC)
• I agree with you that many people might have thrown Elaine Gottschall's book in the bin mainly because it requires a strict diet that most people won't stick to, but equally importantly because, I believe, like many other things the earlier you catch them the easier they are to shake. Someone with an scarred and ulcerated colon caused by 6 years of CD, for example, will probably not overcome the disease while someone like me, who had the disease for 6 months, will be able to turn it around completely. I also believe multiple attacks are beneficial; diet change plus anti-inflammatories like Asacol are probably the quickest way to achieve lasting results. What is needed are some proper studies to determine the effectiveness of these approaches. Unfortunately these are very slow at coming into existance. Perhaps with more and more people getting these things we might see some progress? DocDigi 11:30, 29 August 2006 (UTC)

As soon as there is data and verifiable sources, information should be expanded in the article. However, anecdotal evidence, even from a contributor, simply cannot be relied upon in an encyclopedic article. I agree that the article reads poorly and that the lists need to be converted into readable prose. InvictaHOG 18:16, 29 August 2006 (UTC)

Yes, we should make the prose brilliant. But the content's great in my opinion -- Samir धर्म 02:02, 30 August 2006 (UTC)

Oh, absolutely! The content is superb and I really wish that lists weren't so frowned upon at FAC because they are quite well done. I shouldn't have said that it reads poorly - I simply meant that there is still some jargon (despite a great effort which removed a ton!) and that it needs more prose. InvictaHOG 09:03, 30 August 2006 (UTC)

"Bias towards medical experts"?! 'Alternative' medicine supported only by a few flimsy testimonials and authors out to make a buck should not be included as factual information. Until a treatment is shown to be effective in a properly-controlled, peer-reviewed clinical trial, there is no justification for including it. Samir OP, I suggest that you read the Seven Signs of Junk Science and try to come to a better understanding of what biomedical scientists and clinicians do. (Sign #2: The discoverer says that a powerful establishment is trying to suppress his or her work).

Spin2cool 19:01, 29 August 2006 (UTC)

We should all try to avoid confontational stances. The scientific method knows no credentials. If SCD is indeed an effective therapy for CD, we will eventually know. Until that time, we must recognize and acknowledge that there is little data to support it, despite anecdotal evidence to the contrary. InvictaHOG 20:10, 29 August 2006 (UTC)

I'm the first to want to ensure that there are only cited therapies in this article. I eliminated a whole heap of uncited stuff when I first edited it. Evidence comes in many forms, the best of which is a double blinded placebo ctl'd RCT. Unfortunately, this is rarely achieved for dietary therapy. Thus, we rely on the best evidence we have. There are reviewed citations on SCD: PMID 15497569, PMID 2862371, PMID 14361377 (celiac paper, but cites Crohn's data as well). There's basic science supportive evidence as well. I agree that the evidence supporting SCD is poor (but it exists). A whole heap of patients are using the diet. I think it warrants a one-line mention (i.e. The specific carbohydrate diet has also been suggested as dietary therapy for Crohn's disease). -- Samir धर्म 02:02, 30 August 2006 (UTC)

My apologies, Samir. I didn't notice that the OP was unsigned and mistook your signature for his. Corrected above. Spin2cool 02:42, 30 August 2006 (UTC)

section added by Langrl2

This heading and section were added by Langrl2 and moved here for discussion.

Recent Research

Recent research indicates that cytokines, a group of chemicals that are produced by various cells in the body, may be responsible for generating the response of chronic pain associated with Crohn's Disease. Medications that affect the release of cytokines or block the action of cytokines may reduce the response of chronic pain. Various anti-cytokine medications are now being used to treat painful disease states such as Rheumatoid Arthritis, and Crohn's Disease. In addition, research using the anti-cytokine medication, Thalidomide, is being evaluated for its effect in treating chronic pain associated with Arachnoiditis.

I've notified the user and asked him/her to join the discussion. BaseballBaby 15:08, 21 September 2006 (UTC)

Listy

The article's currently a little too listy. LuciferMorgan 22:51, 8 November 2006 (UTC)

Yes, it's unfortunate. We will have to work on that before FAC. InvictaHOG 19:44, 9 November 2006 (UTC)

So, I went ahead and did it. There's still quite a bit of work to do. I've updated the to do list. InvictaHOG 01:37, 10 November 2006 (UTC)

Research findings.

On checking the material for Crohns I was shocked to see that the BBC report suggesting a bacterial link was missing.

My own research with Crohns sufferers has shown tremendous improvements in the conditions of clients when treated for parasites.

The logic is far too simple and straightforward and asks the question why has science totally ignored this somewhat obvious cause.

The history of ulcers, IBS and Crohns are interrelated and questionable, as all the diseases while different are very similar.

There is a tremendous amount of information in resource books suggesting a bacterial link, to Crohns even MS and more.

Also note the testing for giardia a common bacterial infection, is not very efficient, some 4-5 tests are needed to prove a negative test.

Just some leads for you other researchers.

--Son of Maryann Rosso and Arthur Natale Squitti 04:44, 7 January 2007 (UTC)

Crohns: Treating the disease or the cause: Medical failure ?

In talks with a Dr. Silas Kung, a noted world leading physicist, responsible for the 'the chip', his observation was quite simple and true, "in North America we treat the symptoms, not the cause'.

Well Crohns will be a monument to this microscopic error of reasoning; half-truth logic.

What could it be ? An infection of sorts, but it seems the scientests are reluctant to disclose how little they know, or the financial pressures are on treatments, not a simple cure.

The Cause of Crohns, IBS, is an infection...a bacterial or parasitic infection, that simple....the complications can run the spectrum from diarrhea to MS...or even cancer, as the body react to the toxins, or the lack of proper absorption ...

A lead for reseachers....

--Son of Maryann Rosso and Arthur Natale Squitti 18:01, 7 January 2007 (UTC)

Interior of the Eye

The following should be reworded.

"Inflammation of the interior portion of the eye, known as uveitis..."

Perhaps the word "wall" (or a more appropriate anatomical term) might be inserted following "eye", since the uvea is part of the choroid, whereas "interior portion" suggests the innermost part, which is actually the aqueous humor. Also, the word "portion" is unnecessary, and sounds unscientific. D021317c 04:39, 6 February 2007 (UTC)

Question and comments

In paragraph 1: it states the symptoms but part of that is weight loss and diarrhea. Well some don't lose weight and constipation is there problem. So maybe these can be added into the sentence.

In paragraph 2: the age of who gets crohn's needs to add 30 through 50 year old. There are a lot, me included, who got the disease active during this time. And my question: what does the sentence "There is also an increased spouse risk, indicating a strong environmental factor" mean? Thanks,--Crohnie 20:32, 14 February 2007 (UTC)

Removed picture

I removed this image that ruined the format of the page. If anyone can find a way to fit it on the page properly, go for it. I had a good try but it just wouldn't fit anywhere without distorting the article. --Seraphim Whipp 12:13, 20 February 2007 (UTC)

H&E section of non-caseating granuloma seen in the colon of someone affected by Crohn's disease.

Weasel Tag

I added a weasel tag under the section dealing with diet cahnge because it said "some sufferers claim". Could someone who understands this section deal with it. Cpuwhiz11 13:13, 7 March 2007 (UTC)

I would not say that those words were necessarily weasel words, as reflecting upon my own problems it might be generally understood that diet may affect symptoms. It may (or even probably) be commonly accepted in the Chron's community to try and affect changes by diet. Also, there may be known/unknown food allergies which would also affect symptoms. Hence that statement may not be weasely. I think that statement perhaps needs a citation or rephrasing, rather than outward elimination. Perhaps someone who specifically understands Chron's could chime in. Nodekeeper 18:02, 15 March 2007 (UTC)

I have Crohn's and know about diet and more. I made some suggestions below about this. Diet is a very personal thing. Unfortunately, it is different for most everyone. If we can make a title about diet it would be easier to edit it. One of my pet peeves is spelling this disease correctly, would you please edit your post to spell Crohn's correctly? I really would appreciate it. Things like a food diary, tests to rule out Celiac disease and other things are also useful. But basically what is acceptable to one Crohn's patient maybe harmful to another. I have to get to bed but I would love to work this article with everyone if that is ok. I am a new editor but I don't get my feeling hurt easily, I don't like flame wars and I definitely don't mind anyone correcting me, spelling or anything else. --Crohnie 01:05, 16 March 2007 (UTC)

Prognosis

I added a little to the prognosis section. I am a new editor so feel free to change or delete or whatever you feel is appropriate, it will not hurt my feelings. I think though that what I put does add to this section. I hope others will come and join in. --Crohnie 12:59, 12 March 2007 (UTC)

Also would someone explain what is meant by "There is also an increased spouse risk, indicating a strong environmental factor." that is in the lead section? To me it reads like my husband can get crohn's because I have it.

Under symptoms

The subtitle Gastrointestinal symptoms says that bleeding does not usually occur except for crohn's colitis. This is not true. Bleeding does show up when crohn's starts the serious damage. Then the blood is different depending on where the location and how far along the disease is. If the damage is new the blood is usually red, as the bleeding gets older and it's higher up the blood turns blackish and then it gets to a point that the bleeding can not be seen with the naked eye. I'm not sure how to change this in the article so I defer to more knowledgable editors on this. Thanks,--Crohnie 13:17, 12 March 2007 (UTC)

Pic & Video of recent CT

I am a Crohn's patient and have uploaded the following still from a CT scan taken prior to surgery.

Please feel free to add this the the Crohn's article should people feel it would be helpful.

Also I have video to YouTube of the same CT scan.. I don't know if this could be included but non the less I thought some of you looking at this page would find it very interesting... I am amazed at what these machines can do.

Video of my CT scan prior to Surgery

--Jsaveker 17:02, 10 July 2007 (UTC)

Community Forums

Crohn's Disease Forum keeps being deleted from the appropriate section. There is no good reason for this to be happening.

WP:EL -- Samir धर्म 04:52, 20 October 2006 (UTC)

Crohn's Zone Support Forum was also removed. It was considered spam and thus not allowed. I wonder if this is a bad thing. I found the forum a valuable source of information and support since being diagnosed. I am not affiliated with the site. --Jsaveker 07:25, 9 July 2007 (UTC)

First, Samir I wasn't the one to delete the site you posted but I did delete the other one. But my understanding is personal websites like these are not allowed. If I am wrong, and they are not spam, please advice me with policy. I am still learning though I have been here quite a time but my learning curve do to meds for Crohn's slows me down with understanding. Sincerely, --CrohnieGal^Talk 13:06, 9 July 2007 (UTC)

Links to be avoided Okies... I have taken the time to read External Linking Guidelines and can see two sides to the coin.

Links to sites that require payment or registration to view the relevant content. - Well as it happens in order to view most of the content at Crohn's Zone you must first register. This is not to charge you but rather to enable the site owners to moderate the user submitted conent.

Links to blogs and personal web pages, except those written by a recognized authority.

Again Crohn's Zone is not a personal web page but rather a support community. It is heavily moderated.

It seems to me it is easy to interpret these guidlines either way. After all it does say "links to be avoided" as opposed to "Links not allowed". Non the less I can now understand why CrohnyGal removed the link.

Best not include these links on the page as I do not believe everybody would be in agreement.

Non the less I know better for the future in case I want to add a link.

I do have some images from my last Virtual Colonoscopy that I could upload as they gave me the scan on CD - very cool how I can zoom and pan across the animated 3d image of my bowels... still pics won't do it justice.... What are peoples thoughts on including images like that... or are we only allowed to use images out of text books?

--Jsaveker 12:33, 10 July 2007 (UTC)

Thanks for the info Jsaveker about the external links. I don't know the answer about more pictures but I bet it is cool to see your virtual colonoscopy. I haven't had that one yet but the camera pics I had were awesome. Ask someone if you can upload it here. I would love to see it. --CrohnieGal^Talk 12:53, 10 July 2007 (UTC)

Thanks, the picture is awesome. Can you make it smaller? If you can then I think you should go through the trouble and get it approved to be added to the article. Of course this is just my opinion but I think it would help the article and it shows really well with what Crohn's patient's go through. --CrohnieGal^Talk 14:27, 10 July 2007 (UTC)

Suggestion to add short bowel syndrome and diet

Short bowel syndome is very much part of Crohn's. It usually occurs because of surgeries. As for diet, maybe separating it out of where it is at would make it easier to expand on. The information I have read is both inaccurate or not complete. What I mean is that diet is a difficult thing to figure out. What is good for one person might make another have a major flare or even a blockage. You can read more about this at [3]--Crohnie 13:31, 12 March 2007 (UTC)

Does anyone have any ideas about my suggestion above? Short bowel syndrome is very real to people who have had surgery, usually multiple surgeries. I would appreciate any input on this, thanks. --Crohnie 12:08, 26 April 2007 (UTC)

Diet and Lifestyle

These two are different and need to be separated into different sections. Diet is one of the most difficult things to figure because what someone else can tolerate another may not. Also, a list of 'no' foods can change with time. A lot of times a food get put on your list of not to eat, then down the road all of a sudden you can eat it without ill affects. The [4]has great examples about diet and how to handle it. Just for the record, I am not a doctor nor scientific, just a crohn's patient. Please feel free to correct any errors I may make. --Crohnie 12:55, 16 March 2007 (UTC)

Mortality

doi:10.1111/j.1365-2036.2007.03276.x shows that Crohn's patients are 50% more likely to die than their age-matched controls. JFW | T@lk 14:24, 1 April 2007 (UTC)

The link you provide doesn't work, please try again. --Crohnie 14:48, 1 April 2007 (UTC)

The link doesn't work DOI is corect - Here's a link to the abstract. I don't have access to the whole paper to read their methodology, but it does seem to indicate that there may be a higher mortality risk from Crohn's than previously believed. Spin2cool 18:08, 1 April 2007 (UTC)

Thanks, yes I agree but it also seems to say at the end that more studies need to be done for new current practices. Interesting though, --Crohnie 20:40, 1 April 2007 (UTC)

That data seems very weak Dabomb691 01:31, 24 October 2007 (UTC)

Was this article written mostly by a GI?

The reason I ask is a lot of what is written is not what people who actually have Crohn's happen. The cramp like pain in not cramp like, it hurts and it hurt really bad, enough to change someones life. Bleeding occurs in many Crohn's patients, not just red but depending on where the damage is occurring, it can be black to not being able to be seen by the naked eye. This is just an example. Is there anyone watching and active on the article? If so, I would really like to have a conversation about this article, piece by piece. I have Crohn's disease and I have tried real hard to stay away from this article because of this but I came and read some of the article and it is just too pigeon holed to explain the average Crohn's sufferer. Not all patient's have diarhea some actually have the dreaded constipation. Not all lose massive amounts of weight (I'm not one of those) they actually are heavy in their weight. Thanks,----CrohnieGal^Talk/_Contribs 14:49, 22 May 2007 (UTC)

Also there is comments about diet and sugar and so forth not being good for Crohn's. Diet is very personal, everyone is different on what they can or cannot eat and drink. I think this should be added to the articles. Also, short gut syndrome is missing from the article which occurs a lot to patients with Crohn's who have had multiple surgeries or a surgery with a lot removed. Thanks again, ----CrohnieGal^Talk/_Contribs 14:54, 22 May 2007 (UTC)

We can work on it together -- Samir 18:13, 22 May 2007 (UTC)

Sorry Samir for taking so very long to get back to you. After reading this article over and over again I am having trouble figuring out how to make it more people friendly without changing very important information. I know there is a way to but I am at a lost as to how to make this not so scientific, I guess that's what I am having problems with. Thanks, --CrohnieGal^Talk 14:31, 10 July 2007 (UTC)

"Diet is very personal, everyone is different on what they can or cannot eat and drink." This is very true and something I can personally attest to. It should be added that everyone is very different and diet only helps SOME people. —Preceding unsigned comment added by 63.147.152.182 (talk) 08:19, 8 November 2007 (UTC)

Yes I agree, but I can't figure out how to put this kind of information into the article without it sounding like weasel words. I have hopes to be able to work on this article in the near future with my full attention. I would like to see this people friendly and even maybe it can tell people 'what' Crohn's is and 'how' it can change the lives of people who live with it and even the care givers should be mentioned. The care givers also have a lot to do when a Crohn's patient is flared or surgery is in the future or the only option is surgery, again.

Maybe we can even work in things like stress reactions to the disease and so forth. What I am saying, badly too I must say, is there should be more to this article than the genes and meds, maybe a more personal insight (I do not mean COI type) so that when reading the article you can understand Crohn's and what it feels and does to you. There are a lot of people with stomach problems that never heard of Crohn's or IBD at all. I was one of them until major surgery, just some thoughts. Please share any ideas!

My thoughts are more should be added like; short gut syndrome, diet difference between patients, adhesions and scar tissues issues, more depth about bleeding and vomitting etc. written in a way that is 'not' so scientific but still informative. Thanks, --CrohnieGal^Talk 15:08, 8 November 2007 (UTC)

Some possible ideas

First the age of 15-30 is really not correct. I know of babies who have gotten it which is not unusual to people my age when I got diagnosed with surgery at 40ish then of course it attacks people even later than this.

Another subject that can be expanded on is diet. Diet is different for everyone. What I can eat might send another Crohn's patient to the emergency room. Of course these are just some ideas to chew on. Are there editors watching this article who is willing to work with me on this article? I do want to say that I do not get my feelings hurt if what I edit is changed or deleted. I also do not do edit wars so I pretty much consider myself a pacifist when it comes to all of this. I know edit wars and arguing seem to be the norm on some articles but I would love to be able to edit here in a friendly and constructive way. I hope there are editors reading this and agree. My goal is to make the article informative so that people know what Crohn's is and how it does change the person's life.

Also, how about a section about short bowel syndrome? I think this is needed in this article. Short Bowel Syndrome happens usually via surgeries. Sometimes a lot of surgeries, sometimes just one will cause it depending on if a large amount is removed. I was staying away from this article because I have Crohn's and thought my attitude would not help here. I now think that I can add to this article in a fair honest way without my own WP:POV. Right now to be honest, it reads like a doctor wrote it, which is ok but it makes it difficult for the common person to understand a lot of it. I really would love some feed back on all of this, esp. my becoming active here. Thank you all for your time and your hard work. ----CrohnieGal^Talk/_Contribs 11:10, 12 June 2007 (UTC)

- FWIW, The age of Crohn's onset is usually described as a bimodal distribution. The largest peak occurs between the ages of 15-30 and the much smaller peak is between the ages of 60-80. It is important to remember that this is a distribution, and that does mean that there will be some cases that fall outside of the peaks, including yours.

- Diet is a complex issue, for the reasons you described. Since so little is known about how diet interacts with the disease, there isn't much to say. Any info would be anecdotal, unless you can find some papers on the subject.

- Info on short bowel syndrome belongs on its own page (which already exists). It makes perfect sense, however, to link to that page from a sentence describing how treatment for Crohns can lead to SBS.

- Spin2cool 00:57, 13 June 2007 (UTC)

Thanks for taking the time to respond to me. I will check my links about diet and see if I have anything useful. I think I do but I am not sure at this point. Thanks again, ----CrohnieGal^Talk/_Contribs 12:37, 13 June 2007 (UTC)

Pregnancy and birth

doi:10.1111/j.1572-0241.2007.01216.x - thiopurines are associated with prematurity, but this may still be a marker of disease severity rather than actually being due to the meds. JFW | T@lk 12:08, 24 June 2007 (UTC)

CCFA Links

I reverted several links to the CCFA site and an advertising/PR blurb from the CCFA (made by an IP that traces back to the CCFA). This is not an appropriate forum for advertising, and the CCFA site is already linked in the appropriate section. If you wish to add more information about the CCFA and their mission, I suggest that you create a wikipedia page for the organization. Spin2cool 18:38, 1 August 2007 (UTC)

Anti-yeast antibodies

This page lacks discussion of the potential aggrevating role of ASCA in Crohn's disease or the discussion of lectin binding deficiencies that have been found in ASCA+ patients. This is one criteria missing from the table, Crohn's disease is associated with ASCA and ulcerative colitis has rather low levels. If you pubmed Crohn's and ASCA you will get 127 hits, with Crohn's and yeast 207 hits. This is obvious an area where the article is deficient relative to the literature.Pdeitiker 22:18, 23 August 2007 (UTC)

Absolutely. I've always wanted to add serology to the article -- Samir 05:58, 24 August 2007 (UTC)

The lead

I think the lead is too long and it's supposed to tell the reader what the disease is. I personally think that it's too in-depth and even too medical for the common reader to understand what Crohn's is. The comment that it attacks young people to older people is also incorrect these days. Please read and see what it is trying to say, though I don't think I am saying it too well. Also, many do not lose a large amount of weight. --CrohnieGal^Talk 12:06, 24 August 2007 (UTC)

I would also love to see the article written so people understand it. I for one don't understand a lot of what is said. --CrohnieGal^Talk 12:07, 24 August 2007 (UTC)

I've wanted to do that for a while. I wish I had more time. -- Samir 04:10, 25 August 2007 (UTC)

Thank you for you quick response to me. I will try to find time to do it too. Real life events have taken a lot of my time lately but I will try to get to this and make it reader friendly as soon as I can. Were you able to see the info in the last magazine that was sent out to me? Of course you know you have to sign up to CCFA to get to the articles. If you have problems please let me know and I will email it to you or you are welcomed to email me, if you would like. You being a GI, I know this magazine will be great interest to you. I plan on hopefully soon to be able to put some of this new info into the article, time allowing of course. Also, the CCFA site has a lot of good new promising things happening. --CrohnieGal^Talk 11:49, 25 August 2007 (UTC)

Worked lead a little bit, but I have to CD rash

I have been dealing with a nasty rash, would pictures be appropriate? I am using Benedryl for the itchiness, 150 mg, and a steroid cream and an antibiotic cream. The rash has been on going since Feb of this year. The dermatologist also had me on a antibiotic, though right now I can't remember the name of it. Would putting this info into the article about rashes be appropriate? I know the name of both of the creams as I a still using them multiple times a day. The antibiotic name I can probably get off my insurance list of medications. This rash is annoying, itchy and at times very painful but it is not PG. The dermatologist said that this rash is a common rash for Crohn's patients and that stress can be a big trigger to set it off. (I got it originally when my husband had a heart attack.) If you want, you can respond here, my talk page or even email me. I would really like to work with you on this article. --CrohnieGal^Talk 12:23, 25 August 2007 (UTC)

Nightshade

I removed text that proposed nightshade as a causative agent for multiple reasons. The first is that it was uncited. The second is that it appeared to be a self-promotion for a book. If you'd like to re-add the info, please provide appropriate citations to peer-reviewed research that links nightshade to CD. Spin2cool 02:11, 4 September 2007 (UTC)

Bacterial Link

The bacterial link to Crohn's Disease is already covered, farther down in the section. Most of what you added was redundant. That said, some of it was also inaccurate. The current state of knowledge seems to be that invasive bacteria take advantage of defective microbial clearance. Thus, the bacteria are not causative of Crohns, but rather opportunistic pathogens.

It's also misleading to link any one bacterial species to CD, as several studies have implicated different species, including Enteroadherent and invasive E. coli and MAP. In the most recent and most comprehensive bacterial survey of Crohn's patients, specific strains of E. coli were found to be linked to the disease, but neither MAP nor other suspected pathogenic bacteria were found Nature article Spin2cool 02:11, 4 September 2007 (UTC)

The statement that "neither MAP nor other suspected pathogenic bacteria were found" is factually inaccurate [5][6]. The confusion comes from the fact that different studies have looked in different areas for MAP bacteria, MAP is difficult to culture and requires different staining techniques to see it, there are 2 forms of MAP, and many older less precise studies were done which pop up from time to time. MAP is an obligate pathogen that seems to live in the lymph like tissues of warm blooded animals. Furthermore anti-MAP treatment regimes have been used with great success[7]. One reason MAP is so often implicated is that patients can go into permanent remission form use of anti-MAP drugs but not all antibacterial drugs work against MAP. You may have been reading studies older than a few decades ago before effective anti-MAP treatments were available. Another reason MAP is so often implicated is because the symptoms are often indistinguishable from intestinal TB[8][9][10]. If only 20% of patients went into long term or permanent remission from anti-MAP treatment then other possible explanation would be necessary, or a better treatment design would be necessary. However; anti-MAP treatments when done properly can give greater than 90% remission from those that are able to comply with treatment and more than 80% overall long term remission. Some interesting links follow [11][12][13]. —Preceding unsigned comment added by Halej (talk • contribs) 03:58, 9 June 2008 (UTC)

The nature link seems to be broken as well. —Preceding unsigned comment added by Halej (talk • contribs) 03:59, 9 June 2008 (UTC)

Pregnancy

A write-up on CD and pregnancy would be helpful, especially since CD can affect the vulva and perineum. The article on caesarian notes that CD may be an indication for C-sections. Perhaps more could be included here.--Westendgirl 06:00, 7 September 2007 (UTC)

I added information about pregnancy today at [14]. Maybe it's time to set up a title about Crohn's and pregnancy. I know there is a lot of information pro and con about this esp. about the use of medications etc. --CrohnieGal^Talk 20:18, 7 January 2008 (UTC)

The object of external links is to add....

External links are to add information for the reader to locate things. [15] is a great community but not for Wikipedia of course not unless it is part of the article. WP:EL says to keep external links down as much as possible so we don't have the reader leaving Wikipedia. Sorry, but other policies also apply as far as I know and the External links area is quite long. --CrohnieGal^Talk 20:52, 24 September 2007 (UTC)

Incidence and patterns

A small series from Wales shows that incidence of CD continues to rise slowly, but also that the disease pattern continues to favour the colon over the small bowel. doi:10.1111/j.1365-2036.2007.03576.x JFW | T@lk 21:15, 22 November 2007 (UTC)

IL23R

doi:10.1111/j.1572-0241.2007.01661.x and doi:10.1111/j.1572-0241.2007.01660.x - IL23R and ATG16L1 linked... JFW | T@lk 15:28, 2 December 2007 (UTC)

doi:10.1111/j.1572-0241.2007.01525.x - whoa, the evidence is piling up. JFW | T@lk 19:01, 2 December 2007 (UTC)

Disability

About 5% of Crohn's patients are completely unable to work. Those with a low QOL and frequent relapses are the most likely to land in this category doi:10.1111/j.1572-0241.2007.01561.x JFW | T@lk 23:32, 12 December 2007 (UTC)

I am one of those who can not work do mostly to blockages and chronic pain issues. Trying to get help though is almost impossible without the help of a doctor and an attorney. I plan on doing this a week form today so maybe I'll have some info to update. --CrohnieGal^Talk 20:12, 7 January 2008 (UTC)

Bowel Resection Photos

I had 20 centimetres of my small bowel resected last Friday, as well as a bit of the large bowel and the appendix (not shown), and I was wondering if the article needed some stronger images to show how bad the disease can get in patients who have surgery as their last option like I did.

http://i163.photobucket.com/albums/t297/kowbrainz/bowel2.png

http://i163.photobucket.com/albums/t297/kowbrainz/bowel1.png

Basically any part which isn't a lush pink colour like new strawberry bubblegum is inflamed to some extent, whether it be the bloody red bits, the yellow or the black parts. The metal tool indicates a fistula which was present in the side of the bowel.

If the images are considered too strong for general audiences, then that's fine. If not, then feel free to upload them again to Wikipedia by all means.

Thanks,

Nathan —Preceding unsigned comment added by 124.169.87.225 (talk) 09:00, 14 December 2007 (UTC)

I personally think the photos are appropriate for the article. I didn't get to see what I had sectioned out but your pictures sure hit home with me. You have to go through the acceptance to release the photos for use. I did that, with help from my mentor, of my rash. I hope you are doing better now. I just got out of the hospital so maybe when I get my records I will be able to see what the tests showed too. Better health to you and happy editing. --CrohnieGal^Talk 13:36, 14 December 2007 (UTC)

Question

What is this template for? eDigestive system - Gastroenterology (primarily K20-K93, 530-579) What use is this template? --CrohnieGal^Talk 18:49, 7 January 2008 (UTC)

Good question... The {{Gastroenterology}} template was made by WikiProject Medicine, it looks like, (it's their template for GI-related illness articles to cross-reference between them) and I'd ask them about it. I've found their templates useful on other articles. Note that all but the top line is hidden until you click on "show", so it may not look useful until you do that. — CJewell (talk to me) 01:39, 17 January 2008 (UTC)

I'll move it under "See Also", however, it doesn't contain external links... — CJewell (talk to me) 01:41, 17 January 2008 (UTC)

A couple of things; first I think there are way too many charts. Second, I did like you suggested and checked what was linked. I checked only one article that was linked and it was to a band, which I don’t understand any connection unless it’s to show that a member of the band is dealing with Crohn’s. If that’s the case, I didn’t read the article, and then we could put in the body of the article this kind of thing. It just doesn't seem useful at all for this article. On the bottom of the article it lists other articles so IMHO; this seems like duplicating. Personally I think it should be removed.

Another idea is adding to the article about people who have CD and still can move on into there profession might be useful. When someone with Crohn’s sees a list or something of people who continue with their profession is uplifting. This is just a thought… --CrohnieGal^Talk 16:34, 17 January 2008 (UTC)

External link

I added the Crohn's Colitis Foundation of America and I plan to add more later.--CrohnieGal^Talk 18:53, 7 January 2008 (UTC)

Serology

I was recently found to have Crohn's and I have noticed that this article doesn't seem to have any information about the highly accurate serologic blood tests now being used. That was the very first test my doctor initiated. He found I had the positive serologic markers for the disease (Prometheus IBD Serology; that are 98% accurate), severe anemia of a megaloblastic nature (an astounding feat for a person with beta thalassemia, to go from very small red blood cells to gigantic), elevated liver, and a normal sedimentation rate. My colonoscopy and barium swallow both came back normal only for the wireless capsule endoscopy to reveal extensive damage in the small intestine. My symptoms were loose bowel movements at a rate of one every hour for about a year, blood in my stool, tingling sensation of the fingers, sores in my mouth, fatigue, dramatic increase in nummular dermatitis, and inflammation of the eye. And he believes it to be related to my mother's multiple sclerosis. 71.219.78.10 (talk) 07:02, 11 January 2008 (UTC)

Glad you got the diagnosis; hopefully along with that you'll get some relief of your symptoms with treatment. Thanks for asking about serology. Those tests are actually complicated, because their value is in part determined by your doctor's a priori estimate of your odds of having Crohn's. (See positive predictive value for more info.) Serology can be useful, but it still can't make the diagnosis just yet (at least that's what I was taught in med school this week - what timing!?). Anyway, this probably means that it's even more important to get a good serology section in this article. If I ever get my life/free time back, I'll help out. Antelan ^talk 07:33, 11 January 2008 (UTC)

First let me say I am glad you got diagnosed. It took me over a year and emergency exploratory surgery for my Crohn's to be seen and I had all the tests. I didn't have the camera back in '00-'01 as the camera was not available for me at that time. In a way since I had totally dead tissue which the surgery ended up removing half my small bowel, cecum valve and over 12” of small intestines. The camera would have gotten stuck in me putting me in surgery anyways to remove the camera. Keep in mind that not all tests, including the blood work shows the problems. I had my blood taken many times, had around 4 scopes, 5 barium enemas, many cat scans and so on. None of the tests showed the damage. When I asked my surgeon about taking all these tests and nothing showing up he told me that a colonoscopy was about 75% successful at showing the problems. All the other tests were even lower in percentage. I believe he said that bloods and barium tests were at about 50% accuracy. So, I'm really thrilled it helped up but if you research Crohn's you will see that everyone is different with everything from what you can eat to even how helpful the available tests are. Frustrating? You bet! I have had three surgeries since my '01 surgery and I have another one knocking on the door for me that I am delaying for as long as possible. I would like to see this article more informative and more 'people friendly' than it is now, which is what I am trying to do. If you can help add more to this article so that anyone can come to this article and understand better what CD is. To me it's too medical and is better understood by professionals or people with a good scientific background, which I am not! :) --CrohnieGal^Talk 20:48, 21 January 2008 (UTC)

The prometheus test is appropriate only if it is known that the the patient has inflammatory bowel disease. Then it can help distinguish Crohn's and UC. It is not 96% accurate, however. I think the last numbers was around 80% accurate. It does not prove or disprove the presence of Crohn's or UC. Kd4ttc (talk) 21:14, 9 March 2008 (UTC)

"Proprioceptive Therapy" - should this not be deleted ?

"An Alternative Therapy.... claimed to reverse the anterior rotation of the hips, which in turn, is purported to decompress the intestines and colon..... Since 1950, there is not a single peer-reviewed publication demonstrating any effect of this therapy in Crohn's Disease".

==>This sort of nonsense is surely offensive, and even potentially mis-leading to Crohn's patients, and I suggest that it be deleted. At a minimum, it is totally irrelevant to disease treatment today. io-io (talk) 01:12, 22 January 2008 (UTC)

The section was originally added by someone promoting the theories of a doctor in Italy:^[16]

• Wikipedia talk:WikiProject Spam#Help with user 84.222.140.56 (permanent link)

I will remove it. --A. B. ^(talk) 21:31, 23 January 2008 (UTC)

Thank Youio-io (talk) 17:46, 24 January 2008 (UTC)

Natalizumab's side effect profile regarding individuals with MS - relevant here?

Should the side effect profile of natalizumab as it relates to treating multiple sclerosis be included in this article? Io-io has inserted it into this article (As of late December 2007, more than 21,000 MS patients were receiving natalizumab mono-therapy without a single incidence of PML occurring.). It is my opinion that this, at best, belongs in an article about natalizumab. Placing it on this page strikes me as promotional, especially since it is out of place, discussing individuals with MS, not individuals with Crohn's. What do others here think? Antelan ^talk 02:14, 22 January 2008 (UTC)

I have debated this with Antelan. The problem was that before I added this, there were 5 lines on natalizumab as the newest therapy, and a further 5 lines why it was russian roulette to use. It reads more like media sensationalism than a reference encyclopedia.

It would be unbalanced to describe that the Drug is "linked" (rather spuriously now) to the PML issue, which is totally independent of the underlying disease, Crohns or MS, without giving this actual in-practice update. If that update had been different, say several cases of PML, then it would never even have been approved for Crohn's (which it just was, last week). Also the "link" to PML was found in MS first, and in combination-therapy only (when used with other immuno-suppressive drugs) - the actual practice (to date, in MS) has been in mono-therapy as is required by the FDA.

The other imbalance is that near the top of the page there are biological drugs mentioned (Remicade and Humira), and these have proven in practice to be at least as dangerous as natalizumab, in fact with dozens of fatalities - however there is no mention of that, nor any citations provided as to their clinical results or practice.

However I see that there are links here to 2 other pages: "Main articles: Treatment of Crohn's disease and Biological therapy for inflammatory bowel disease" - and perhaps most of the natalizumab safety material should be moved there, as both pages are anyway well out-of-date in this respect.

io-io (talk) 23:07, 22 January 2008 (UTC)

Sorry I know I am late to respond. I think some of this article can be moved over to the other articles mentioned, but I have to read them in total to know for sure. I just know that medication comments in this article seem to be scattered about which I commented on in another thread here. I hope the two of you come back here to edit, I sure could use some help. I've been trying to make the article so that people who do not know what Crohn's is understand from reading the article and so far it's not there. I have asked others to read the article and they still didn't know what Crohn's is other than painful if not in remission and that there is no cure for it. Thanks, --CrohnieGal^Talk 14:39, 12 February 2008 (UTC)

The PML issue should be briefly mentioned in the Crohn's article. Cases of PML have been a definate chill in the Crohn's treatment community. Also, it may be that it is a pediatric problem and may relate to concomitant use of azathioprine. Leaving it only in the natalizumab article would bury it. However, it doesn't need a full story here. A line along the lines of "natalizumab has been rarely associated with a deadly neurodegerative disease (see discussion at natalizumab)" would serve to alert the interested reader while keeping the main discussion at natalizumab. Stephen Holland, M.D. (Gastroenterologist) Kd4ttc (talk) 21:11, 9 March 2008 (UTC)

I agree with the 2 points raised - the PML issue is not specific to N, and the description should be very brief..... io-io (talk) 23:20, 11 March 2008 (UTC)

History section

Should it talk about Dr. Crohn and his collegues and then explain the others? It seems backwards in reading it. Thoughts? --CrohnieGal^Talk 14:28, 12 February 2008 (UTC)

Looks like it is written in chrono order, which makes sense to me. The whole section could definitely be expanded, and the referencing is less stringent - CCFA could be a source as could other official governing bodies' websites. WLU (talk) 16:41, 15 February 2008 (UTC)

Brand names of drugs

WLU, why do you object to using brand names in the article?

I realize that there are objections to commercial promotion.

But giving both generic and brand names makes it easier for the reader to understand the article. That outweighs any other consideration that I can think of.

For some drugs, like Adriamycin, the brand names are incorporated into standard treatments, like CA (cyclophosphamide, Adriamycin). You can't understand what doctors are talking about if you don't know the brand names.

Even the NEJM has started to give brand names now.

I'm not aware of any WP policy against it. On the contrary, we use brand names all the time.

Can someone come up with a good objection? Or should we add the brand names back? Nbauman (talk) 17:22, 14 February 2008 (UTC)

Note that I've moved all the medication to the Medication section, out of the lead, and replaced it with a generic summary of treatment. Adding the specific drugs to the lead doesn't seem necessary, and we would have to include all other types of treatment to balance things out - which would make the lead much longer.

I think that the use of brand names is not necessary, as the name will be mentioned in the lead of the specific drug's page, and the drugs themselves are wikilinked. I see the brand names as a type of spam, but I'd like some guidance on this as well, though MEDMOS doesn't seem to say anything. I would object to adding the brand names back, but I've brought this up at Wikipedia talk:Manual of Style (medicine-related articles)#Drug names in non-main articles and with Jfdwolff as well, though I'll point him to TALK:MEDMOS to centralize the discussion. WLU (talk) 16:54, 15 February 2008 (UTC)

One can use the notation "Brand name ( nonproprietary | Manufacturer )" to include both. For example, Imuran (Azathioprine|Prometheus Labs) would be a full description of a drug. Kd4ttc (talk) 21:19, 9 March 2008 (UTC)

Changes to lead

WLU has made major changes to the lead, for example deleting all references to drug treatment and moving it to the bottom.

I think that drug treatment is important information that people reading this entry want to know, and the names of major drugs belong in the lead.

Comments? Nbauman (talk) 21:03, 15 February 2008 (UTC)

Actually, the only changes I had made to the lead was to remove the specific discussion of 'medical treatment' (which was actually 'drug treatment' and didn't mention lifestyle, hookworm or surgical options). Just before posting this message I made some wording tweaks, added a wikilink and a citation template.

There's now an internal wikilink to the treatment section below. The lead should reflect the rest of the page; there should be an overview, not a detailed summary of one aspect. A discussion of all the specific drugs to treat Crohn's disease is a bit odd to me in the lead, and to do something similar with the rest of the page we would have to summarize all the tests to diagnoses Crohn's, all the symptoms, everything related to the causes, and put in something about the epidemiology. Also, citations in the lead are (or should be) unusual as the information and citations should be in the body of the page, not the lead. If people want to know the treatment options, there is now a main link to the Treatment of Crohn's disease page, which will give far more information, and in greater detail, than the CD main page ever would or should.

If Nbauman or anyone else thinks that my reading of Wikipedia:Lead section is off, or thinks there is a better way, I am happy to discuss. WLU (talk) 21:38, 15 February 2008 (UTC)

I think the main Crohn's disease page should have a useful summary of major treatments. It's not an acceptable alternative to link to the Treatment of Crohn's disease. Even if it were true in principle, the Treatment of Crohn's disease page has a long way to go before it will be a useful, or usable, page.

Take for example natalizumab. Treatment of Crohn's disease classifies natalizumab under "Research on medications in progress", along with drugs that are in Phase II or less. It places natalizumab below "Helminthic therapy," which according to the link is in proof-of-concept stage. Furthermore, it doesn't cite the Cochrane Collaboration study, which is the most reliable source of meta-analyses and evidence-based medicine that I know. (Even the NEJM has reviews by doctors with financial interests in the drugs they write about; Cochrane doesn't.)

Natalizumab is approved by the U.S. FDA, and evaluated as an effective therapy by the Cochrane Collaboration. An article that gives less emphasis to an approved, effective therapy than it gives to experimental helminthic therapy violates WP:WEIGHT.

My point is that an entry like Crohn's disease has to stand by itself, with a summary of all the most important information that an ordinary reader would want, including a summary of current treatments. Wikilinks are supplementary. It's not a valid argument to delete things and say that the reader can follow the links to that material in other articles in Wikipedia, when those other articles are in such a bad state that most people wouldn't be able to find that important information, or the information isn't in there at all, and when the more detailed articles might not be as up to date. Wikipedia is not a maze.

When I write an article, I don't write for my own benefit, I write for the benefit of my readers, the kind of people on this talk page. I'd like to know what they think. Nbauman (talk) 23:11, 15 February 2008 (UTC)

The Crohn's disease page has a treatment section in Crohn's disease#Treatment. The link to the main article on treatment in the lead is there because it is the most useful of all links to put in that spot. The section on treatment has a link to the main article, and a brief summary of the treatments available. The article does not give more weight to helminthic therapy - helminthic therapy is its own section because it is the only section on treatment using microorganisms (I assume, I didn't write it). In my mind, natalizumab is one treatment among many, and shouldn't be given too much weight (as in its own section or an extended discussion) because it's recommended as a second line treatment, not first.

If you have an issue with the main treatment page, feel free to edit it; it's easy enough to reorder. But really that discussion belongs on talk:Treatment for Crohn's disease, not this one. You don't have to convince me of this, I don't particularly care about the order of that page. And I haven't deleted anything, I moved something out of the lead, into the appropriate section.

Unless I missed something in my rewrite of the Natalizumab page, it's not worth putting in the lead. Am I missing something of its importance? You seem to consider it very important, but from what I've read on that page it is a slightly more useful medication than some of the extant ones, but with considerable risk of potentially lethal side effects. WLU (talk) 23:40, 15 February 2008 (UTC)

If Nbauman told you that natalizumab was approved for Crohns, then why suggest it has "considerable risk of potentially lethal side effects"? It is also a new class of Drug (both Remicade and Humira target anti-TNF alpha), and should be an option instead of surgery and obvious downsides to that....io-io (talk) 23:20, 11 March 2008 (UTC)

That reading was based on my initial assessment of the drug over three weeks ago; now I realize that the risk of lethal side effects are currently considered minimal and primarily in conjunction with other drugs. And my initial point was, natalizumab is one treatment among many. I see no reason to single it out in the lead with a sentence or part of a sentence when on this very long page, it occupies only one section and does not appear to have revolutionized treatment for Crohn's disease. If it has, and this is documented in medically reliable sources, then this should be easy to demonstrate and the page should reflect this change. You seem to think I have some sort of medical expertise - far from it. I'm not a specialist, I'm frequently wrong about factual information (less so about wiki-specific topics), and if this is demonstrated by a reliable source, I edit accordingly. But I'm not the boss of wikipedia. If I'm horrifically mangling pages with malicious intent, perhaps WP:ANI is the place to go. WLU (talk) 10:40, 12 March 2008 (UTC)

You can see what Kd4ttc wrote 9th March on N and PML by scrolling up the page.....io-io (talk) 23:43, 13 March 2008 (UTC)

Infobox caption

The reason I tried a different wording in the infobox is because on my browser everything in the third line of text is cut off. Is it a direct quote? Can the picture be adjusted? Am I unique in this problem? WLU (talk) 22:04, 15 February 2008 (UTC)

What's your operating system and browser version? Maybe who knows Wikipedia markup better than we do can fix it. Nbauman (talk) 22:34, 15 February 2008 (UTC)

Colon Ca example misleading

The colon ca shown is an adeno ca arising in uninflammed colon. Ca in Crohn's often develops from flat lesions. The Ca shown here is atypical for colon ca associated with Crohn's. It is a nice pic of an advanced adenoma, early colon ca, though. Kd4ttc (talk) 05:50, 18 February 2008 (UTC)

It's pretty difficult to get pictures for pages like this one that are GFDL-compatible. Though calling for a better one isn't a bad idea. If you're certain of the issues with the picture, feel free to adjust the caption to reflect this. WLU (talk) 12:45, 18 February 2008 (UTC)

I understand. Luckily, I don't see much Ca in my IBD patients, sending the occasional patient at the dysplasia stage. Rather than confuse the public on this fine point let's just keep an eye out for something we can use. Kd4ttc (talk) 17:52, 18 February 2008 (UTC)

It's a pretty obscure topic (someone with two very specific comorbidities), so good luck. You could try the Commons perhaps. I'm surprised to see it at all, it's the rare doctor who would ask "by the way, can I throw a picture of your colon cancer on wikipedia?" That's ballsy. WLU (talk) 18:00, 18 February 2008 (UTC)

If I get a pic I'll post it. More likely now is to see dysplasia in a dysplasia associated raised mass, known to us obscure IBD people as a DARM. I've got a few pics up on wikipedia. I'm proud of my polypectomy resection seen there. With no patient ID it works well, and I encourage other docs to put their pics here. I guess Ballsy is as Ballsy does. Kd4ttc (talk) 17:50, 22 February 2008 (UTC)

SCD diet

A claim popped up here about the SCD diet. No one in clinical medicine uses it. The reference that was added was malformed. The SCD diet does come up on a lot of lists for IBD treatment, so mentioning it is reasonable. The reference and discussion would be better if it were on the SCD diet page, which this article links to. Kd4ttc (talk) 17:46, 22 February 2008 (UTC)

Fixed the reference and added pubmed number. There's no abstract, so I can't tell what the article is actually about. If the citation says there is no evidence it works, why is it here? This is the second time this has been spammed to the page. If there's no evidence it is useful for CD, I agree it should be removed. WLU (talk) 18:00, 22 February 2008 (UTC)

Autoimmune Disease & "Classification"

Looked odd that this was barely mentioned, its listed even if Wiki's own list as a confirmed Autoimmune Disease (rather than suspected). I know its not in MeSH as such. Many autoimmune sufferers have another disease plus Crohns, is it not beyond doubt? I editted. Also under "Classification" it actually attempts to categorize (would that be a better word in text) the different kinds as they present....io_editor (talk) 03:02, 2 April 2008 (UTC)

Famous people with IBD

I deleted an edit about a famous person with Crohn's disease because of how it was written and lack of any citations. Saying that though, I think a section of famous people could be included and actually did some quick research, though I think more can be located. "here" is a list of famous people, now would a section about this be appropriate or would a category be more appropriate? Thanks for any inputs, --CrohnieGal^Talk 15:12, 12 May 2008 (UTC)

Awhile back on the MedMOS, many were arguing that we should try to keep "famous people with X" out of these articles. The idea is that it doesn't really tell you anything about the disease. For some diseases, we have "list of people with X" in their own separate articles. Antelan^talk 15:14, 12 May 2008 (UTC)

Thanks, good point that I didn't think about other than my own perspective. I see putting them in as proof that even people with chronic disabling diseases can still go on to see their dreams come true. --CrohnieGal^Talk 15:25, 12 May 2008 (UTC)

Hey, I hadn't considered that perspective. Good point to you, too! Antelan^talk 15:26, 12 May 2008 (UTC)

Three edit conflicts in a row, what are the chances?

Ya, agreeing with Antelan's original point - Wikipedia:Manual_of_Style_(medicine-related_articles)#Notable_cases has guidance. Lack of citations is a very good reason to delete, and insist on deletion without good sources per WP:BLP. You could always start the suggested 'list of' page, but they're usually spam/trivia magnets and I see them as only useful when you've a wager riding on who has x condition. There's lots of precedent for 'list of' pages, so if anyone wants to create one, as long as its sourced there's no reason not to. I wouldn't do it myself, but that's 'cause I hate lists in general.

I will note that your (Crohnie's) reason is not really the reason wikipedia exists, but one can, through careful wording, create a page or section that fulfills your purpose while being in keeping with wikipedia's purpose. But always wikipedia's policies and guidelines must come first. I don't know however, if the foundation's webpage would be sufficiently reliable and that's possibly a question for WP:BLPN. I don't do much work on BLP so I can't unfortunately help. Obviously however, WP:NPOV requires neutral reporting, so it would have to reflect that the people have CD and not 'and look what they've done'; the only real detail I could see that could be included as an extra is how the disease has actually affected their personal or professional lives. WLU (talk) 15:32, 12 May 2008 (UTC)

Thanks guys, it gives me a way to research this without my own POV becoming an issue, which I always try to keep out but it's honestly hard to do.  ;) I think that if it does become part of the article then the last part of what WLU says about how the disease affects the personal and professional lives would be the way to attempt it. I will have to think about this some more and do some more research on this area as I am aware that some of them had major battles with the CD to over come to be able to continue their roads to success and/or remission/control of the disease. Thanks to both of you for your input. --CrohnieGal^Talk 17:43, 12 May 2008 (UTC)

See also section

I removed the two sections about incontinence since I didn't see anything useful for this article. Please feel free to put them back in if there is something I missed to show the connection someone was trying to make.

Also, a suggestion, I would like input about the three new sections about MAP. The information is good to me but instead of just external links in the 'see also' shouldn't these be put into the article explaining the possible uses MAP has for Crohn's patients? Just a thought, though I am also unsure if the three links should even be in the 'see also' section.

I guess what I am trying to say is I would like others input on this prior to adjusting the article. Which section would "MAP" even go into or would it have its own header? Thanks in advance for any input. --CrohnieGal^Talk 11:23, 13 June 2008 (UTC)

JAMA historical

http://jama.ama-assn.org/cgi/content/full/300/4/439 - Burrill C. and his bunch in the historical spotlight. Unsure if the PDF of the original paper is free. JFW | T@lk 22:47, 22 July 2008 (UTC)

Bot report : Found duplicate references !

In the last revision I edited, I found duplicate named references, i.e. references sharing the same name, but not having the same content. Please check them, as I am not able to fix them automatically :)

• "Bernstein" :
  • {{cite journal | last = Bernstein | first = Charles N. | year = 2006 | month = July | title = The Epidemiology of Inflammatory Bowel Disease in Canada: A Population-Based Study | journal =The American Journal of Gastroenterology | volume = 101 | issue = 7 | pages = 1559–1568 | doi =10.1111/j.1572-0241.2006.00603.x | pmid = 16863561 }}
  • {{cite journal | last = Bernstein | first = Michael | coauthors = Sue Irwin and Gordon R. Greenberg | year = 2005 | month = September | title = Maintenance infliximab treatment is associated with improved bone mineral density in Crohn's disease | journal = The American Journal of Gastroenterology | volume = 100 | issue = 9 | pages = 2031–5. | doi =10.1111/j.1572-0241.2005.50219.x | pmid = 16128948 }}

DumZiBoT (talk) 11:48, 8 August 2008 (UTC)

Cause, cure and genetics.

I was sure there was a source that pointed to a 'bacterial' cause, as was the case with ulcers.

It appears the whole 'intestinal system' diseases are merely flaws in testing.

As to the genetic component, seems people of a 'Genetic' background would be more suseptible to diseases that, so this 'genetic' flaw is really a half-truth.

Listeria, or giardia difficult to detect, can cause related problems. There are links about, and it is important to find them.

--Caesar J. B. Squitti  : Son of Maryann Rosso and Arthur Natale Squitti 03:42, 10 September 2008 (UTC)

Here is a link suggesting a bacterial link.

Research: Bacterial Infection Linked to Crohn's Disease (Is Bacteria the Cause of MS?)

By the way, China and Africa supposedly do not have IBS or Crohns ? Interesting...?

IBD and Crohns High in Alberta Canada

I truly believe research is being corrupted into simple causes, and allowing the disease to exist.

--Caesar J. B. Squitti  : Son of Maryann Rosso and Arthur Natale Squitti 03:50, 10 September 2008 (UTC)

There is no known cause as you know and putting in that there are isn't acceptable to Wikipedia. Your links above do not show that bacteria is the cause or cure of Crohn's. They also speculate that the reasons that IBD is not prominent in other counties may be do to lack of medical care and diagnoses. Your last ref states that there is no known reasons here "There are theories, but at this point we're not really sure what causes IBD," Fedorak said. "I truly believe research is being corrupted into simple causes, and allowing the disease to exist." this comment does not factor in to making a good article. Please do not add this information to the article. I remember it was deleted and you were asked not to put it back in. You think it's half truths but your personal opinions about bacteria doesn't belong in the article, sorry. Also giardia can be tested and found. --CrohnieGal^Talk 14:07, 10 September 2008 (UTC)

Neither of those sources meet the high standards required of medical pages (see WP:MEDRS). Wikipedia is about verifiability, not truth; in this case verifiability requires high-quality sources, which means medical journals. Try looking on pubmed to see if the UAlberta researcher has published anything, but based on those sources there is no reason to change the main page. WLU (talk) Wikipedia's rules^(simplified) 17:49, 10 September 2008 (UTC)

Thank you for the opinion.

1. How can China and Africa afford better medical care and diagnosis ? 2. Co-incidently having spent some 18 years with an 'undetected intestinal infection' the experience has left me for an insight into the system's inability nor desire to find a treatment. You and I are making assumptions. They, the drug companies, like the cigarette companies are in business of what ? 3. I am glad to see the Canadian governemnt moving to remove the pharmaceutical drug influence.schools and journals fight drug industry influence 4. There is a strong influence on many publications to include or not include research. Remember many researchers are sworn to alligince and secrecy. 5. A section should add 'the possibility' and secondary sources given the corruption in the whole medical field. If China and Africa can cure the disease why can't North America. Its a different system, a sysetm that rewards diseases....

Sad to see that the 'bacterial link' is missing...then again, let history record this.

--Caesar J. B. Squitti  : Son of Maryann Rosso and Arthur Natale Squitti 00:02, 12 September 2008 (UTC)

Talk pages are for discussing changes to the main pages. Please do not use them to soapbox. If you do not have any suggestions or sources to back up your original research, there's no point in continuing this conversation. WLU (t) (c) ^{(rules - simple rules)} 13:35, 12 September 2008 (UTC)

There are sources, and even a reference to theories is merited.

The Cause for a cure for Crohsn Disease

[http://www.cbc.ca/cp/health/080911/x091102A.html Medical sch ools and journals fight drug industry influence]

Seems the references are one sided ? Why? --Caesar J. B. Squitti  : Son of Maryann Rosso and Arthur Natale Squitti 13:57, 12 September 2008 (UTC)

Incidence in siblings

The article has a line somewhere about siblings of a person with crohn's being 30 times more likely than the general population to develop the disease. The problem is, it doesn't say what the incidence in the general population is - so how do we know the odds that '30 times more likely' equates to? Is someone familiar with the proper figures and could maybe put it in the form of, say, 'A person whose sibling has Crohn's has a 1 in *number* chance of developing Crohn's'?

(This is actually the question that I came to the article looking for the answer to). —Preceding unsigned comment added by 61.9.146.23 (talk) 00:27, 17 September 2008 (UTC)

Credibility of sources ?

Soapbox hidden by WLU (t) (c) ^{(rules - simple rules)}

<span id="Soapbox hidden by WLU (t) (c) ^{(rules - simple rules)}"> In Canada the government has moved to remove the influence of drug companies on the medical system. "The influence that the pharmaceutical companies, the for-profits, are having on every aspect of medicine ... is so blatant now you'd have to be deaf, blind and dumb not to see it," said Journal of the American Medical Association editor Dr. Catherine DeAngelis[Medical schools and journals fight drug industry influence Medical schools and journals fight drug industry influence]

If China and Africa, using old traditional practices can treat this disease what is it about the North American system.

A word of caution to accept what you read, and note any conflict of interest...'sockpuppets' as you call them in wikipedia.com

--Caesar J. B. Squitti  : Son of Maryann Rosso and Arthur Natale Squitti 00:11, 12 September 2008 (UTC)

Again, there is no suggestion on how to change the main page, and that's not even a source. Please do not use wikipedia for advocacy, this is not your mouthpiece. WLU (t) (c) ^{(rules - simple rules)} 13:38, 12 September 2008 (UTC)

Incidence in siblings

The article has a line somewhere about siblings of a person with crohn's being 30 times more likely than the general population to develop the disease. The problem is, it doesn't say what the incidence in the general population is - so how do we know the odds that '30 times more likely' equates to? Is someone familiar with the proper figures and could maybe put it in the form of, say, 'A person whose sibling has Crohn's has a 1 in *number* chance of developing Crohn's'?

(This is actually the question that I came to the article looking for the answer to). —Preceding unsigned comment added by 61.9.146.23 (talk) 00:24, 17 September 2008 (UTC)