Patient: At the beginning of this year, a colonoscopy for diarrhea revealed a recurrence of Crohn’s disease, which later led to a fistula at the original anastomosis and surgery at your hospital on May 4. 20 cm of small intestine was removed, and now there are ulcers in the colon and 15 cm of narrowing in the small intestine.
Laboratory tests, August 21: blood sedimentation 8, C-reactive protein 1.04 (0-6.8), liver function transaminases elevated, low percentage of neutrophils
After the operation, he was treated with 3 bottles of Rexin/day, 6 tablets/day of Raglan, and 4 capsules of compound phenylephrine/day to stop diarrhea (now stopped), and then reduced to 4 tablets/day because of the elevated transaminase, after which the transaminase decreased, but it has not returned to the normal range.
Now I have 2 bottles of Risu/day and 4 tablets of Radix et Rhizoma/day, and due to diarrhea, I use Flavopiridol 3 times a day, 3 tablets each time to stop diarrhea, and now I have 3 bowel movements per day, and I would like to ask Director Zhu about the bloating and vague pain after eating recently, and I eat not much.
I don’t eat much, how can I get it? You suggested me to do colonoscopy this month, should I do it at your hospital or locally in Wuxi?
General Surgery Department Zhu Weiming: Diarrhea is better, but the stomach is bloated after eating, consider a review, come to us to check, so that I can also look at it.
Patient: Could the bloating be due to the stoma tube being placed and not eating for more than 3 months? Or is there an indirect relationship between eating and bloating and my disease? (My stomach was not very good in the past, I often have bloating and stomach pain, especially the side effects of medication on the stomach are very obvious) Do you mean that the review should be done even for gastroscopy? I don’t know how long it takes to do a colonoscopy at your hospital from the time of booking to the time of doing it? Do I need to do any preparation in advance? Actually, I don’t think the diarrhea problem has improved significantly, sometimes less and sometimes more, so it seems that flavopiridol is not effective. Is it okay to use one bottle of Risu a day in my current situation?
The general surgery department of Nanjing Military General Hospital Zhu Weiming: The review should include gastroscopy, in fact, the entire gastrointestinal tract of Crohn’s disease may be involved, you now have symptoms in the gastrointestinal tract, you should consider whether there are other parts, so you should review it, and if it is confirmed that there are no other problems in the gastrointestinal tract, stop diarrhea on the line. You can have a gastroscopy, a colonoscopy, and a full gastrointestinal barium meal in Wuxi.
Patient: I am afraid that it will not be done well in Wuxi. The doctors here are not very experienced in Crohn’s disease and I am afraid that they will not be careful enough. I feel that the stomach is not good digestive function (the gastroscopy done at the end of 2005 is chronic superficial gastritis, there has been little change in the past few years), in addition to doing colonoscopy delayed a little bit has no relationship, this time there are things. Today I went to the hospital for laboratory tests
CRP 0.59(0-6.8);ESR
3, liver function transaminase and medium granulocyte percentage have been normal, hemoglobin and total protein has also increased than last month. It seems that the use of compound phenylephrine does have an effect. These days I don’t take flavopiridol, I’m pooping 4-5 times a day without it, and about the same with it. Can I reduce the nutrient solution to one bottle a day in my current situation? Please set your treatment plan. Thank you! And is it possible to lose hair with Radix Rehmanniae? I’ve been losing a lot of hair lately.
Zhu Weiming, General Surgery Department, General Hospital of Nanjing Military Region: I saw you in the clinic last week, and the problem was solved, right?
Patient: Director Zhu: The problem of the tube is solved. Thank you! I’ve been losing my hair since a month or so ago, and lately it’s getting worse and worse, and my scalp is a little itchy. If this continues, I may become bald, is there any nutrient I lack or is it the negative effect of the thunderbolt? What can I do? I want to come for a checkup next month, is it okay?
Zhu Weiming, General Surgery Department, General Hospital of Nanjing Military Region: You should reduce the Radix to 1 capsule in the morning, 1 capsule at noon, and 2 capsules at night, and watch it for a month.
Patient: Because of the elevated liver transaminases, I have adjusted the amount of Leigongteng to one capsule in the morning, one capsule at noon, and two capsules at night, and I have been using this amount for two months. In fact, I also had hair loss after my first surgery in 2006, and then I started to eat for a period of time and then I stopped losing my hair, and the time was about the same, it started slowly after two or three months, and then it fell out more and more, and it was very brittle and easy to break in the middle, I don’t know if this time is also because of poor nutrition? Or is it because of the use of the thunderbolt?
Zhu Weiming, General Surgery Department, Nanjing Military Hospital: You didn’t use Leigongteng in 2006, and your hair fell out at that time, which means it has nothing to do with Leigongteng. It may be related to the lack of vitamins and trace elements, diet adjustment for a period of time to say. I thought eating black sesame seeds had a hair care effect, you can try it.
Patient: Director Zhu: I used two bottles of Rexian a day last month, and one bottle from this month. Last time, because the stoma tube was blocked, the small tube to the intestine was removed, and now I am hanging with the one to the stomach, hanging a bottle a day. I would like to ask: Is it still the case that Rui Xian has been using one bottle a day? Can I drink it instead? When can the tube be removed? I want to take the hepatitis B vaccine, can I? Today’s hospital test results: normal blood count, normal liver function, total protein
78.1 (66-87), albumin 50.8 (35-50), globulin 27.3 (26-35), CRP 0.76 (0-6.8), ESR 5
Zhu Weiming, General Surgery Department, General Hospital of Nanjing Military Region: The situation is very good. The first thing to do is not to stop, stick with it for a while, do not pull the tube. Hepatitis B vaccine can be given.
Patient: Director Zhu: I want to switch to drink can?
General Surgery Department of Nanjing Military Hospital Zhu Weiming: You can try drinking it first.
Patient: Director Zhu: Hello! Today to the hospital laboratory tests are as follows: CRP 1.34 (0-6.8), ESR
5, total protein 71.7 (66.0-87.0), albumin 47.5 (35.0-50), globulin 24.1 (26.0-35.0), blood count, liver function, kidney function are normal.
1. I am currently on a normal diet plus a bottle of Rexin a day, two days ago to the General Hospital of the Military District to dispense, the hospital is out of stock, I would like to switch to the use of allergicin can it? Which of these two is more effective compared to the other? If I can use it, how much should I use and how should I use it in my current health condition?
2. I basically have two bowel movements a day, the first one is mushy and the second one is loose, and the interval between the two is not long.
3. CRP has increased compared to last month (0.76 last month), should it matter?
Zhu Weiming, General Surgery Department, Nanjing Military General Hospital: CRP and ESR are good, no need to adjust the amount of drugs, if Rizol is out of stock, you can use Neng Quan Su. The colonoscopy is checked every six months, must be insisted on, otherwise relapse is not known. Now the situation is very good, to maintain, to cherish, this condition is not easy to come ah, how much to pay the price in exchange for ah. Do not eat indiscriminately.
Patient: Director Zhu: Good New Year!
Today to the hospital to do laboratory tests: routine blood; hemoglobin 112 (116-179), lymphocyte percentage 41.1 (20-40), platelets 323 (99-303), normal liver and kidney function, total protein 63.7 (66-87), albumin 32.6 (35-50), ultrasensitive C-reactive protein 2.63 (0-6.8), blood sedimentation 12
I came to Nanjing Hospital on December 10th for a small bowel microscopy, but the small bowel microscope was broken and has not been repaired yet. The platelets and sedimentation have gone up a lot, and the lymphocyte percentage is also over, but I’ve had a cold for the past two days, so I wonder if that could have anything to do with it? I remember last month’s albumin was 47, but now it’s only 32.6, so it’s dropped so much. (Albumin is slowly coming down since I started using it in November), now I have 1-2 stools a day, paste-like, nothing else uncomfortable. What is my situation now, Director Zhu? What can I do?
Patient: Director Zhu: I think back, in the past two months I ate the same diet as normal people, did not drink any soup, and did not eat much, just rely on the full vegetation to maintain, I think it is poor absorption, resulting in a slow decline in nutritional status, you see? I am now taking 4 tablets a day, last time because of elevated liver transaminases reduced 2 tablets, I do not know if I can go back to using 6 tablets a day?
General Surgery Department of Nanjing Military Hospital Zhu Weiming: Small intestine microscopy has been repaired, you come to check it, wait for the test results before considering the adjustment of the treatment plan.
Patient: Director Zhu: I have no time before the New Year, I will come to do the examination immediately after the New Year, does it matter? What should I pay attention to during the New Year? Can you please explain my current situation to me? This will give me some peace of mind for the New Year. Thank you very much!
Zhu Weiming, General Surgery Department, General Hospital of Nanjing Military Region: It is okay to come after New Year. There is nothing special during New Year’s Eve, but you should eat in moderation and not be reckless. Absolutely no drinking or smoking.
Patient: Happy New Year to you! Thank you!