Shit Watch 2013 is Over

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So Shit Watch 2013 has finally ended. After several days of Miralax and Proctofoam, my lower colon opened up just enough to....you know, let loose.

Normal Colon

Why has this been happening? My doctor thinks I probably have a colon stricture. This is a narrowing of the colon---for me, the lower colon. This was the area last year that gave me a tremendous amount of difficultly that had resulted in my switch over to Imuran. As I have mentioned before, Crohn's can manifest itself in any part of the digestive system---from the mouth to the anus, internal and external. Until last year, my Crohn's was intent on hanging out in my upper colon, near the connection to the the small intestine. Apparently not happy with just that neighborhood, my Crohn's bought some real estate in my lower colon--in the anorectal area. The lesions and inflammation there sent me to the hospital and required a new approach to treatment.

Colon with Stricture

It's that area once again that has been causing some problems as of late. Evacuating the bowels (this is the technical term for "taking a shit") has become difficult, due to increased inflammation. However, I have not had the pain that I had last year and this could be due to a stricture.

What causes a stricture? Could be a variety of things--from simple inflammation to a hernia, fissure, twisting of the colon or a tumor. Stress can make it worse. The only thing that can be done to find out the cause is to---you guessed it, shove a camera into the neighborhood and look around.

So I am heading to the hospital again on April 8th for a "flexible sigmoidoscopy." Fun.

Depending on the cause of the stricture, the solution can be relatively easy. According to my doctor, it could be just "ballooning" the area to open it up a bit or simply removing an obstruction that might be present. Biopsies will also be taken on the inflamed tissue as well.

And pictures. Hopefully, plenty of pictures.

Is That an Ass Inhaler?

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Oh, the glories of a being Crohn's patient.

Things have actually been going quite well lately, all things considering. Other than a few days down with the flu, I've been pretty pleased at my progress on Imuran. I am currently at 100 mg a day and have been going one or two times a day. Formed stools, for the most part.

Pretty good, other than for the constipation. Well, what I thought was constipation.

You see, I have had a difficult time--sometimes--going. Straining actually. Like I need to push out a large loaf that turns out to be only a small flat coin. For all the pushing, you expect so much more. "That's all?" I often say to myself in a rather disappointed voice after taking a glance in the bowl. After such a fight, you expect to see something much bigger. Miralax didn't help and I had the same problem in full blown diarrhea-mode when I had the flu.

The problem wasn't the stool, it was the exit. Although I don't have any pain at all (unlike last year), the entire lower section of my colon is inflamed. So it's like trying to push out through an opening that's 90% smaller than normal. Miralax isn't going to make a difference.

Even though I am on vacation in Florida (a sunny 46º here. Brrrr), I needed to call my doctor as I am on day 3 of Shit Watch 2013. So there I was, standing in a crowded parking lot, explaining my symptoms. That's the thing about being a Crohnie, you really don't care anymore what people hear. It's kind of liberating actually, to be able to talk about your "ribbon-like" bowel movements, not caring who is around or what they think.

The nurse called back later and said that my doctor wants me to try "Proctofoam."

"What's that?" I asked.

"It's used to treat anorectal inflammation."

"How do you use it?"

There was a pause. "I'm not sure actually. I've never seen it," replied the nurse. "The instructions are on the package."

Not wanting to be blindsided, I quickly looked up the product. And this is the description from the website:

"Proctofoam-HC® is mucoadhesive analgesic and anti-inflammatory foam prescribed by health professionals for the relief of anorectal inflammation and swelling associated with hemorrhoids, pruritus ani, anal fissures and other anorectal discomforts. 

This unique metered-dose aerosol foam is particularly effective for the relief of postpartum hemorrhoids affecting as many as 3 out of 4 natural childbirthing women."

Okay, sounds good enough--even though I am not a "natural childbirthing" woman.  Then I saw a picture of the product:

I laughed.  I have an asthmatic child and I recognized the cartridge immediately.

It was an ass inhaler.

Having had Crohn's for awhile, I am accostomed to seeing all sorts of procedures, medicine and devices. But this was a first.

Hmmm.  As long as it works I am up for anything.

Even an ass inhaler.

Aluminum: In my pits and in my colon

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I am a sweater.  Always have been.  Big wet circles under my pits are not uncommon.  Therefore, antiperspirants have been an important part of my daily routine.  And I have tried every kind with varying amounts of success.  I even keep an extra stick in my work bag, just in case.

Antiperspirants work by causing water to be drawn into the cells near the sweat glands.  The swelling of the cells squeeze the sweat ducts closed so that they cannot excrete sweat.  As the antiperspirant wears off, the swelling shrinks and the sweat gland can begin releasing sweat once again.

The active ingredient in all antiperspirants is aluminum, in the form of either aluminum chloride, aluminum zirconium tricholorohydrex glycine, aluminum chlorohydrate, or aluminum hydroxybromide.

Aluminum is also a primary ingredient in vaccinations as well.  It serves as an “adjuvant;” that is, to increase the immune response to the vaccine.  The problem is that aluminum is believed to have a negative affect on the immune system in diseases like Crohn’s.   One study in 2007 linked exposure to aluminum to the “induction or the maintaining of inflammation” in Crohn’s. (1) The study suggests that inflammation may increase in the colon with increased exposure to aluminum.  Aluminum is also thought to “stimulate bacterial virulence,” (2) which, according to some theories in regard to Crohn’s, is one of the main culprits of the disease. 

Aluminum is the most abundant metal on the planet and its use in everyday products have increased over the years.  Aluminum is found naturally in some foods, such as tea and other leafy herbs.  However, it is also now used to a greater extent in processed food.  It can be found in flour and baking powder as an anti-caking agent.  Most processed foods with flour, such as tortillas, cakes and bread have very high levels of aluminum.  Medicines, such as buffered aspirin, antacids and vaccines contain large amounts of aluminum as well.  It is found in shampoos, soaps and antiperspirants.

I do not plan on getting all processed food out of my system, but close examinations of labels can reduce one’s exposure to aluminum and other ingredients.  One of the biggest sources of aluminum that is absorbed directly into the bloodstream is from the use of antiperspirants.  This is something that I can have direct control over.

So, last week I decided to ditch my antiperspirant for a “natural” deodorant.  I chose a Tom’s of Main product that contains only natural ingredients.  I wasn’t expecting much, actually.   In fact, I was expecting to sweat like crazy and smell like a hobo.

But that didn’t happen.

In fact, I have noticed that I have actually produced less sweat on a mere deodorant than I did using an antiperspirant.  Weird, eh?

So, I have been aluminum-free in the armpits now for over a week.  My overall aluminum levels must be down.  But have a noticed a difference when it comes to Crohn’s?  No.

Not in the least.

However, reducing the amount of aluminum in my body is not a bad thing, regardless of the Crohn's.  And as long as my sweat glands cooperate, I will continue to avoid the aluminum-containing antiperspirants.

And who knows?  Maybe in weeks or months I may notice a difference. 

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(1) Aaron Lerner, “Aluminum is a potential environmental factor for Crohn's diseaseinduction: extended hypothesis” Annals of the New York Academy of Sciences (2007 Jun;1107:329-45)

(2) R Balfour Sartor, “Mechanisms of Disease: pathogenesis of Crohn’s disease andulcerative colitis” Nature Clinical Practice Gastroenterology & Hepatology (July 2006 Vol 3 No 7)