Case Report - Ulcerative
Colitis/Crohn's Decease
FERRE AKBARPOUR, M.D., F.A.C.I.P.
Fellow of American College of International Physicians
ORANGE COUNTY IMMUNE INSTITUTE
Huntington Beach, California
April 17, 2003
SERVICE DATE: August 30, 2002 to January 16, 2003
Identification
Due to confidentiality reasons, the patient is referred to has C.B.
C.B. is a 49-year-old female who was diagnosed with
ulcerative colitis in 1999. It has been documented by biopsy and colonoscopy. The patient has other multiple problems including severe chronic fatigue
and fibromyalgia as well as natural killer cell deficiency. She also suffers from major depression and sleep apnea. She has diabetes mellitus secondary
to steroid usage and obesity. She has been diagnosed with degenerative discogenic disease in the cervical and lumbar areas.
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History of Present Illness/Current Complaints
The patient initially came into this office on August 30, 2002, in a very desperate state. She apparently had been told that due to
worsening of her ulcerative colitis symptoms including diarrhea and abdominal pain, she was advised to go for colectomy since she had tried
chemotherapy agents and a high dosage of Prednisone. Prednisone caused weight gain, disturbed immune system, and her diabetes became out of
control. Her depression worsened. The chemotherapy apparently had some toxic effects on the patient; thus, the chemotherapy and Prednisone
treatments were not he treatment of choice for her. She was even taken off the chemotherapy agents and Prednisone for two months. She did okay
initially but her colitis symptoms returned to include frequent diarrhea and blood in the stool. She reported having a bowel movement at least 15 times a
day and would have to get up throughout the night to use the bathroom. She stated the diarrhea was so severe and so out of control that some nights
she had to sleep in the bathroom sitting on the toilet bowl as she could not control her stool incontinence. She also developed some urinary
incontinence. This made her extremely miserable. She had no energy. She complained of spending most of her time in bed. She complained of ankle
pain either due to ulcerative colitis arthritis or some other form of arthritis or cause. Her pain caused depression and she was seeing a
psychiatrist.
The patient was given the option of a total colectomy. She was then told she was not a good candidate due to her severe obesity and due to her
diabetes, which had gotten out of control. Since she was on a high dosage of Prednisone on a daily basis and due to her immune suppression, she
was told she wan a high-risk patient for surgery. Also, should she survive the surgery, the diabetes could have been trouble postoperatively. Steroids
were causing immune suppression, which could have caused severe postoperative infections. The patient declined the surgery and came to our clinic
for alternative treatment. At the time she presented to this office, she also complained of constant severe lower back pain and upper back pain.
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Medications
At the time of admission her medications included Glucophage 1,000 mg twice a day, morning and evening; Actos, once a day for diabetes. She was
on Prednisone 35 mg per day. She was taking Levsin for abdominal cramps and ulcerative colitis pain. Furosemide or Lasix, 20 mg three times a day
for leg swelling was taken. She took Trazodone 300-400 mg at night as well as Ambien 10 mg at bedtime. She took Zoloft 200 mg at bedtime.
Morphine, tablets and liquid, were provided for breakthrough abdominal pain and joint pain. This was provided through her pain management clinic. She
was also given Lorazepam 1 mg three times a day.
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Laboratory and Diagnostic Studies
Laboratory studies on December 20, 2001 revealed serum ferritin was 12 (normal 10 to 29)
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Treatment Course
The patient was started on dietary changes after consulting with the dietician. Her diet was changed to an anti-inflammatory diet. Elimination was
done. She was advised to be started on intravenous vitamin C, detoxification, antioxidant therapy, and probiotics. Trilovin was started about a week
after the treatment started. The patient's case of inflammatory bowel disease was a difficult case. It had been difficult treating it with standard medicine
for the reasons previously mentioned. Fortunately, with alternative approach and dietary supplements as well as lactobacillus probiotics in the form of
powder and tablets, the patient reported improvement in her diarrhea, and the abdominal cramps and pain gradually disappeared. Both the patient and
her friend reported that the uncontrollable diarrhea was being controlled. She continued on supplementation after discharge.
In the follow-up office visits in our clinic the patient and her friend both reported they do not believe ulcerative colitis existed any longer. They felt they
had complete control of this illness. Subsequently, the patient had been able to lower her Prednisone intake. At the time of admission, she was taking
35 mg of Prednisone and at times took 40 mg. Due to the alternative approach and specifically, the probiotics she had been taking, she had been able
to mange her severe inflammatory bowel disease and ulcerative colitis which at the time of admission, she was not responding to any standard
medication and has been advised to go for a total colectomy, As noted , through our alternative treatment, apparently alternating between 15 mg and 16
mg every other day. Since being on the lower dosage of Prednisone, her diabetes has been more controllable. She is very pleased with this.
In summary, at the time of her January 16, 2003 office visit here at the clinic, she stated, "I no longer have to wear diapers; I am free". She was
extremely happy that her ulcerative colitis was in remission and she was no longer having episodes of accidents with diarrhea. She was able to sleep
adequately at night not having to get up for diarrhea episodes as previously. She no longer had abdominal cramping or pain. She is very happy with the
results of her alternative treatment. I do believe that treatment with Trilovin probiotics have had a great impact on the patient's protocol.
I look forward to reporting in the future on other success cased relating to ulcerative colitis/Crohn's disease. |
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