Patient's Query
Hello doctor,
I am 34 and recently diagnosed with Crohn’s disease after an MRI enterography showed terminal ileum inflammation. My CRP is 28 mg/L, ESR 56 mm/hr, and albumin is slightly low at 3.1 g/dL.
I am currently taking Budesonide and Azathioprine, but I still get abdominal pain and four to six loose motions daily. My concerns are -
Does this mean the medicines are not working, and should biologics like infliximab be considered?
Also, my vitamin B12 is 185 pg/mL. Could supplementation help with energy and gut healing?
Are probiotics actually effective for Crohn’s?
Lastly, does long-term Crohn’s increase the risk of strictures or colon cancer?
Kindly help.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
Your reports confirm active Crohn’s disease involving the terminal ileum. The raised CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate), along with low albumin, indicate ongoing inflammation despite Budesonide and Azathioprine.
Persistent symptoms suggest that current medicines may not be sufficient, and escalation to biologics such as Infliximab, Adalimumab, or Vedolizumab should indeed be discussed with your gastroenterologist.
These treatments are effective for inducing and maintaining remission when standard therapy does not achieve control.
Your vitamin B12 level is low, which is common in ileal Crohn’s. Supplementation (oral or injections) can improve energy, prevent anemia, and support gut and nerve health. This should definitely be started.
Regarding probiotics, their benefit in Crohn’s is limited and not as strong as in ulcerative colitis, and they may help gut balance, but are not a substitute for standard treatment.
Crohn’s disease can cause strictures due to scarring and chronic inflammation. There is also a modestly increased risk of colon cancer, particularly with long-standing or extensive disease. Colonoscopic surveillance is usually advised eight to 10 years after diagnosis, with biopsies every one to two years thereafter.
Regarding follow-up, follow up with me after two days.
Thank you and take care.
Regards
Was this conversation helpful?
Answered byDr. Kanishka Sharma
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.