Ava Hosea uncovers the process of Step Therapy, an insidious and harmful protocol used by insurance companies to reduce costs. Erin McKeon, Associate Director of Federal Advocacy for the Crohn’s and Colitis Foundation, and Grace McCarthy, a fellow teenager suffering from chronic illness join her to offer professional and patient perspectives on this critical issue.

Your Chronic Illness Isn't The Only Thing Making You Sick

WHAT CAUSES DIGESTIVE ISSUES AND TO REVERSE THEM ALL! https://mealbetix.com/take-back-your-health-podcast

WHAT CAUSES DIGESTIVE ISSUES?

Autoimmune diseases are complex conditions where the body's immune system mistakenly attacks healthy cells. To manage these diseases, doctors use various types of medications. Let's explore the main categories of drugs used to treat autoimmune conditions.
1.	Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These are often the first line of treatment for many autoimmune diseases. NSAIDs help reduce inflammation and relieve pain. Common examples include ibuprofen and naproxen. While they're available over-the-counter, stronger versions may be prescribed by doctors for more severe cases.
2.	Corticosteroids: These powerful anti-inflammatory drugs mimic the effects of hormones produced naturally in the body. Prednisone is a well-known example. Corticosteroids can be taken orally, applied topically, or injected directly into inflamed areas. They're effective at quickly reducing inflammation but can have significant side effects if used long-term.
3.	Disease-Modifying Antirheumatic Drugs (DMARDs): DMARDs work by suppressing the overall activity of the immune system. They're often used for conditions like rheumatoid arthritis and lupus. Methotrexate and hydroxychloroquine are common examples. These medications can take several weeks or months to show full effects but can be very effective in slowing disease progression.
4.	Biologics: These are a newer class of drugs made from living organisms. They target specific parts of the immune system involved in inflammation. Examples include tumor necrosis factor (TNF) inhibitors like adalimumab and etanercept. Biologics are often used when other treatments haven't been effective.
5.	Immunosuppressants: These medications work by broadly suppressing the immune system's activity. They're used in severe cases or when other treatments haven't worked. Examples include azathioprine and mycophenolate. While effective, they can increase the risk of infections.
6.	Targeted Synthetic DMARDs: These are newer drugs that target specific molecules inside immune cells. Janus kinase (JAK) inhibitors like tofacitinib fall into this category. They can be effective for conditions like rheumatoid arthritis and psoriatic arthritis.
7.	Intravenous Immunoglobulin (IVIG): This treatment involves giving antibodies from donated blood to patients. It's used for conditions like multiple sclerosis and myasthenia gravis. IVIG can help regulate the immune system's function.
8.	Plasmapheresis: While not a medication, this treatment involves filtering the blood to remove harmful antibodies. It's used in severe cases of some autoimmune diseases.

What Are The Main Types Of Medications Used To Treat Autoimmune Diseases?

Immunosuppressants play a crucial role in treating autoimmune conditions by dampening the overactive immune response that characterizes these diseases. Let's dive into how these medications work and their impact on the immune system.
At its core, an autoimmune disease occurs when the immune system mistakenly attacks healthy cells in the body. Immunosuppressants aim to reduce this inappropriate immune activity. They do this by interfering with the immune system's normal functions in various ways.
One common way immunosuppressants work is by inhibiting the production or activity of T cells and B cells. These are types of white blood cells that are key players in the immune response. For example, medications like azathioprine and mycophenolate mofetil work by blocking the production of purines, which are essential for the rapid multiplication of T and B cells.
Another mechanism involves blocking signaling molecules called cytokines. Cytokines are proteins that help coordinate the immune response. By interfering with cytokine signaling, drugs like cyclosporine can prevent the activation and proliferation of immune cells.
Some immunosuppressants, like corticosteroids, work more broadly. They affect multiple components of the immune system and also have powerful anti-inflammatory effects. Corticosteroids can quickly reduce inflammation and provide relief from symptoms, but they're often used short-term due to potential side effects from long-term use.
Newer types of immunosuppressants, such as biologics, target very specific parts of the immune system. For instance, rituximab targets and depletes B cells, which are responsible for producing antibodies. This can be particularly effective in diseases where harmful antibodies play a major role, like rheumatoid arthritis or lupus.
It's important to understand that while immunosuppressants can be very effective in managing autoimmune diseases, they don't cure the underlying condition. Instead, they help control symptoms and prevent damage to organs and tissues by reducing the immune system's attack on the body.
The use of immunosuppressants requires careful monitoring. By suppressing the immune system, these drugs can increase the risk of infections. Doctors often perform regular blood tests to check for signs of infection or other side effects. They may also recommend vaccinations before starting treatment to provide protection against common infections.
The dosage of immunosuppressants is typically adjusted over time. The goal is to find the lowest dose that effectively controls the autoimmune condition while minimizing side effects. This balance can take time to achieve and may need to be readjusted as the disease progresses or if circumstances change.
Research published in Nature Reviews Immunology has shown that different autoimmune diseases may respond better to targeting specific parts of the immune system. This has led to the development of more targeted therapies, allowing for potentially more effective treatment with fewer side effects.

How Do Immunosuppressants Work In Treating Autoimmune Conditions?

What are the potential side effects of common autoimmune disease treatments?
While autoimmune disease treatments can be highly effective in managing symptoms and slowing disease progression, they can also come with a range of potential side effects. It's crucial for patients to be aware of these possibilities to make informed decisions about their treatment and to know when to seek medical attention. Let's explore the potential side effects of common autoimmune disease treatments.
1.	Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs, while generally well-tolerated, can cause stomach upset, ulcers, or bleeding in the digestive tract. Long-term use may increase the risk of heart attack or stroke. Some people may experience kidney problems or high blood pressure.
2.	Corticosteroids: These powerful drugs can have numerous side effects, especially with long-term use. Potential issues include weight gain, mood swings, increased risk of infections, osteoporosis (bone thinning), high blood sugar, cataracts, and skin thinning. They can also cause adrenal suppression, where the body stops producing its own cortisol.
3.	Disease-Modifying Antirheumatic Drugs (DMARDs): Side effects can vary depending on the specific drug. Common issues include nausea, diarrhea, and liver problems. Some DMARDs, like methotrexate, can cause mouth sores, hair loss, and lung problems. Regular blood tests are usually required to monitor for potential liver or blood cell issues.
4.	Biologics: These drugs can increase the risk of serious infections due to their effects on the immune system. There's also a small increased risk of certain types of cancer, particularly lymphoma. Injection site reactions are common with drugs that are administered subcutaneously. Some people may develop antibodies against the biologic, making it less effective over time.
5.	Immunosuppressants: The main concern with these medications is an increased risk of infections, which can sometimes be severe. They may also increase the risk of certain types of cancer. Some immunosuppressants can cause kidney or liver problems, requiring regular monitoring through blood tests.
6.	Targeted Synthetic DMARDs: JAK inhibitors, for example, can increase the risk of serious infections, blood clots, and certain types of cancer. They may also cause changes in blood cell counts and lipid levels.
7.	Intravenous Immunoglobulin (IVIG): While generally well-tolerated, some people may experience headaches, fever, or chills during or after the infusion. In rare cases, more serious side effects like blood clots or kidney problems can occur.
8.	Plasmapheresis: This procedure can sometimes cause low blood pressure, dizziness, and fainting. There's also a risk of bleeding or infection at the site where the catheter is inserted.
It's important to note that not everyone will experience these side effects, and the benefits of treatment often outweigh the risks for many patients. However, being aware of potential side effects allows patients to report any issues to their healthcare provider promptly.
Researchers are continually working on developing treatments with fewer side effects. For example, a study published in the Lancet showed promising results for a new class of drugs for rheumatoid arthritis that may have a better safety profile than some existing treatments.

What Are The Potential Side Effects Of Common Autoimmune Disease Treatments

How often do patients need to see their doctor for autoimmune disease management?
The frequency of doctor visits for autoimmune disease management can vary widely depending on several factors. These include the specific autoimmune condition, the severity of symptoms, the type of treatment being used, and the individual patient's overall health. Let's explore this topic in more detail to give you a comprehensive understanding.
For many patients with autoimmune diseases, regular check-ups are an essential part of their care. These visits allow doctors to monitor the progression of the disease, assess the effectiveness of treatments, and make any necessary adjustments to the treatment plan.
In the early stages of diagnosis or when starting a new treatment, patients may need to see their doctor more frequently. This could be as often as every 4-6 weeks. During this time, doctors closely monitor how the patient is responding to treatment and watch for any potential side effects.
Once the condition is stable and well-controlled, visits may be spaced out to every 3-6 months. However, this can vary based on the specific autoimmune condition. For example:
1.	Rheumatoid Arthritis: Patients with well-controlled RA might see their rheumatologist every 3-6 months. Those with more active disease may need monthly visits.
2.	Lupus: The Lupus Foundation of America recommends check-ups every 3-6 months for stable patients, but those with active disease may need more frequent visits.
3.	Multiple Sclerosis: Patients often see their neurologist every 3-6 months, with MRI scans typically performed annually.
4.	Type 1 Diabetes: Patients usually have check-ups every 3-4 months, with more frequent visits if blood sugar control is challenging.
5.	Inflammatory Bowel Disease: Patients in remission might see their gastroenterologist every 6-12 months, while those with active disease may need monthly visits.
It's important to note that these are general guidelines. The actual frequency of visits can vary based on individual circumstances. For instance, patients taking certain medications may need more frequent blood tests to monitor for potential side effects. A study published in the journal Arthritis Care & Research found that patients with rheumatoid arthritis who had more frequent check-ups (every 1-4 weeks) showed greater improvements in disease activity compared to those seen less often.
In addition to scheduled check-ups, patients should be prepared to see their doctor if they experience a flare-up of symptoms or develop any new health issues. Many autoimmune conditions can affect multiple body systems, so new symptoms should always be evaluated promptly.

How Often Do Patients Need To See Their Doctor For Autoimmune Disease Management?

Physical therapy plays a crucial and often underappreciated role in the treatment of many autoimmune diseases. While medications are typically the cornerstone of treatment, physical therapy can significantly improve a patient's quality of life, manage symptoms, and in some cases, even slow disease progression. Let's explore the various ways physical therapy contributes to autoimmune disease management.
1.	Pain Management: Many autoimmune diseases, such as rheumatoid arthritis, lupus, and multiple sclerosis, can cause chronic pain. Physical therapists use a variety of techniques to help manage this pain. These may include:
•	Manual therapy techniques like massage and joint mobilization
•	Heat and cold therapy
•	Transcutaneous electrical nerve stimulation (TENS)
•	Therapeutic exercises designed to reduce pain
A study published in the Journal of Physical Therapy Science found that a combination of physical therapy interventions significantly reduced pain in patients with rheumatoid arthritis.
2.	Improving Mobility and Flexibility: Autoimmune diseases can often lead to joint stiffness and reduced range of motion. Physical therapists design exercise programs to improve flexibility and maintain or increase joint mobility. These exercises are tailored to the individual's condition and abilities. For example, for someone with ankylosing spondylitis, a physical therapist might focus on exercises to maintain spine flexibility.
3.	Strengthening Muscles: Muscle weakness is common in many autoimmune conditions, either as a direct result of the disease or due to inactivity caused by pain and fatigue. Physical therapists create strength training programs that target specific muscle groups affected by the disease. This can help improve overall function and reduce the risk of falls.
4.	Fatigue Management: Fatigue is a common and often debilitating symptom of many autoimmune diseases. Physical therapists can help patients develop energy conservation techniques and design exercise programs that gradually build stamina without causing exhaustion. A review published in the Cochrane Database of Systematic Reviews found that exercise interventions can significantly reduce fatigue in people with autoimmune conditions like multiple sclerosis.
5.	Improving Balance and Coordination: Some autoimmune diseases, particularly those affecting the nervous system like multiple sclerosis, can impair balance and coordination. Physical therapists use various exercises and techniques to improve these skills, reducing the risk of falls and improving overall function.
6.	Education and Self-Management: Physical therapists play a crucial role in educating patients about their condition and teaching self-management techniques. This might include:
•	Proper body mechanics for daily activities
•	Joint protection techniques
•	How to use assistive devices effectively
•	Home exercise programs
7.	Addressing Specific Disease Manifestations: Different autoimmune diseases may require specific physical therapy interventions. For example:
•	For inflammatory bowel diseases, physical therapists might focus on core strengthening and pelvic floor exercises.
•	In Sjögren's syndrome, they might teach exercises to improve saliva production and eye moisture.
•	For scleroderma, therapists often focus on maintaining skin elasticity and joint mobility.

What Role Does Physical Therapy Play In Autoimmune Disease Treatment?

Are there any specific diets recommended for people with autoimmune diseases?
Diet plays a crucial role in managing autoimmune diseases, as what we eat can significantly impact inflammation levels in our body. While there's no one-size-fits-all diet for autoimmune conditions, several dietary approaches have shown promise in helping to manage symptoms and potentially slow disease progression. Let's explore some of the most commonly recommended diets for people with autoimmune diseases.
1.	Anti-Inflammatory Diet: This is a general approach rather than a specific diet plan. It focuses on consuming foods that reduce inflammation in the body while avoiding those that may promote it. Key components include:
•	Plenty of fruits and vegetables, especially those rich in antioxidants
•	Whole grains
•	Lean proteins, especially fatty fish high in omega-3 fatty acids
•	Healthy fats like olive oil, avocados, and nuts
•	Limited processed foods, sugar, and saturated fats
A study published in the journal Frontiers in Immunology found that an anti-inflammatory diet could help reduce disease activity in rheumatoid arthritis patients.
2.	Mediterranean Diet: This diet is similar to the anti-inflammatory diet and has been associated with reduced inflammation and improved symptoms in several autoimmune conditions. It emphasizes:
•	Fruits, vegetables, and whole grains
•	Olive oil as the primary fat source
•	Moderate amounts of fish, poultry, and dairy
•	Limited red meat
•	Moderate red wine consumption (if appropriate)
Research published in the journal Rheumatology found that adherence to a Mediterranean diet was associated with lower disease activity in rheumatoid arthritis patients.
3.	Autoimmune Protocol (AIP) Diet: This is a more restrictive diet that aims to eliminate foods that may trigger inflammation or immune responses. It involves:
•	Eliminating grains, legumes, nightshades, dairy, eggs, coffee, alcohol, nuts, seeds, refined sugars, oils, and food additives
•	Focusing on vegetables, fruits, meat, and fish
•	Gradually reintroducing foods to identify triggers
While more research is needed, a small study published in Inflammatory Bowel Diseases found that the AIP diet improved symptoms in patients with inflammatory bowel disease.
4.	Gluten-Free Diet: This diet is essential for people with celiac disease, an autoimmune condition triggered by gluten. However, some people with other autoimmune diseases report improved symptoms when avoiding gluten. It involves eliminating all sources of gluten, including wheat, barley, and rye.
5.	Paleo Diet: This diet aims to mimic the eating patterns of our prehistoric ancestors. It includes:
•	Fruits, vegetables, nuts, and seeds
•	Lean meats and fish
•	Avoidance of grains, legumes, dairy, refined sugar, and processed foods

Are There Any Specific Diets Recommended For People With Autoimmune Diseases?

Her kommer første del av to episoder fulle av tips og råd. Jeg samlet IBD-panelet å vi delte våre og dere lytteres tips.  I denne episoden tar vi for oss tips til å mestre tømming før undersøkelse, stomi tips, forstoppelse, tips mot magesmerter, vond lukt på do og mye mer…. 
God lytt!

E112 Tips og råd del 1.

I denne episoden er gastroenterolog Stephan Brackmann gjest. Han skal i en hel episode gi deg alt du trenger å vite om Crohns sykdom. 
God lytt

E118 Crohns sykdom

Når Ida (Crohnsglede) ble alvorlig syk som 17-åring med kronisk fordøyelsessykdom savnet hun et sted å finne info, høre om andre sine erfaringer og å få tips og råd til hvordan takle livet som kronisk syk. Nå, 18 år senere, har hun i samarbeid med Takeda laget det hun selv så sårt ønsket seg den gangen; nemlig en podcast for alle som er berørt av kronisk fordøyelsessykdom. Det kan være vanskelig å forklare pårørende hvordan livet med disse sykdommene er og nå har pårørende mulighet til å høre og lære fra kronikerne selv. Helsepersonell kan få tilgang til pasientene sine på en måte de aldri før har hatt. Og du som er syk vil få høre om forskjellige temaer som berører oss. Det vil bli personlig, tårer, kunnskap, glede, håp, diskusjoner, latter og sterke menneskemøter som setter spor. Ida får gjester i studio som deler av sin erfaring samtidig som forskjellige eksperter også deltar i samtalene. La oss sammen fjerne tabuer og gi håp om gode liv på tross av sykdom! 
Har du spørsmål i forbindelse med denne podcast-serien ta kontakt via crohnsglede@outlook.com

Fotograf: Line Loholt https://www.facebook.com/fotograflineloholt/

New tracks tagged #Crohns