Crohn’s disease needs constant attention

Dear Doctor: My son always has had problems with his digestive tract, and at age 17 he was diagnosed with Crohn’s disease. He was sometimes getting as many as 15 bouts of diarrhea a day. A succession of doctors gave him stronger and stronger drugs. He ended up on Humira. He was not happy about this. He took the drug for about one and a half years, through his freshman year in college. My son, now an independent-thinking 20-year-old college student, stopped taking the Humira cold turkey, without saying anything to anyone. Not the best approach. However, so far so good. No random pain. No more diarrhea. I tried to talk him into seeing another doctor, but I think he has rather had it with your profession. — R.

A I have great sympathy for your son, as growing up with a chronic disease is exceedingly frustrating. I often see (and my colleagues in pediatrics and adolescent medicine will confirm) that adolescents and young adults stop their medications and even doctor visits for a time. This is immediately disastrous in young people with conditions like Type 1 diabetes, where daily medication is necessary for survival.

In the case of Crohn’s disease, it is not so simple. Crohn’s usually or often has periods of quiet intermixed with flares of the disease. It may be that the adalimumab (Humira) had induced a remission of the disease.

I would recommend that he see a Crohn’s disease expert soon.