The FDA has required Hoffmann-La Roche to change their label for Accutane many
times. The most recent label states - Inflammatory bowel disease: Accutane has been
associated with inflammatory bowel disease (including regional ileitis) in patients
without a prior history of intestinal disorders. In some instances, symptoms have
been reported to persist after Accutane treatment has been stopped. Patients experiencing
abdominal pain, rectal bleeding or severe diarrhea should discontinue Accutane immediately.Pursuant to FDA Rules and Regulation, the reporting of Adverse Side Effects is on a voluntary basis. In other words, the doctor, hospital, or other medical person or facility are not required by law to report an adverse side effect from a drug. The FDA reported that perhaps only one in one hundred side effects ever get reported. One could only imagine about how many serious Adverse Side Effects there are from taking Accutane, that have never been reported to anyone!
Individuals with inflammatory bowel disease have significantly higher risks of colon cancer than in the general population!
What is Crohn's Disease?
In 1932, Dr. Burrill B. Crohn, Dr. Leon Ginzburg, and Dr. Gordon D. Oppenheimer published a landmark paper describing the clinical features of what is known today as Crohn's disease. Crohn's and a related disease, ulcerative colitis, are the main divisions of the group of illnesses called inflammatory bowel disease (IBD).
Because the symptoms of these two illnesses are so similar, approximately 10 percent of cases are unable to be diagnosed definitively as either ulcerative colitis or Crohn's disease. In both illnesses, there is an abnormal immune response. White blood cells infiltrate the intestinal lining, causing chronic inflammation. These cells then produce noxious products that ultimately lead to tissue injury. When this happens, the patient experiences the symptoms of inflammatory bowel disease.
Although Crohn's disease most commonly affects the end of the small intestine (the ileum) and the beginning of the large intestine (the colon), it may involve any part of the gastrointestinal (GI) tract. On the other hand, ulcerative colitis limits its GI involvement to the colon. In Crohn's disease, all layers of the intestine may be involved, and there can be normal healthy bowel in between patches of diseased bowel. In contrast ulcerative colitis affects only the superficial layers (the mucosa) of the colon in a more even and continuous distribution, which starts at the level of the anus. Depending on what part of your intestine is affected by Crohn's disease, your doctor may refer to your illness as ileitis (inflammation of both the ileum and the colon). Crohn's colitis (inflammation of the colon alone), etc.
What are the symptoms of Crohn's disease?
Common symptoms include loose, watery, or frequent bowel movements. Other symptoms are crampy abdominal pain, fever, and, at times, rectal bleeding. Loss of appetite and subsequent weight loss also may occur. During periods of active symptoms, patients also may experience fatigue, joint pains, and possibly, skin problems. Some patient may develop tears in the lining of the anus (fissures), which may cause pain and bleeding, especially during bowel movements. Inflammation also may cause a fistula to develop. This is a tunnel that leads from a loop of intestine to the bladder, vagina, or skin. Fistulas occur most commonly around the anal area. If this complication occurs, you may notice drainage of mucous, pus, or stool from this opening. Because Crohn's is a chronic disease, patients will experience periods when the disease flares up, followed by times of remission. Some patients will experience symptoms that range from mild to severe. But, in general, people with Crohn's disease lead active and productive lives.
How is Crohn's disease diagnosed?
There is no single test that will unequivocally diagnose Crohn's disease. To determine the diagnosis, physicians consider a combination of information from the patient's history and physical exam. They examine the results of laboratory tests, X-rays, and findings on endoscopy and pathology tests, and exclude other known causes of intestinal inflammation. X-ray tests may include barium X-rays of the upper and lower GI tract. Endoscopy tests may include flexible sigmoidoscopy and, sometimes, colonoscopy, which allow the doctor to directly examine the colon with a lighted tube that is inserted through the anus. During these tests, biopsies may be obtained. It is important to make sure that an infection is not causing the patient's symptoms, so examination of the stool for harmful organisms is done routinely.
Because Crohn's disease often mimics other conditions and symptoms may vary widely, the correct diagnosis may take some time.
The Crohn's and Colitis Foundation of America, Inc., has regional and local chapters. It provides free educational materials, as well as educational activities, through local chapters in most parts of the country. The foundation may be found here .