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Alka Goyal, MD

Clinical Professor- Pediatrics Gastroenterology

Q: I am 53 yr old male with Crohn’s disease over 20 years ago. Had remicade 8 years ago, surgery to resection intestines over 20 years ago. started Inflectra. Been going to ER every two weeks now for past 2months. Having very bad stomach pains and can’t use the toilet after eating.. this just started happening two months ago! food is just sitting in my stomach and won’t move. When I get to ER they give me steroid and pain meds, in a couple hours I’m like new man! What could be wrong?

A: I am sorry that you have had to visit emergency room so often. I would suggest discussing with your GI doctor and getting a full re-evaluation with him/her. It seems that you improve with steroids which goes in favor of Crohn’s rather than constipation. hide answer

Q: My granddaughter was diagnosed with crohns 3 years ago. She had to have a small section of her intestines removed. She has been on remicade and was doing good until her body was being covered with red blisters. Her head has such terrible psoriasis she has patches of bald spots and now has these lumps filled with pus. They switched her to Stelara and says this will clear up. How long will it take she is 16 and not happy.

A: I am sorry that your granddaughter has to go through this problem. We all realize that body image is very important at this age. Please reassure her that her psoriasis is very likely to resolve completely. It may take 4-6 months. I also recommend discussing with your doctor about seeing a dermatologist. hide answer

Q: I'm 16 and was diagnosed with Crohn's last year. However, I experience severe constipation and have been hospitalized before because of it. Information I read says to eat vegetables when constipated but a lot of the veggies I can't eat because of narrowing. I am currently on methotrexate and I don't want to have to go on biologics. What foods will help with constipation? What other lifestyle and diet changes should be to help with this issue?

A: I am concerned that you may be constipated due to the narrowing that you describe. If your doctor does not think that you need different medications or a surgery for the narrowing then I can suggest some tricks for the constipation. Limited amounts of soft, cooked vegetables and vegetable soup, plenty of water (64 ounces or more) and using a laxative as directed by your doctor can all help. The best lifestyle change can be walking. I suggest discussing with your doctor whether you are at the point where methotrexate is the right choice for you or you might need surgery or escalating therapy. Trying biologicals too late does not help with reversal of disease. hide answer

Q: What is your thoughts on using Senna Tea for constipation?

A: Senna tea can help with constipation but if you have an obstructive stricture, this will not be a good idea. There can also be side effects of the tea so be sure to discuss the use of any products with your health care provider. hide answer

Q: Will almond milk or peanut butter cause inflammation or will it aggravate Colitis ? I know eating nuts and seeds in their solid natural form is hard to digest but what if the food is in a liquid and or butter form, i.e. almond milk or peanut butter ?

A: Almond milk or peanut butter will not cause any harm. Nut by themselves are not harmful, we recommend avoiding nuts in patients with strictures in case undigested material gets impacted. hide answer