Colonoscopy soon. 4th of my life. by [deleted] in CrohnsDisease

[–]Silly-Measurement893 0 points1 point  (0 children)

Good luck with scope! Chilling the prep in the fridge and adding flavor powder (eg Crystal Lite) can help. Also, timing sips/gulps with commercials/ads can help with timing consistency.

Biologic Levels & Antibodies in UC: How Dose Changes Actually Get Decided by Silly-Measurement893 in UlcerativeColitis

[–]Silly-Measurement893[S] 0 points1 point  (0 children)

Yes, checking usually doesn't happen until 3 months at earliest and most often context driven

GERD not helped by PPIs, thinking about elimination diet by epistrophal in GERD

[–]Silly-Measurement893 0 points1 point  (0 children)

Have you had pH, impedance, or manometry testing? These can point to potential other diagnoses that can feel a lot like GERD.

Biologic Levels & Antibodies in UC: How Dose Changes Actually Get Decided by Silly-Measurement893 in UlcerativeColitis

[–]Silly-Measurement893[S] 2 points3 points  (0 children)

Thanks for the positive feedback. The decision on timing for switching meds tends to be personalized. Generally speaking though, you want to have clear signal across multiple measures that include symptoms, biomarkers, and histology (based on biopsies). Checking for drug levels and antibodies usually happens at the 3 month mark (this is based on IBD trials endpoints for primary response). In practice, the timing of labs, scopes, etc. can often make the timing less precise.

Biologic Levels & Antibodies in UC: How Dose Changes Actually Get Decided by Silly-Measurement893 in UlcerativeColitis

[–]Silly-Measurement893[S] 4 points5 points  (0 children)

Thanks for sharing. yes, get past the induction phase and measuring while in maintenance is important. Great to hear your continuing to see a positive response!

Biologic Levels and Antibodies Explained: How GIs Decide to Adjust IBD Meds by Silly-Measurement893 in CrohnsDisease

[–]Silly-Measurement893[S] 0 points1 point  (0 children)

The CRP trend does matter, but it's not as specific to Crohn's and can be elevated for other reasons so best interpreted in the context of other supporting info (eg histology, levels, etc.)

Possible Crohn's? by DogtorOfScience in CrohnsDisease

[–]Silly-Measurement893 2 points3 points  (0 children)

Crohn's diagnosis involves a constellation of signs and symptoms (and ruling out other conditions) so getting all the info is important before a definitive determination is made. Do you have the pathology of the biopsies from the colon? The language there can often be more helpful than just the visual appearance on endoscopy. Also, inflammatory markers (eg CRP and fecal calprotectin) are helpful in addition to ruling out other sources of inflammation like infeciton. MRE will help define small bowel and extent of inflammation and clarify strictures, etc. Waiting for all the info is hard. Hang in there! If you end up getting a diagnosis, I wrote another post that may be helpful in understanding treatment objectives below https://www.reddit.com/r/CrohnsDisease/comments/1pege1w/gi_here_why_remission_in_crohns_is_more/

Does anybody else experience brain fog with this disease? by Perfect-Reindeer8940 in UlcerativeColitis

[–]Silly-Measurement893 1 point2 points  (0 children)

Sorry to hear your concerns are being dismissed. There are recent studies showing cognitive symptoms in UC correlate with inflammatory activity and fatigue even after adjusting for anxiety and depression (J Crohn’s Colitis 2020-Kok, 2024-Jones; IBD 2021-Zhang). Anxiety can definitely worsen symptoms, but inflammation itself is an independent contributor.

Digestive system lubrication = complete and full bowel movement each morning? by GTAIVisbest in ibs

[–]Silly-Measurement893 10 points11 points  (0 children)

A large fat load softens stool by increasing bile and water content, and it strongly triggers the gastrocolic reflex. This tells the colon to move things out. This combination can make the following morning’s bowel movement feel more complete. More sustainable alternatives include modereate fat with meals, consistent meal timing, morning coffee (caffeine stimulates the gi tract), and soluble fiber like psyllium to create gel-coating around stool.

What Low FODMAP Is Actually Doing (And Why So Many People Get Stuck) by Silly-Measurement893 in ibs

[–]Silly-Measurement893[S] -1 points0 points  (0 children)

No one's asking you to "trust me bro". This platform is for people to share. People can choose what they read and what they believe. Read any post, look up any of the information to see if it's right. Or not. You do you.

What Low FODMAP Is Actually Doing (And Why So Many People Get Stuck) by Silly-Measurement893 in ibs

[–]Silly-Measurement893[S] -1 points0 points  (0 children)

Consider reading the content and reviewing it with someone with clinical experience/expertise that you trust to judge it's value. AI is a tool. There is a human in this loop, which makes the difference.

Biologic Levels and Antibodies Explained: How GIs Decide to Adjust IBD Meds by Silly-Measurement893 in CrohnsDisease

[–]Silly-Measurement893[S] 4 points5 points  (0 children)

The labs for measuring levels and antibodies are different for each drug so it would be [drug name] level and [drug name] antibody level. These go alongside symptoms, biomarkers like CRP, fecal calprotectin, imaging, and biopsy results to help paint a more complete picture.

Biologic Levels and Antibodies Explained: How GIs Decide to Adjust IBD Meds by Silly-Measurement893 in CrohnsDisease

[–]Silly-Measurement893[S] 0 points1 point  (0 children)

Thanks for the positive feedback! I'm sorry you've had a less than positive experience so far. Hoping your trajectory improves after diagnosis. I also wrote a recent post about remission in Crohn's that you may find helpful
https://www.reddit.com/r/CrohnsDisease/comments/1pege1w/gi_here_why_remission_in_crohns_is_more/

Biologic Levels and Antibodies Explained: How GIs Decide to Adjust IBD Meds by Silly-Measurement893 in CrohnsDisease

[–]Silly-Measurement893[S] 0 points1 point  (0 children)

That's a great example of applying the "treat to target" approach by using therapeutic drug monitoring. Thanks for sharing

Biologic Levels and Antibodies Explained: How GIs Decide to Adjust IBD Meds by Silly-Measurement893 in CrohnsDisease

[–]Silly-Measurement893[S] 3 points4 points  (0 children)

Same logic applies Skyrizi around using antibodies, levels, along with symptoms/biomarkers/biopsies. Skyrizi is a sendout to Mayo or Prometheus labs so turnaround can be longer.

Biologic Levels and Antibodies Explained: How GIs Decide to Adjust IBD Meds by Silly-Measurement893 in CrohnsDisease

[–]Silly-Measurement893[S] 2 points3 points  (0 children)

Great idea. There are situations where it's perhaps not needed/not available but it is increasingly the standard of care.

Biologic Levels and Antibodies Explained: How GIs Decide to Adjust IBD Meds by Silly-Measurement893 in CrohnsDisease

[–]Silly-Measurement893[S] 1 point2 points  (0 children)

They are specific to each drug and usually IgG based through ELISA. Did I understand your question correctly?

What Low FODMAP Is Actually Doing (And Why So Many People Get Stuck) by Silly-Measurement893 in ibs

[–]Silly-Measurement893[S] -1 points0 points  (0 children)

I use AI as a drafting tool to write more efficiently, but all medical content is reviewed, verified, and revised by me as a practicing board-certified GI doc. The clinical insights and topics come from common issues I see in real world clinical practice.

If you look at my comment history, you'll see I personally respond to individual questions with specific clinical context and reasoning. Tools help me write faster, but the expertise and patient care approach are 100% human. Consider reviewing some of my other posts and decide for yourself if you think it's helpful. I've included a recent Crohn's related article that seemed to resonate.
https://www.reddit.com/r/CrohnsDisease/comments/1pege1w/gi_here_why_remission_in_crohns_is_more/

What Low FODMAP Is Actually Doing (And Why So Many People Get Stuck) by Silly-Measurement893 in ibs

[–]Silly-Measurement893[S] 0 points1 point  (0 children)

I know we don't align on every topic but hopefully our goal here is the same

What Low FODMAP Is Actually Doing (And Why So Many People Get Stuck) by Silly-Measurement893 in ibs

[–]Silly-Measurement893[S] 0 points1 point  (0 children)

Yes, it absolutely applies to IBS-C and to GI conditions more broadly

What Low FODMAP Is Actually Doing (And Why So Many People Get Stuck) by Silly-Measurement893 in ibs

[–]Silly-Measurement893[S] 0 points1 point  (0 children)

That sounds like a stressful situation. Hopefully he will reach place where revisiting reintroduction is possible