He has taken every medication I can imagine, including Humira injections into his stomach. At present, he is taking hyoscyamine and Apriso plus pain medication when it gets too severe. He has a colonoscopy every year. When he has one of these “attacks,” the pain is so severe that he gets in a fetal position and can barely walk. He has been to the hospital at least 15 times in the past two years. He recently went twice in one week and before that, in just a three-month span, he went seven times.

He is unable to work because he is sick or too weak to function at least five days a week. He has never used drugs, alcohol or tobacco. Surgery has been suggested, but we are trying to avoid that if possible. He has seen at least six different doctors, and we are now hoping that you can help us. Please.

DEAR READER: Crohn’s disease is a type of inflammatory bowel disease (IBD). It can be debilitating and may lead to life-threatening complications, so it should be taken seriously by the sufferer and the treating physician(s). While there is no cure, there is good news. Today’s treatments can greatly reduce symptoms and may even lead to long-term remission.

The most common symptoms include diarrhea, abdominal pain and cramping, reduced appetite, weight loss, ulcers and blood in the stool. Others, especially those with severe Crohn’s, may also experience inflammation of the liver or bile ducts, arthritis, fever, fatigue, skin disorders and eye inflammation. Children may experience delayed growth or sexual development.

Complications include bowel obstruction, malnutrition, anal fissures, ulcers, fistulas (an abnormal connection between different parts of the intestine) and more. There is also an increased risk of colon cancer; however, the vast majority (more than 90 percent) of sufferers never develop it.

There are several types of treatment available. The first type is anti-inflammatory drugs, such as the Apriso (mesalamine) that your grandson is on, as well as azulfidine and corticosteroids. Immune-system suppressors are also used. Your grandson was placed on at least one of these, Humira (adalimumab). There are several others in this category. Antibiotics, which may be helpful in treating some of the complications, such as ulcers, abscesses and fistulas, may also be beneficial for those without complications, as many researchers believe that antibiotics will reduce levels of harmful bacteria within the intestine, as well as suppress its immune system.

Commonly used medications include pain relievers, antidiarrheals, iron supplements, laxatives, vitamin B12 injections, calcium and vitamin D, and/or special diets, such as nutrients introduced directly into the veins, which can bypass the stomach and intestine, thus reversing malnutrition.

Finally, surgery. If diet, lifestyle changes, medication and other treatment fail to relieve symptoms, surgery to remove a damaged portion, close fistulas or remove scar tissue may be recommended. Unfortunately, at best, surgery can provide years of remission, but it will be temporary. Nearly three-quarters of patients who undergo surgery will experience recurrence, with approximately half of them requiring a second procedure or more. Even if signs and symptoms improve, medication is often prescribed following surgery in an attempt to reduce the risk of recurrence.

I suggest your grandson try some of the following lifestyle and home remedies and at least meet with a surgeon to discuss his situation. He is clearly suffering, and if medications have not worked for him thus far, surgery may be his best option.

There is no evidence that diet can cause IBD, but certain foods and drinks may aggravate symptoms. He should limit his dairy intake; eat smaller meals; drink plenty of fluids; eat foods lower in fat, especially if the Crohn’s is affecting his small intestine; consider taking multivitamins to supplement lost nutrients; avoid foods that worsen symptoms; experiment with fiber to find the foods that cause the least upset but help reduce diarrhea; and finally, consider consulting a dietician familiar with the disorder to get further suggestions. He should also try to keep his stress levels down by exercising within his limits, practicing relaxation and breathing techniques and, perhaps, even learning biofeedback. He may also wish to see a Crohn’s specialist at a nearby teaching hospital.

To provide related information, I am sending you a copy of my Health Report “Irritable Bowel Syndrome.” Other readers who would like a copy should send a self-addressed stamped envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Acupressure is an ancient healing art that uses the fingers to press against specific areas of the body for the release of muscular tension. It promotes the circulation of blood, and can relieve pain, ease tension and arthritis, and a great deal more. Thanks for writing.

DEAR READER: The soap-under-the-sheets remedy is very simple. Place an unwrapped bar of soap under the bottom bedsheet nearest to the affected area. Some readers have had success using wrapped soap, as well. It was originally recommended for nighttime leg cramps but has also been found to be beneficial for other nighttime aches and pains in other areas, such as the shoulders, feet, back and neck. The soap may need to be replaced once in a while, say every three to six months, but it still retains its cleaning ability so it does not need to be thrown away. I suggest your wife try it since she has nothing to lose other than her pain.

I formerly was walking two miles a day; now I can barely walk a half-mile, and that is with stops. I have tried niacin and red yeast rice. I am currently taking omega-3 and flaxseed-oil capsules.

I am 5 feet, 2 inches and weigh 168 pounds. I am careful about my diet. I feel good and energetic when not taking a statin; however, I’m lethargic when taking the drug. I’m afraid to quit but am truly miserable, so which is the lesser evil? I truly do not know what to do.

DEAR READER: Statin drugs work well, but for some people, the price is high. This poses the question of whether the benefits outweigh the risks. No one wants to suffer a heart attack or stroke, nor do they want unpleasant side effects such as those you have experienced. The answer should be a decision between a patient and his or her physician. That said, there might be alternatives. First, however, let’s hit some possibilities.

You can lower the dose of your medication. This may reduce or eliminate the leg cramps and fatigue but may also reduce the effectiveness of the statin. You can change to another label; however, this might not be successful. You have already cut back on your exercise routine, so I can’t endorse a further reduction. While some researchers question its effectiveness, you might consider ezetimibe, a prescription cholesterol-absorption inhibitor, or you might try an over-the-counter with natural plant stanols and sterols. You don’t indicate if the niacin was at all effective. Did you give it a try for a satisfactory length of time?

If you smoke, discontinue the habit. Eliminate fried foods, the skin on chicken and the fat on steak. Broil meats, and be sure to cut off any excess fat prior to cooking. Continue to exercise and modify your diet. Eat more fruits, vegetables, whole grains, fish and chicken. Limit the amount of cheese and eggs you consume, and switch to fat-free milk.

Ask your physician if he or she would consider an appropriate length of time so you can initiate a new diet and exercise plan. Perhaps a referral to a nutritionist and the physical-therapy department of your local hospital will be appropriate. Consider an OTC that doesn’t contain a statin component.

Ask your physician or specialist for advice on treating your leg cramps. If an underlying cause, such as iron deficiency or peripheral neuropathy, enters the equation, obtain appropriate treatment. Then consider ibuprofen, meditation, yoga and warm or cold packs. Avoid caffeine and alcohol. Place a bar of soap under your bed sheet to alleviate cramping. Exercise, but don’t overdo it, because fatigue will make your symptoms worse.

To provide related information, I am sending you a copy of my Health Report “Understanding Cholesterol.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

I had some blood work done more than a year ago and am sharing the results with you. My doctors don’t feel the work needs to be repeated. TSH 3.48, T3 2.8, T4 1.06, rheumatoid factor 8, ANA, 80, potassium 3.8, bilirubin 0.2, and sedimentation rate 2. I hope this helps you.

DEAR READER: Based on your symptoms and lab results I strongly believe that you have hypothyroidism. This means your thyroid gland is not producing enough thyroid hormone to maintain your health. The thyroid gland produces several types of hormone, mainly thyroxine which contains iodine that allows for normal body growth and function.

As for your lab work, your TSH (thyroid stimulating hormone) should be below 4 but anything higher than 2.0 coupled with an abnormal T4 (thyroxine) (4.5-11.2) is a red flag for early-stage hypothyroidism. Your T3 (triiodothyronine) level should be 1.0 to 2.0. Yours is elevated because your body is attempting to fix itself by releasing more of one hormone to compensate for the lack of another. However, this attempt is failing in your case. The ANA is abnormal and in some individuals with thyroid disease can be increased, much as yours is. The other levels are all within normal limits.

I strongly urge you to see an endocrinologist who specializes in glandular disorders such as thyroid disease. He or she should run more tests to get up-to-date results. I suspect, they will clearly point to hypothyroidism. The specialist should also check you for other disorders and forms of thyroid disease such as Hashimoto’s thyroiditis and others.

Treatment is simply thyroid medication taken every day. Once on medication you should start to feel better within a few days.

As an aside, depression is not generally associated with thyroid disease but given your situation and lack of resolution it can be expected. If your depression does not go away once you start to feel better, I recommend you see a psychiatrist or counselor. He or she can work with you and, if necessary, prescribe medication.

To give you related information, I am sending you a copy of my Health Report “Medical Specialists”. Other readers who would like a copy should send a self-addressed 4 ¼“ X 9 ½“ letter-sized stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.