At some point after the first surgery, Crohns disease can recur in the healthy parts of the intestine, usually at the resection site. (For example, if a patient with Crohns disease has an ileocecal anastomosis, in which the caecum and terminal ileum are removed and the ileum is joined to the ascending colon, their Crohns will nearly always flare-up near the anastomosis or in the rest of the ascending colon). Medical therapies
Medical treatment of IBD is individualised to each patient. The choice of which drugs to use and by which route to administer them (oral, rectal, injection, infusion) depends on factors including the type, distribution, and severity of the patients disease, as well as other historical and biochemical prognostic factors, and patient preferences. For example, mesalazine is more useful in ulcerative colitis than in Crohns disease. Generally, depending on the level of severity, IBD may require immunosuppression to control the symptoms, with drugs such as prednisone, tumor necrosis factor inhibitors (TNF inhibitors), azathioprine, methotrexate, or 6-mercaptopurine.Steroids, such as the glucocorticoid prednisone, are frequently used to control disease flares and were once acceptable as a maintenance drug. Biological therapy for inflammatory bowel disease, especially the TNF inhibitors, are used in people with more severe or resistant Crohns disease and sometimes in ulcerative colitis.Treatment is usually started by administering drugs with high anti-inflammatory effects, such as prednisone. Once the inflammation is successfully controlled, another drug to keep the disease in remission, such as mesalazine in UC, is the main treatment.
Cold sensitivity or cold intolerance is unusual discomfort felt by some people when in a cool environment.There is much variation in the sensitivity to cold experienced by different people, with some putting on many layers of clothing while others in the same environment feel comfortable in one layer.Cold sensitivity may be a symptom of hypothyroidism, anemia, fibromyalgia or vasoconstriction. Vitamin B12 deficiency usually accompanies cold intolerance as well. There are other conditions that may cause a cold intolerance, including low body weight, high body temperature and low blood pressure. There may also be differences in people in the expression of uncoupling proteins, thus affecting their amount of thermogenesis. Psychology may also play a factor in perceived temperature. See also
Apparent temperature
Thermoception
Raynaud syndrome


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