Underground chocolate dens

Last night I dreamt that chocolate was outlawed because scientists discovered that it has the same chemical effect on the brain as cocaine and in large quantities posed just as dangerous health risks as other drugs, such as obesity which then leads to heart problems, diabetes and death.

Of course I was horrified, and in no time at all I quickly sourced some underground supply of the delectible substance.

I spent the entire night holed up in seedy, dimly lit, Cocoa dens trying to get a fix. At one point I ran out of money and the dealer just wouldn't extend me anymore credit. I started to get agitated and began alternating between swearing at him and pleading with him.

It didn't take long before a guy that was 8 foot tall and 3 foot wide approached me and said in very James Earl Jones like voice "I think you've had enough" I made one last futile dash for the 80% cocoa stash on a nearby table and was promptly scooped up and thrown out the door. "Don't come around here no more ya bum" He shouted as I crawled out of the gutter.

It was then that I was approached by a rather unsavoury character in a long trench coat. He helped me to my feet and began telling me that he knew where we could get the good stuff. I went with him willingly to another of these Cocoa dens.

The air was thick with chocolate and the room was slightly to warm. It felt like I was breathing pure chocolate. I began to relax. The lights were low and soft music played gently in the background while semi-sleepy people rested about on worn red velvet couches. In the corner of the room was a giant chocolate fountain and littered around the bottom were an array of small children lazily dipping spoons and lollypops into it.

I was told that I could have unlimited access to this chocolate utopian world and all I had to do was sign away the rights to my bank accounts, house and dog. Hypnotised by the dark chocolate crème centres I could see in front of me I scrawled a rough signature on the piece of paper muttering something like, "Sure Bill, whatever you need, man" and took a seat in front of a pile. I began to eat as much as I could. nom nom nom...

I woke up from this dream feeling full, bloated and nauseas. My stomach is sore and crampy. It doesn't seem fair that I should suffer all the ill effects of gorging myself senseless on chocolate when I haven't actually had the pleasure of said chocolate. Where are the Crohn's police. I want to lodge a complaint.

exhale

I think I've forgotten what it's like to feel healthy. I know too many people who have their health without any real effort. While I don't begrudge them this in the slightest, sometimes I do feel a little twinge of envy. 

It's such a delicate balance between eating enough that your nourished, but not eating so much that you feel sick, eating something that's nutritious, but not going to upset the disease. Between getting enough exercise, but not wearing yourself out, taking it easy but not being sedentary. Between having a life, but not overdoing it, having a quiet one and becoming withdrawn...

Generally I do a pretty good job I think. So I'm throwing caution to the wind and having pizza, garlic bread and wine for dinner. Tonight I feel weary of this Crohn's saga.

Everything you never wanted to know about Crohn's Disease

While randomly roaming around the internet, as I often do in moments lacking of any alternative productive activity, I stumbled across Ventedspleen.com. One of the blogs there caught my attention. 

Tom Humberstone is a comic artist and illustrator based in London. His first comic 'Art School Scum' became a critically acclaimed cult hit and his latest book 'How to Date a Girl in 10 Days' won the 2008 Eagle Award for Favourite black and white British comic.

Tom Humberstone's "Everything you never wanted to know about Crohn's Disease" comic is an interesting piece. It's worth checking out.

Predictors of disease behaviour change in Crohn's disease

Using the Vienna classification system, it has been shown in clinic-based cohorts that there can be a significant change in disease behaviour over time, whereas disease location remains relatively stable. Clinical and environmental factors as well as medical therapy might be relevant in predicting disease behaviour change in patients with CD. In previous studies, early age at diagnosis, disease location, perianal disease and, in some studies, smoking were associated with the presence of complicated disease and surgery.

The combined effect of markers of disease phenotype (e.g., age, gender, location, perianal disease) and medical therapy (steroid use, early immunosupression) on the probability of disease behaviour change were, however, not studied thus far in the published literature.

A research article published on 28 July in the World Journal of Gastroenterology addresses this question. Members of the Hungarian IBD Study Group led by Dr Peter Laszlo Lakatos from the Semmelweis University investigated 340 well-characterised, unrelated, consecutive CD patients (M/F: 155/185, duration: 9.4 +/- 7.5 years) with a complete clinical follow-up. Medical records including disease phenotype according to the Montreal classification, extraintestinal manifestations, use of medications and surgical events were analysed retrospectively. Patients were interviewed on their smoking habits at the time of diagnosis and during the regular follow-up visits.

They found that perianal disease, current smoking, prior steroid use, early azathioprine or azathioprine/biological therapy are predictors of disease behaviour change in CD patients.

The new data with easily applicable clinical information as presented in the article may assist clinicians in practical decision-making or in choosing the treatment strategy for their CD patients.

From: World Journal of Gastroenterology 2009; 15(28): 3504-3510 http://www.wjgnet.com/1007-9327/15/3504.asp