The Trouble with the Word “Remission”

It’s pretty much been six months since I was diagnosed with Crohn’s Disease and according to the results of the blood sucking work taken this past Friday, I am now in “biochemical remission” from the Crohn’s.

Happy Dance!

This, naturally, is very good news, because it means that my immune system has finally dampened down enough that it is doing the job its meant to be doing (attacking infections of various sorts) and not the job it thinks it should be doing (attacking me). This was the whole point of that horrible experience with the Prednisolone and why I subject myself to self-injection and the horrible Humira-yucks.

It also conveniently proves to that bastard first consultant that I was right about biologic drugs being the right course of treatment for me, but I digress . . .

Of course, this doesn’t mean that I am in anyway ‘cured’, it just means that the disease is not currently active. Which is good. But it doesn’t mean that the symptoms are totally gone. I still have good days and bad days, and if you asked my digestive system this past Saturday what it thinks, it made a very clear statement that it was not happy with me. Why? I have no idea. I didn’t eat anything out of the ordinary, but it sounded like a scene out of Alien and it was a miserable day.

Seriously, this is exactly what Crohn's Disease feels like

And that’s the trouble when it comes to the word “Remission” and IBD. All of the scientific markers, like your CRP (inflammation marker in your blood), White Blood Cell Count (elevated levels indicate that your immune system is fighting something) and the Calprotectin in your, well, let’s not discuss that, can indicate that everything is “normal”, but you can still have symptoms. For some doctors, the definition of ‘remission’ is based on the above. Some define remission as the reduction of all inflammation of the muscosa (the lining) of your guts, except the only way to prove that is by biopsy, which is a pretty invasive way to prove a point. For others, it’s the complete elimination of all symptoms, which is known as ‘clinical remission’. The trouble with that goal is that one mild case of food poisoning could mean that you no longer fit that definition. The other problem with that definition is that, although very different illnesses, IBD and IBS can (un)happily co-exist. So you may have taken care of the problem that is destroying your guts, but you can still have the “functional” problem.

So as you can see, there is lots of debate about what the definition of Remission is. But in the meantime, I’m just going be happy that my over-active immune system has been turned down a notch.

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