MbShea@PWP@English@UMCP

ABSTRACT: Crohn's disease rates are increasing within North America and other developed regions around the world at unprecedented rates. Crohn's disease is a condition characterized by chronic inflammation of the gastrointestinal tract. Common symptoms include stomach pain, fatigue, diarrhea, fevers, and cramping. There is a belief in the scientific community that a faulty immune system, in combination with other environmental and genetic factors, may bring on the disease. Due to the increasing rates of CD around the world and the toll the disease takes on a patient's emotional and physical health, I thought it would be wise to write a patient manual on how to deal with all facets of this complex disease. Furthermore, I have had CD myself for the past five years. I have been through various medications, doctors, diets, therapies, and done personal and lab-related research on the disease. Thus, the knowledge within my head and the sources that I can draw from are of the most relevant to patients who have just been diagnosed with CD and may be a little confused about what is happening to their body. Throughout this manual, I will discuss the symptoms, treatments, and causes of the disease. Furthermore, I will talk about lifestyle changes associated with the disease, holistic dietary treatment options, and the emotional impacts that patients and parents feel when they or their child becomes diagnosed with CD.

WC = 229
I imagine a reader skeptical that a gastrointestinal condition could cause depression, anxiety, or other mental health disorders. I especially believe this from a patient who does not believe in mental health.

READER's RESPONSE: The gut microbiome may play an important role in gastrointestinal health, but could it really influence your mental state? How could it be that bacteria in your gut, that are not even cells of your own body, cause you to feel sad? To go even further, the science behind mental health is lacking. I believe that being "depressed" or anxious has more to do with a situation you are in, how you react to it, and how you move on from it. I think depression is just another word for sadness. I do not fully believe that chemicals in your brain can make you chronically sad. Even if they could, I do not think that Crohn's disease, gut bacteria, or anything dealing with the gut could give you depression. I would like some more data on this.

**** NOTE: I just want to clarify that I do not feel the same way as my reader's response. This is just from the point of view of an imaginary, skeptical, uninformed reader. I actually feel the complete opposite of this and wholeheartedly believe in mental health and the connection it has to CD. I will use extensive research articles, doctor's opinions, and personal experiences to counter this uninformed reader.

J, you have a wonderful plan for this patient guide. Let's talk about two different ways to interject your voice in the memoir aspects of this guide:

first person cover note and end note (like a letter) OR

use of commentary set off by italics, in the body of your guide.