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Crohn's Disease Forum » Pregnancy, Trying to Conceive & Breast Feeding with IBD » Azathioprine/Pregnancy & Right Hemicolectomy Operation


01-08-2014, 02:28 PM   #1
kelster
 
Join Date: Jan 2014
Location: aberdeen, United Kingdom
Azathioprine/Pregnancy & Right Hemicolectomy Operation

Hi,

I am hoping to hear from some of you that may have been in similar situations that I am in.

I am 33 and have had Crohns diagnosed when I was 21. I have never been admitted to hospital because of my Crohns and any flare ups I have had have been a few days maximum.

5 years ago my specialist told me to get an operation as I have 20 cms of bowel that is narrowed and the only way to fix this is to operated.

I decided again the operation and seen a dietician - from then on I cut out things like peppers, tomatos, fruit with skin - anything that is hard to digest.

I am on 150mg of Azathioprine a day. I then lived with my Crohns managing it by my diet and medication. I have only ever been on steroids once and that was before my medication.

I decided to come off Azathioprine in 2012 because my symptoms had more of less gone then I gradually started to weaken and had sharp pains in my right hand side where the narrowing is.

I was sent for an MRI scan in April 2013 where they basically confirmed about the strictured part of my bowel as 'severe'. The crohns is only in my right side where my large bowel joins the small. My options were basically get a right hemicolectomy or try infliximab! I decided the operation was the best way but went back on Azathioprine. A few months later I was feeling fine again! Therefore I guess the medication is definitely working.

To add to this, we want to start a family this year. My specialist recommends I get the operation before I try. I am struggling to get my head round getting this operation when I feel fine and am controlling it.

The surgeon suggested I don't get it if I don't need it.

I worry about getting pregnant while on Aza but my specialist says this will be fine - but I have heard some stories about birth defects.

I also worry if I don't get the operation and go ahead with pregnancy could this worsen the narrowing and risk my bowel perforating?

My thoughts are if I have never came off aza I'd have never got the MRI scan so never be in this situation.

Hoping someone out there may have had something similar...

A very confused lady
01-09-2014, 07:21 AM   #2
dollykitten84
 
Join Date: Jan 2014
Hi there, i am 29 and have crohns disease. i have been on azathioprine (150mg) for about 8 years now. i got pregnant and had my little boy in 2010 all whilst staying on aza, i then had a resection of 10cm in 2011, and i had my little girl in nov 2012. i have never came off aza, the only downside i was told is that i couldnt breastfeed whilst on it. If you come off aza before getting preg it is more dangerous for the baby in case you relapse whilst carrying the child and get really poorly! its safer for yourself to be helathy and well whilst pregnant. i have heard about the birth defect thing (not through professionals though) but it was highly advised that i stay on aza. I got told that the only thing that could happen is that baby would be smaller than average when born - so had regular growth scans to keep a check on this! my son was 9lb 10oz and my daughter was 9lb 2oz - so that obviously wasnt the case with me ha ha!!

i did get told that after my first child my crohns could flare up, and i suppose it did as 1 year later i had a blocakge and had a resection.

hope this helps a bit :-) xx
06-16-2014, 11:37 PM   #3
LovingtheCoast
 
LovingtheCoast's Avatar
 
Join Date: May 2013
Location: Duncan, British Columbia

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Hi,

I am hoping to hear from some of you that may have been in similar situations that I am in.

I am 33 and have had Crohns diagnosed when I was 21. I have never been admitted to hospital because of my Crohns and any flare ups I have had have been a few days maximum.

5 years ago my specialist told me to get an operation as I have 20 cms of bowel that is narrowed and the only way to fix this is to operated.

I decided again the operation and seen a dietician - from then on I cut out things like peppers, tomatos, fruit with skin - anything that is hard to digest.

I am on 150mg of Azathioprine a day. I then lived with my Crohns managing it by my diet and medication. I have only ever been on steroids once and that was before my medication.

I decided to come off Azathioprine in 2012 because my symptoms had more of less gone then I gradually started to weaken and had sharp pains in my right hand side where the narrowing is.

I was sent for an MRI scan in April 2013 where they basically confirmed about the strictured part of my bowel as 'severe'. The crohns is only in my right side where my large bowel joins the small. My options were basically get a right hemicolectomy or try infliximab! I decided the operation was the best way but went back on Azathioprine. A few months later I was feeling fine again! Therefore I guess the medication is definitely working.

To add to this, we want to start a family this year. My specialist recommends I get the operation before I try. I am struggling to get my head round getting this operation when I feel fine and am controlling it.

The surgeon suggested I don't get it if I don't need it.

I worry about getting pregnant while on Aza but my specialist says this will be fine - but I have heard some stories about birth defects.

I also worry if I don't get the operation and go ahead with pregnancy could this worsen the narrowing and risk my bowel perforating?

My thoughts are if I have never came off aza I'd have never got the MRI scan so never be in this situation.

Hoping someone out there may have had something similar...

A very confused lady
Hi kelster,

I am in a very similar situation to you. I have been on AZA for about 5 years and after about 4 years feeling well, I started to have more and more flares and partial obstructions. After a great deal of careful thought and research, I started Humira and my symptoms greatly improved. All of a sudden I had energy, my hair and nails grew long and strong for the first time in decades, and I was able to work out again. However, I was still have partial obstructions due to my stricture/ scar tissue. These episodes - while infrequent - were awful. My husband and I are ready to start a family, so after much discussion with my doctor, I have decided I am ready to have the stricture removed, aka a right hemicolectomy. My surgery has not been booked yet, but it will likely be in the next two months. My surgeon suspects that I will be in a good position to consider conceiving after I am fully recovered for the surgery. It is by no means a "forever solution", but it is my hope that it gives me a window of time to have a healthy pregnancy and baby. My intention is to go off of AZA, but stay on Humira until the third trimester (per my GI's recommendation - but everyone has to make their OWN personal decision when it comes to treatment + pregnancy. I am hopeful and I wish you the best of luck as you make decisions for your next step.

All the best,
steph
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