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01-05-2017, 07:14 PM   #1
kernelmom3
Senior Member
 
Join Date: Sep 2014
Flare treatments?

After my post last night, DD has had more odd looking (ahem) poop. First bright green, then light green and finally VERY light brown. She came in and admitted to me that she's been in pain for the last 2-3 days so I had GI paged. Right now she's eating normal, no fever and labs at her infusion last week were good. GI ordered labs and stool studies and said we could bring her in to get blood drawn tomorrow if she's still in pain. She doesn't want to start her on steroids right away. She thinks it may be a stomach bug (my youngest DS threw up a few days ago, but only once so not sure it's a bug). What does your kiddos GI do if/when there's a possible flare?
01-05-2017, 07:28 PM   #2
Maya142
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Usually we start with blood work and stool studies to make sure it's not a bug. We usually do FC if those are negative.

What dose of Remicade is she on? Is she also on MTX?
Hang in there!
__________________
Mom of M (20)
diagnosed with Crohn's Disease at 16
Juvenile Idiopathic Arthritis at 12
Juvenile Ankylosing Spondylitis at 16

Mom of S (23)
dx with JIA at 14
Ankylosing Spondylitis at 18
01-05-2017, 07:32 PM   #3
my little penguin
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Join Date: Apr 2012

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Basically what your doing
Bloodwork
Stool studies
And watch closely
Document bm types etc..
Depending then we go from there
Ds has had bloody stool for two days and then gone

We avoid steroids
Depending on results more tests imaging or scopes if needed
Most of the time things calm down.

Fwiw
Our GI doesn't care about any colors including green
Only wants to know about tar black
Pure white
Or maroon /bloody stool

Green stool can be caused by purple or blue popsicles slushy drinks etc...
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DS - -Crohn's -Stelara -mtx-IVIG
01-05-2017, 07:39 PM   #4
kernelmom3
Senior Member
 
Join Date: Sep 2014
She's on Remicade every 8 weeks (7.5 per kilo last infusion 12/27) and Methotrexate 10 mg every Saturday. Really hoping this isn't a flare

Thanks!
01-05-2017, 08:36 PM   #5
Maya142
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Hang in there! There are a lot of bugs going around, so it could just be that she's picked up something.

We will usually do scopes/tests if there is something that indicates that there is inflammation. And then we go from there - we increase meds or add something if necessary or change meds altogether. It really depends on the situation.

Easier said than done, but try not to worry too much until the tests come back.
01-05-2017, 09:56 PM   #6
pdx
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Join Date: Dec 2014
Location: Portland, Oregon

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My daughter has been flaring this fall, so we've just been through this. In her case, it was pretty clearly a flare--her symptoms always started about 4 weeks after her Remicade infusion, and included night sweats and joint pain in addition to diarrhea and cramping. Even so, our doctor first ordered a whole panel of stool tests, to rule out anything infectious. We also did the usual blood tests to look at inflammation markers, along with Fecal Calprotectin and Remicade levels/antibody testing.

Her Fecal Calprotectin was very high and Remicade trough levels were low, so we decided it was indeed a Crohn's flare. Her CRP and sed rate were very low, however, so those don't seem to be good indicators for her.

To treat the flare, we added back methotrexate about 5 weeks ago, and we're going to increase her Remicade dose a bit starting at her next infusion. So far, the treatment changes are really helping. She's asymptomatic at 5 weeks post infusion right now and has gained back all the weight she lost.

Based on the fact that your daughter just had her Remicade infusion about a week ago, I'd say there's a chance that she just has a bug. I hope that the testing gives you some answers soon!
__________________
Daughter E (15) dx with Crohn's 12/18/14 at age 12

Current treatment:

Remicade started 12/24/14 (currently on 9 mg/kg every 6 weeks)
Oral methotrexate restarted 12/2/16 (15 mg weekly)
vitamin D, folic acid, multivitamin, Prozac

Past Treatment
90% EN via NG tube 2/9/15 - 4/2/15
50% EN via NG tube 4/3/15 - 4/18/15
Supplemental EN via NG tube 5/7/15-6/19/15
Budesonide 3/3/15-6/30/15
Oral methotrexate 3/13/15 - 5/14/16 (15 mg weekly)
Topical clobetasol for Remicade-induced psoriasis
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