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Crohn's Disease Forum » Treatment » What is the typical first step for treatment?


01-27-2017, 05:18 AM   #1
skittle
 
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What is the typical first step for treatment?

I'm seeing the specialist on Thursday and I'm 99% sure I have crohns. I'm wondering why to expect from this appointment. I'm in daily pain, extremely intense and to the point of vomiting.

What do most specialists do once diagnosed? Do you have a range of medication for different symptoms? Is there something in particular I should ask for? Any advice on going into this would be great.
01-27-2017, 06:20 AM   #2
ronroush7
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I am guessing that the specialist will want to run some tests to determine if you have Crohns Disease. I am not sure which ones. If you do have Crohns Disease, it will depend on the severity of the disease to determine what type of medicine he prescribes. I wish you the best.
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01-27-2017, 06:25 AM   #3
skittle
 
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Thanks ronroush. I've already had a ct scan, colonoscopy and gastroscopy, and a barium swallow. You don't think he will make a diagnosis based on that?
And as far as medication goes, worst case scenario - am I potentially looking at numerous meds or do they try one at a time?
01-27-2017, 06:33 AM   #4
ronroush7
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Depending on how severe the disease, he may start you on one and if that isn't working then add some others. I am no expert. Please keep us appraised of how you are doing.

01-27-2017, 06:38 AM   #5
skittle
 
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Thank you. Yep I'll update after my appointment. I'm hoping like hell he can give me something because at the moment I'm not functioning! I spend half the day on the toilet and the other half in pain! My kids are missing out, I'M missing out. My life feels like it's on hold.
01-27-2017, 06:39 AM   #6
ronroush7
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I am sorry. I hope he can get you into remission soon.

01-27-2017, 08:21 AM   #7
eleanor_rigby
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He will most likely get you on steroids as a first step if you are diagnosed to bring down inflammation. Then they will want to do blood tests to see what treatment you may be suitable for and this will also depend on what country you live in what they will want to prescribe you.
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Emergency open bowel resection after perforation in 2011 (age 22) (wrongly diagnosed as burst appendix ). Three years remission following this unmonitored

DX with perforating small bowel Crohn's Disease 01/2016 (terminal ileum, duodenum) and coeliac disease (age 26)

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01-27-2017, 11:29 AM   #8
Scipio
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There are two steps to most treatment plans for Crohn's: Induction and Maintenance.

Induction is the initial phase of therapy to knock down the inflammation and get the disease under control. Steroids are usually used for that, although some biologics can also be used for induction. But steroids have a lot of side effects and thus are not a long-term solution. So sooner or later the doc will try to move you to a maintenance medicine.

Depending on the severity of your disease the doc may recommend an immunosuppressant drug such as azathioprine (brand: Imuran) or perhaps methotrexate. Or you may go directly to a biologic or he may prescribe both. A biologic is a human or humanized antibody that interrupts the immune response in some way, usually by attacking your tumor necrosis factor (TNF) of by blocking the activation or the target binding of your white blood cells. Biologics are complex proteins rather than small, simple molecules so they are administered either by injection or infusion.

Also available are the salicylate derivatives, but they are very mild drugs and are not very useful for Crohn's in the first place. They are better used for Ulcerative colitis. From your symptoms I suspect your disease is too severe for those drugs.

Good luck
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