Crohn's Disease Forum » Treatment » Which way to go

01-10-2012, 06:31 PM   #1
curlywatts's Avatar
Join Date: Dec 2011
Location: LEEDS, United Kingdom
Which way to go

Hi all,
Just trying to get some advice on the treatment options I have been given.
I was diagnosed with crohn's last November and I was tapering down prednisolone while starting Aza.
I have just come out of hospital again after having a allergic reaction to aza.
I have gone back on Prednisolone and been asked to think about 3 options open to me.
I should first say I am 56yrs and the bit affected is 20cm (8 inches) mural thickening of the terminal ileum plus reactive lymph nodes.

The choices are Methotrexate, Infliximab, or surgery.

I know I have to make the final decision but

any advice for and against each option, I would be grateful.

Diagnosed Crohn's Nov 2011.
Nexium (PPI).
Taken Off Azathioprine.

What matters is not the length of the wand,

but the magic in the stick.
01-10-2012, 06:35 PM   #2
My dog has hands!
ekay03's Avatar
Join Date: Feb 2011
Location: Balch Springs, Texas
Hi curlywatts, Personally I would go meds before surgery.
Crohns dx 1992
Bowel resection in 2000 and remission since then.
150mg Azathioprine maintenance dose
Ferrous Sulfate
Folic acid
Bentyl as needed
Lyrica x2 daily for pain
Norco as needed for pain
Ondansetron as needed for nausea
Miacalcin for the bones
That's a lot of stuff, but I feel good

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01-10-2012, 07:00 PM   #3
jlanier's Avatar
Join Date: Dec 2011
Location: murray, Kentucky

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I agree. Although i was very thankful to have had my surgeries, i definitely think that surgery should be something you do when you dont have any other options.
Diagnosed with crohns Aug '11.
Surgeries: 2 total. The first was removed part of my colon, part of my small intestine, removed my appendix, and was given an ileostomy. The second removed more of my small intestine, and reversed my ileostomy.

Current Medications: Azathioprine 50mg once a day, Prednisone 10mg once a day, Humira 40mg every 2 weeks.
01-10-2012, 07:08 PM   #4
Join Date: Jan 2012
Location: Ohio
My inflammation is also in the terminal ileum. My doctor said we would try meds and surgery would be a last result. I would try the meds first and leave surgery being the last thing. ( Of course, I'm already thinking surgery for me, but meds haven't helped me too much) I hope you get feeling better soon! Surgery is very expensive too.
01-10-2012, 08:40 PM   #5
Join Date: Apr 2011
Location: Georgia
As long as you are not experiencing heavy bleeding or a possible preforation or some other potentially life threatening situation, I would also vote meds before surgery. Per my GI doc, "After surgery, Crohn's always comes back. It might take several years, or I have seen it return in several months, but it always comes back."

Unless the Mayan calendar is correct and the world will end in December, you're going to be dealing with Crohn's for a long time. Might as well figure out how to best fight it now.
DX March, 2011 - Symptoms 5 years prior
Azathioprine (Imuran) - 200mg
Vitamin B12 - 1500mg
Slow Fe - 180mg
01-10-2012, 09:28 PM   #6
Senior Member
SdN's Avatar
Join Date: Sep 2010
I agree with taking meds before surgery. However, I would let the docs decide which medicine is best suitable for you. That said I'm now taking 500mg Infliximab (Remicade) every 8 weeks and it is finally working wonders for me. I hope it lasts!
Diagnosed with Crohn's September 2009

50mg Imuran - Jun 2010
increased to 150mg Imuran - Jan 2011
5mg/kg Remicade every 8 weeks - Mar 2011
stopped Imuran - Aug 2011
7.5mg/kg Remicade every 8 weeks - Nov 2011
Remicade is still working - Nov 2014
Colonoscopy shows no Crohn's! - Dec 2014

Current meds - 7.5mg/kg Remicade
01-11-2012, 02:09 PM   #7
curlywatts's Avatar
Join Date: Dec 2011
Location: LEEDS, United Kingdom
Thanks for your replies, they will help me make a decision.
I would have thought surgery was a last resort but out of the other two I'm not sure which one has the least side affects.
That said most people seem to cope on Aza but it didn't suit me.

Thanks again.

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