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Just diagnosed with Crohn's this morning

Hello everyone,

I guess I'll start by giving my history. I'm currently 25 years old and around 3 - 4 years ago I suddenly experienced a lot of pain in my stomach. It was a new type of pain that would hurt even if I took a breathe, the only time I could relax was laying down in a certain position. I went to the emergency room and they did a ct-scan and were unable to find anything. This happened again around 3 months later. Once again I went to the emergency room and once again they found nothing. I put it in the back of my mind because the pain would only last for a few days before going away.

As the years went by the flare ups became more frequent, gradually going from 3 months in between to 2 months and so on, I no longer went to the hospital for the pain after the second time because I was tired of them putting me in a ct-scan just to find nothing. Eventually it got to happening at least once a month before my primary physician sent me to a GI. They did a Breath-Test and found some bacteria in my stomach and put me on some anti-biotics and told me to start taking pro-biotics everyday. The pain went away and I felt some relief for a few months. I thought it was over but the pain eventually came back, a new doctor decided to take me off the pro-biotics saying it was doing more harm then good at this point and had me do a colonoscopy where he find some very small white ulcers in a very small portion of my lower intestines. Everything else was fine though and it was assumed the ulcers were from the prep.

The flares up would continue until it got to the point where they would occur every other week. Another doctor told me to take dairy out of my diet, and when I had done that the flare ups of pain became less frequent. Once again, after a few months it go worse so my primary GI ordered another colonoscopy and endoscopy with a different prep and found those same ulcers. After that he told me that there was a chance I had Crohn's even though I had no other symptoms beside the pain. He order a IBD Serology 7 test with Prometheus Labs to be sent to LA, but unfortunately after I did the test the insurance denied it on account of it being too expensive and "unnecessary". I also had to do a few other blood tests, and with the results from those and the colonoscopy, my GI diagnosed me with ileitis in final section of my small intestines and prescribed me Pentasa with the warning that while not 100% this may be Crohn's Disease.

Fast forward 2 months and I've only had one flare up which I consider mild compared to my previous bouts of pain, and I believe this to have been brought on by the Lactose-Free Milk the GI suggested I try while off of dairy.

To my shock, when I went in for another visit this morning my GI said he spoke with another Pathologist in order to get his opinion and when comparing both colonoscopy results, they believe I have Crohn's Disease with 99% certainty. Now he wants to put me on Humira which scares the daylights out of my because of the known side-effects even though Pentasa is working. When I brought Pentasa up he said it was just another indication that I have Crohn's because it's been working so well. At this point I have no idea what to do or think, and reading up on the possible side effects of Humira specifically the chance of Lymphoma no matter how low it may be terrifies me. He currently wants me to do the standard blood tests and vaccines before getting my started on Humira, but I was hoping to somehow convince my insurance to allow me to take the IBD Serology 7 test and make sure I'm being treated for something I have.

I don't experience weight loss, diarrhea, vomiting, or blood, only pain. The pain starts gradually until it reaches a peak over the next 24 hours, I then break out into a short fever before the pain gradually goes away over the next 48 hours.

Sorry for the long post, but I'd appreciate any advice about what to do at this point... Pentasa seems to be working, but would it work in the long run and stop Crohn's from reaching the point of surgery? Would Humira reduce the chances of Crohn's going beyond this point? What are the chances that this is just ileitis and not Crohn's? Any help would be appreciated.
 
Hi, sorry to hear that.

I have quite the same story with Crohn's.
I'd consider as a good thing that your GI wants to put you on Humira. This way he wishes to kick out your Crohn's and put you in remission. Probably the fact that you have pain since 5 years has motivated him to such an approach.

Otherwise you could try azathioprine and others drug a bit softer. You could ask him about.

In my case they didn't work and humira seemed to do the job, at least on CRP/blood level.
Regarding the side effects, yes it's crazy. For the moment, after 3,5 months, I've experienced none of them, just a fatigue for two days after the shot.

Keep us informed
 

Angrybird

Moderator
Location
Hertfordshire
Hello and welcome to the forum :)

It is not uncommon for docs to go from the top down when it comes to meds, there are alternatives however that you can have a look at in our treatment forum that you may like to discuss with your doc before making a final decision: http://www.crohnsforum.com/forumdisplay.php?f=16. Also I think I have read here that Pentesa isn't a med that was created for crohn's - it's actually an approved treatment for Ulcerative Colitis so many here find that it doesn't keep things settled long term and have to move onto other meds.

Please keep us updated on how you get on.

AB
xx
 

SarahBear

Moderator
Location
Charleston,
Hi, welcome to the forum!

I'm glad to hear you've been feeling well!

As has already been said, Pentasa isn't the most effective maintenance medication for Crohn's. It treats only the top layer of the intestine, but Crohn's can affect the deeper tissues. Pentasa is usually used in addition to other medications, sort of like an added safety net. Do you know if they're planning to keep you on the Pentasa after adding in another medication?

If you're uncomfortable with Humira, let your doctor know. You can check out our Treatment forum, like Angrybird suggested, for information on Humira and other medications. They all have scary-sounding side effects... just keep in mind that they're possible side effects. As long as you keep an eye out for any warning signs and stay in contact with your GI, there's not much reason to worry.

I hope everything goes well for you! Please let us know what you chose. :)
 

David

Co-Founder
Location
Naples, Florida
Hi there and welcome.

The important information has already been covered so I'll just offer you a piece of advice. Learn everything you can about Crohn's disease. Chances are you're going to have to advocate for yourself as this is a VERY complicated disease. The more you learn about everything from the medications to dietary changes to alternative treatments, the better off you're going to be in the long term.

We're here to help every step of the way.

All my best to you.
 
Hi.....I agree that Pentasa is not a drug that will keep your crohns from causing more damage. I have had crohns for 10+ years and mine is generally pretty quiet. I was put on humira to put my crohns in remission. Which means no more active crohns. It does work really well. I was afraid of all the side effects to. I had all my vacinations b4 starting it. I had very few side effcts. No soreness at the injection site. I tolerated it really well. This could be the thing that nips it b4 it gets really bad. But talk to your doc if u have questions and concerns. The humira website has lots of good info on it. Good luck, hope things work out for the best :)
 
I have a very similar experience . I too was first just having pain. It happened my senior year of highschool and they sent me for an ultrasound for right lower quadrant pain and found nothing. The pain persisted but no other side effects. I had a colonoscopy and they couldn't see clearly and put me on pentasa but never "diagnosed" me. I will say two years later that looking back the pentasa which helped and seemed mild/ harmless ended up prolonging the inevitable for me. I thought it was working but apparently it's like putting a bandaid over something that could need a stitch. ( maybe a bad analogy) but I've also learned prolonged use of mesalamine as well as other meds can be harmful at times. My advice is to start hunting for a doctor you love. Who understands your fears who you can confide in who agrees with you as a patient. I too heard the words 6 mp and humiera at the first appointment where I learned I was " diagnosed" and I was in shock. My "crohns wasn't even bad" but don't be so quickly to judge these drugs by their cover their bark is somewhat worse than their bite in most cases. I have used both. Not that they are not to be taken lightly and they do have warning labels but what in our society doesn't these days. Life is too short . I would take the no other side effects use it to your advantage and if it is crohns you've caught it early take it to heart and nip it in the bud before you have to experience any symptoms :)
 
Hello....I am sorry that you are having these problems. I will represent the other side of the coin. Like you, I am very concerned about the side effects of the biologic medications such as Remicade and Humira. I recognize that my fears may not be totally in line with the reality of the chances of having any of the scarey side effects. But, I have been on the wrong side of statistics before ( totally unrelated to my Crohns) and so the idea that one has a very small chance of something happening does not ease my anxiety. I do recognize that many people have been helped tremendously by these medications.

I have chosen ( after having emergency bowel resection due to a perforated bowel occurring during a colonoscopy) that i am going to opt for no medication right now. My doctor is supporting this decision, although he has told me that it does not coincide with best practices right now. I am totally symptom free since my surgery ( 7 weeks ago). I will however, strongly consider using one of these medicines if my symptoms return.

One of the hardest parts of this disease, for me, is that there is not always one right answer. You need to do your homework, and figure out for yourself what you feel you can live with. I do understand your fears about Humira. I share them.

I hope you can figure out what wil be best for you.
-Lisa
 
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