Crohn's Disease Forum » Treatment » Imuran/Azathioprine/6-MP » Avoiding infection with immunosuppression

01-24-2015, 11:26 AM   #1
Join Date: Jan 2015
Location: United Kingdom
Avoiding infection with immunosuppression

Hi all,

Advice needed for avoiding catching infections...

I've been diagnosed with Crohn's disease for three years and for the past two years have been treated with azathioprine and mesalazine. In that time I have repeatedly picked up colds/viruses which have progressed into chest infections. I have been admitted to hospital with influenza and last summer I had a particularly bad bout of bronchitis which I could not shift (with repeated courses of antibiotics) which developed into pneumonia.

On the plus side the treatment is working really well at controlling my Crohn's and I do not want to change it. I'm an assistant-headteacher at a large secondary school (UK) and the time that I have been having off with infections is impacting my role. I feel that I am not only getting more infections but also that I am taking much longer to get rid of them.

Does anyone have any hints for avoiding infections. I am really rigorous about hand hygiene. In terms of diet, I'm assuming that taking traditional 'immune boosters' like vitamin C will have little benefit due to the medication. Besides, I eat a well balanced diet with plenty of fruit and vegetables.

Kind regards,

01-24-2015, 11:59 AM   #2
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DJW's Avatar
Join Date: Jul 2013
Location: Ontario

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Hi and welcome.

I've bee pleasantly surprised at how few colds iI get.

Make sure you also sanitized when handling menues, phones, and door knobs. Those are magnets for bacteria.

Diet wise I make sure I eat healthy and rest.

I'm pretty fortunate.
Crohn's Disease
DX 1978 (12 yrs old)
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01-24-2015, 12:22 PM   #3
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Join Date: Mar 2011
Location: New Brunswick

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Handwashing is the biggest thing.

Diagnosed since 1990
Current Medications: None currently. Was on Imuran (150mg/day) and 5-ASA (3000 mg/day) as maintenance meds prior to surgery
Surgeries: Left hemicolectomy 2014.
01-24-2015, 05:51 PM   #4
Join Date: Feb 2014
Location: Springfield, Missouri
The advice for hand hygiene that I will add is that I wear shirts with extra-long sleeves so that I can use the sleeves as "gloves" to handle doorknobs, etc.

If your neutrophil or lymphocyte counts are near (or below) the low end of the normal range, then you may want to consider reducing your dosage of aza, although it will take 3 to 6 months for the counts to return to a higher level. Of course, this would mean balancing your reduced risk of opportunistic infections against the increased risk of Crohns symptoms.

You might also consider avoiding unnecessary social gatherings like visiting your in-laws more than once a year, or attending church more than twice a year on Easter and Christmas.
01-26-2015, 08:46 PM   #5
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Join Date: Feb 2014
Location: South bend, Indiana

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Hand washing is key. Encouraging those with whom you have a lot of contact to wash their hands. Encouraging students and fellow to teachers to stay home when they're sick.

Why do you think the usual immune boosters won't help?
How are your vitamin levels?
01-27-2015, 05:36 AM   #6
Join Date: Jan 2015
Location: United Kingdom
Thanks for the feedback. I've been obsessive about washing hands since being on azathioprine.

In terms of thinking immune boosters won't help, I've always worked on the assumption that azathioprine successfully controls my Crohn's by damping down my immune system. So taking anything that traditionally wards off infections (vit C etc.) will have little effect due to the immunosuppression. If it did have a positive effect on my immune system I'm assuming that it could then have a negative effect on my Crohn's?

I'm fortunate that my diet has little or no effect on my Crohn's so I can pretty much eat what I want. It is well balanced with plenty of fresh and raw salad and vegetables, berries, nuts and seeds.

I was away from work for two months last year and did not have any problems with colds/infections in spite of our two young children having repetitive colds. Then in the last two months I've been off three times with two bouts of bronchitis and a S. aureus skin infection which has caused severe peeling and blistering on my face. I appreciate the problem of jumping to conclusions but working in an environment with so many children does seem to be the cause.
01-27-2015, 11:48 AM   #7
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Join Date: Feb 2013
Location: Ontario

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Children should be taught to sneeze into their bent elbow, it contains the germs better.
I try not to touch my face at all, that's how the germs from your hands get into your system. When you pick up fruit and veggies at the store, they have already been handled by a myriad of people. When you get home, wash them well. Also, wash your hands before eating. I've been very fortunate when it comes to catching things, I'm also a bit of a hermit on purpose.

Crohn's Disease Forum » Treatment » Imuran/Azathioprine/6-MP » Avoiding infection with immunosuppression
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