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25 weeks pregnant and crohns flaire-up

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Crohn's Disease
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Posted 2/5/2014 2:20 PM (GMT -5)
Im 25 weeks pregnant and Im having a horrible time with my crohns; joint pain and belly pain.  My OB ruled out anything is wrong with my pregnancy.  I wasnt on any medication... my GI just put me on a steriod pack that I started this morning.  hoping that will help with my joint pain.  My GI also ordered a MRI of my pelvis and abdomin.  He assured me that it is fine to get while pregnant but I was wondering if any of the crohns moms have had one while pregnant?  Im very anxious but also know I cant go the next 15 weeks with this pain.

Would love to hear your thoughts / concerns  

Posted 2/5/2014 2:27 PM (GMT -5)
Make sure you stay hydrated!!!
Posted 2/5/2014 2:56 PM (GMT -5)
I think the MRI itself is harmless, but what about the contrast they'll give you? And will you have to lie on your back for 45 minutes? That is bound to be uncomfortable. But the alternatives aren't great in terms of diagnostics available to you.

The steroids should help - but what is the longer term plan? Are you able to tolerate mesalamines? Where is/was the inflammation before your pregnancy? Should you use entocort instead of or in addition to pred to manage your illness for the rest of your pregnancy?

Are you keeping up with expected growth? Is your iron staying normal?
Posted 2/5/2014 3:30 PM (GMT -5)
Kazbern - thank you, I didnt even think about the contrast, Ill look into that. We did go over the "long term plan" depending on the results of the MRI is what Im going to start on... his current plan "could change after results" is to put me on entocort for the rest of my pregnancy and then after I deliver Ill go back on humira. Yes, baby is doing great. Ive had and will continue to have ultrasounds and stress test every 4 weeks to insure the growth and fluid level are OK. My labs arent so great... my hgb was 9.8 and hct was 31.0 on Friday so they up'd my iron and going to recheck my levels this friday.

Im not sure what mesalamines are?
Posted 2/5/2014 4:22 PM (GMT -5)
Mesalamines are the first line meds (safe during pregnancy) like Pentasa and Asacol. BTW, humira and remi are also safe during pregnancy, but I'm not sure about restarting while pregnant.

Low iron is pretty common in the 3rd trimester, but 9.8 is getting awfully close to scary.
Posted 2/5/2014 7:06 PM (GMT -5)
I'm sorry to hear that you're flaring. I don't know much about an MRI while pregnant, but I do know about meds while pregnant. I took asacol, prednisone, omeprazole, and remicade or Humira with all 3 of my pregnancies. Did you stop the Humira because you were pregnant? I was part of the OTIS study in Humira during pregnancy. It showed that Humira has no negative effects on the baby. I switched from remicade to Humira sometime around 13-14 weeks with my 3rd kiddo because the remicade wasn't working for me anymore. I'm sure there would be a little concern in starting you up now, but it's better than what could happen if all heck breaks loose and you flare badly. Has your GI mentioned restarting? As Kazbern mentioned mesalamine is pretty safe. I took asacol and it breaks apart in your intestine so it has a local effect instead of a systemic effect (like entocort, but not a steroid). That could possibly be a good help.

It sounds like your doc is really on top of things so, that is great! I hope you can get this under control without too much trouble so that you can enjoy the rest of your pregnancy.
Posted Yesterday 1:01 PM (GMT -5)
So sorry you have to deal with a flare during pregnancy. I flared pretty much the moment I conceived and ended up having to be hospitalized. I was thankfully able to get the flare under control with IV steroids, and I started sulfasalazine as well for my joint pain. I thought I'd have to try Cimzia after I got off the steroids (since Remicade and Humira didn't work for me), but miraculously I was able to maintain on just the sulfasalazine for the rest of my pregnancy and had an almost 2 year remission after that.

If you don't have a sulfa allergy, sulfasalazine may be a good option for you since it's supposed to help with the joint pain. It also is supposed to help with Crohn's colitis, but if your inflammation is elsewhere, you may need to try something in addition to that.

I also had to have an MRI while pregnant since I developed fistulas. You won't be able to use contrast since you're pregnant, but your doctor will probably put notes on your MRI request. You may may just want to double check with your doctor to make sure. I think I was about 20 weeks when I had the MRI, and my baby went crazy kicking from all the noise, but it really wasn't that bad of a procedure. I was still having some joint pain but it was doable. Honestly though, it seemed almost pointless since when I spoke with the cool-rectal doctor he said he couldn't really tell for sure where the fistula tracks were, but my baby had no negative side affects.

Try not to worry too much about your baby, which I know is pretty much impossible. My GI said I had the worse pregnancy he's ever seen, and I didn't think I'd be able to get through it, but I did and my daughter is perfect! It was worth all the pain. Good luck to you, I hope you can get in remission soon.
Posted 2/8/2014 4:33 AM (GMT -5)
Octobergirl - thanks for sharing! My MRI is wo contrast but they said I would still have to drink stuff... Does that sound right?
Posted 2/8/2014 4:38 AM (GMT -5)
Stef17 - I've been on humaria 2 different times... Each time my Bp would go crazy!!! With my 1st child I was on humaria & they just medicated my Bp... Ended up having him at 36 weeks due to Bp issues. The longer I seem to be off humaria the better my Bp is. Maybe it's not related but I'm convinced it is. I know I need a good maintenance drug.. Hoping I find one that works.
Posted 2/10/2014 9:24 AM (GMT -5)
I didn't drink anything, but I only had the MRI done on the lower end of my pelvis due to fistulas. Maybe since you're getting your abdomen looked at it is different? Good luck with the MRI, it shouldn't be a big deal. I hope you can get your flare under control quickly and have a comfortable rest or your pregnancy.

FYI, if you end up having to stay on steroids for a while, you may want to ask your doctor to prescribe you a glucose monitoring kit. I had to be on steroids for a few months after the IV steroids, and they wanted to make sure I didn't develop gestational diabetes. Thankfully, I was able to control my blood sugar with just dietary measures, it was a bit difficult because you can't eat many carbs, but at least I didn't have to take insulin.
Posted 2/16/2014 8:51 AM (GMT -5)
Follow whatever the doctor tells you! I went into labor at 26 weeks because of a flare. I had to stay in the hospital on bed rest and pumped full of drugs to keep the labor under control. While all that helped, I still delivered early. My son was in the NICU for two months. And I had to stay longer as well--my flare was more complicated than the original MRI showed. I had fistula and abscess and almost required surgery.

On top of feeling horrible physically, I felt like the worst mother--especially when I couldn't nurse because of the drugs. (Breastfeeding is best for preemie babies.)

Get as healthy as possible by any means possible. The baby has developed so much that s/he will be fine--as long as you get healthy!
Posted 2/26/2014 8:25 AM (GMT -5)
I am getting ready to try and conceive, but am currently on 6mp. Did you get off of all meds when TTC because your dr told you to?

I have an appointment with my Dr. for 3/3, but am trying to do all of my research before going. Remicade is not an option for me - my insurance doesn't cover it and it's way too expensive. I used to be on Asacol, but it never worked for me.
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