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Crohn's Disease
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Posted 3/7/2014 2:02 PM (GMT -5)
Going to try and be short, I was diagnosed with Crohns in 2008. I went through the drugs, and did really well on 6-mp/pred. Pred was tapered and then 6-mp was great for a long time . I started to cut my dose of 6-mp from 100-50-25, and eventually I was off and feeling great. I was off for about a year and a half.

Symptoms came back last august. Went back to the Gastro in Dec, put me back on 6-mp. Was hesitant about pred for some reason. After a month had a really bad flair so, went to the ER and told them I needed Pred. Start pred, and already tapered off. about 6 total weeks on pred, started at 30mg.

Had a Colonoscopy, Dr said moderate inflammation in terminal Ileum which didn't surprise me. He then said he thought we should move into. Biologics. I'm confused by the haste. I've only been on the 6-mp 2.5 months. He knows it takes time. Not having any flairs, but do have pain in lower right stomach area. This pain is moderate some days, to non existent others. Has anyone else's Dr tried to rush them to Biologics? It just seems like he doesn't want to give 6mp a chance, even tho it worked in the past.
Posted 3/7/2014 2:12 PM (GMT -5)
Why were you tapered off 6mp if it was working for you?
Posted 3/7/2014 2:16 PM (GMT -5)
I wasn't tapered off by him. I did it myself, young and stupid. I didn't want to be on meds the rest of my life, especially without knowing long term side effects. I was pretty irresponsible with if, I know that now. But I understand more about it now.
Posted 3/7/2014 3:17 PM (GMT -5)
I've been there and done that. I struggled with and still struggle with this sometimes. I would skip doses when feeling well or just plain forget or be inconvenienced. At one point I was supposed to take 4 pills 3-4 times a day, and I would frequently miss my afternoon dose.

The first time you took steriods/6mp, did the steriods put you in remission? Or did you still have pain afterwards and the 6mp eventually calmed it down? For me, I've always needed steriods to go into remission and then maintenance meds (like 6mp) would allow me to ride that remission out longer than no drugs would. Perhaps the concern of your doctor is that you are not in remission.

One of the selling points that the biologics take in their marketing push is that with biologics you only take it every so often. It's not an every day oral medicine. Perhaps that is another reason your doctor is considering it for you?

Hopefully, your doctor is like mine and allows you to make the final decision. I opted not to take Humira for a while, but we talked about it at most appointments after the Remicade stopped working in 2006.
Posted 3/7/2014 3:19 PM (GMT -5)
My GI told me there is a real push in the field now to start with biologics rather than the more "light weight" meds, so that could be the reason, or at least part of it. I assume this is because they have now been around for over a decade and have proven to be the most effective treatment for inducing remission.

When I was first diagnosed back in 2006, it was very different--we started conservative and slowly got more aggressive as the more conservative treatments failed.
Posted 3/7/2014 3:45 PM (GMT -5)
I believe the steroids, within a couple days made me feel almost 100 percent. I then tapered and I remember when I tapered that I never had a flair up again, but the pain there slowly went away.

I haven't had an actual flair since I started the pred in the middle of January. I finished my taper about a week or so ago. Once I hit the 10mg pred mark the pain started to come back just like the first time. It almost feels like I pulled a muscle. It isn't a horrible pain, nothing compared to a flair.

I can't afford remicade, wife is not working and in nursing school. It just seems so rushed. He knows I've only been back on 6-mp for 2.5 months, and he is talking like it isn't working... Well we all know that it takes (in most cases ) longer than this to work. A part of me feels like the pharmaceutical companies are pushing these drugs because they are more expensive. It feels like his whole view on 6mp/pred has changed in the last 4 years.
Posted 3/7/2014 4:12 PM (GMT -5)
You have a right to make an informed decision about your meds. If you want to try 6MP a little longer then just tell him that's how you feel. There is a fair amount of financial aid for biologics if you decide to go that route. I think the newest research is supporting the "top down" approach for anyone who needs steroids to get into remission.
Posted 3/7/2014 4:27 PM (GMT -5)
Hello, i am new here too... also dealing with 2008 diagnosis. There are many ways to keep these diseases in check (no cure yet) but it's coming soon, esp with research

Things such as diet really do make a difference, and if you are not comfortable with the move to biologics yet, do some more research on your own-- the dr's do work for you, and you are always able to ask for a second opinion as well. Best of health to you!
Posted 3/7/2014 4:32 PM (GMT -5)
ps: in 2008, the meds included Prednisone, pentasa, prilosec, ciproflaxin, immodium, and entocort; it was hard to feel good while taking at least 20 pills per day

Today, things are much better-- careful diet, and Prednisone when asthma flares up. (Also, now use LDN to help w/ remission)
Posted 3/7/2014 5:22 PM (GMT -5)
Like someone else said, GIs now are starting from the top (biologics) and working their way down. Honestly, a lot of the "lower" drugs like 6mp really aren't strong enough for a lot of people, and people have been getting sicker longer because in the past doctors start at the bottom and work their way up. I know I could have saved a lot of months of being really sick if I had just started with Remicade instead of trying all the others and at increasing doses. Even taking both imuran and mesalamine at high doses together, I never got in remission and spent months longer on pred than I should have because of it, causing osteopenia and other problems from long-term use of high doses of pred. So I don't think it's a "rush" to the higher stuff, but because they want to help people get as healthy as they can as quickly as they can, you know?
Posted 3/7/2014 5:25 PM (GMT -5)
I can understand the top down method. My main concern why didn't he just have me on remicade in Dec. He put me on 6-mp, so why not let it play out for 6-8 months. If it doesn't work, then move on to the remicade
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