6MP and Humira vs SCD

I was diagnosed last year with Crohn's, after discovering I was anemic. The pill cam, endoscopy, and colonoscopy last year indicated mild stricturing, along with ileitus and some erosions, etc., in the small intestine. Since then, I've been on Asacol, although I just finished a six week stint of Prednisone because my stools (when I don't have diarrhea) have been small for quite a few months. The prednisone didn't help at all.

I went to dr, and he wants me to start taking MP6 and Humira. Well, I've since found out my insurance won't cover the Humira completely, so that's out of the question (haven't told dr yet). The MP6, quite honestly, scares me because of the side effects. My husband really doesn't want me to take it because of it (it scares him too). We started the Specific Carbohydrate Diet today in hopes it will help heal the inflammation. It's pretty strict, so I'm praying I can be disciplined! I'm trying to decide if I should stay on just the Asacol and continue with the SCD, or if I should go on 6MP and continue on the SCD. I want to do the right thing. My husband feels the dr is leading me down the wrong path with these crazy meds and wants to go the route of nutrition. I feel the same way, except there's a part of me that is scared I'll end up with severe problems if I don't.

I don't feel my symptoms are very bad, compared to many other people. It's pretty unnerving knowing damage can be done without any severe symptoms. Have any of you just gone the route of nutrition and declined, say, MP6 or Humira? If so, was it successful? I really want to do the right thing, but I'm just not sure what that is right now.

Thanks for any input!

I'm assuming the stricturing wasn't enough to get the capsule stuck.

Asacol is very, very unlikely to help you. It's a medication for UC, not for Crohn's. Many published reports over the last 5-10 years have shown that the entire class of mesalamines, of which Asacol is one, is not effective in treating Crohn's. It will do nothing to prevent your strictures from getting worse.

6mp or its sister medication imuran are often used. They don't work as well as biologics like Humira or Remicade, but they certainly can work better than mesalamines. They do have a *risk* of side effects, but many people get none. My brother has been on imuran for years with no side effects whatsoever. On the other hand I couldn't tolerate it - it made me too nauseous. In rare cases it can cause pancreatitis. You will need frequent blood tests to start it, and that will be to check your liver. If you tolerate it well, you can take it long term. If you do have troubles with side effects, you can stop it and they will go away. So it's worth trying, IMO.

But I would caution you this: If your strictures are developing relatively rapidly, then Humira or Remicade or another biologic is really appropriate. Otherwise you're risking a blockage and needing surgery to fix the strictures. So whatever meds you do or don't take, be sure to get regular MRI's of the small bowel to follow the progression (or lack thereof) of the strictures. Remicade or Humira or other biologic meds are your best chance of preventing them (but still not foolproof).

Diets may or may not do any good at all. Many people report improvements in *symptoms,* but little is known whether diets can do anything to prevent Crohn's complications like strictures or fistulae. So feel free to try whatever diet you want, but I'd suggest doing it along with medication, not instead of medication.

You and your husband's fears of strong medications are legitimate, but perhaps too strong. You have to weigh this: What are the risks of the medications, and what are the risks of *not taking* the medications? With Crohn's, the risks of not taking them can be higher than the risk of the medications. Otherwise they would never get approval. Crohn's is a serious disease you can't just wish away, no matter how much we'd all like to.

I agree with beave and NCOT.

I haven't posted in a really long time, but happened by and saw your thread. I've followed SCD myself for 8 years, and am very happy with it. I was strict SCD for the first 4 years, and the last 4 years I have an occasional cheat of cocoa powder. I've been is remission since about 1 year into SCD (I have a colonoscopy every 2 years to monitor). My fistulas healed within a few months of starting the diet (which alone is enough to keep me on SCD).

The only crohn's med I take is Pentasa. I used to take 6MP, Imuran, Remicade, and Humira, but all they did was give me a fatty liver. I gave up the Humira about a year after I started SCD, and felt comfortable that the diet was working for me.

The only larger study I'm aware of about the efficacy of SCD can be read at http://www.andjrnl.org/article/S2212-2672(15)00504-3/fulltext?cc=y= . There have also been smaller ones, like at http://pulse.seattlechildrens.org/novel-diet-therapy-helps-children-with-crohns-disease-and-ulcerative-colitis-reach-remission/ .

Good luck with whichever option you choose!