Right. There are some studies, as shown above, that anti-TNFs can and do help with small bowel Crohn's. There's not a huge amount of studies or data, but there is some, probably enough to support the...
Entocort can be used for inflammation of the terminal ileum. It's targeted to work there with far lower side effects than prednisone. But, like prednisone, it's not a long-term solution. Your...
Unfortunately, yeah, that sounds like it's probably Crohn's disease. There's a small chance it's from the ibuprofen use, but that's pretty unlikely, especially with the family history. I'm sorry for...
It is. https://www.tga.gov.au/resources/auspmd/omvoh...
Of course you can have Crohn's disease in the colon. At least 60 to 70% of Crohn's patients have at least some disease activity located in their colon. A good 30-40% have it only in their colon....
Yep, self injection of infliximab (or a Remicade biosimilar) and self injection of Entyvio have just recently gotten approval. You have to do the injections every two weeks (I think), not every 8...
If you're still having rectal inflammation on a biologic, it's perfectly fine to use rectal meds if they help. If they rectal inflammation is severe, it might indicate that you need to try a...
If a person gets into a pretty good remission on a biologic, then the benefits of continuing on mesalamines are debatable. Downsides include the cost and the hassle of so many pills. Benefits include...
Your scope results - no visible inflammation - are quite good. The biopsy report is disappointing, and it shows there is microscopic inflammation occurring - but that doesn't entirely negate the...
It's a patchwork of spiderwebs thrown together, and nobody wants to fix any of it because that might reduce profits for somebody involved. A couple of months ago I went in for a routine doctor visit....
Quincy's reply hits on some good points. The symptoms yo-yo mentions are not typical for a flare of UC. I can't help but wonder if there's something else going on, or if it's not UC at all but...
Did you seem to get a response to Entyvio at all (before this most recent flare)? What about when you were on Stelara - did you respond to it at all or not at all? Tremfya is an anti-IL23 inhibitor,...
You are right that increasing Entyvio frequency is done for people who get a response but metabolize the drug too quickly and have low levels by week eight (and also may start to flare before their...
Combination therapy of azathioprine with an anti-TNF is well-studied and shown to be more effective than monotherapy alone (with the downside being increased risk of several side effects). Adding aza...
Can you find out what your duodenal biopsies showed from the 2021 upper endoscopy that saw the superficial ulcers? Did the doctor give any explanation of why you have those ulcers?...
I was looking at your post history. Was the scope around 2021 your last one? When they've done upper endoscopies and seen the problems in your duodenum, did they biopsy that area? I can't help but...
You're certainly welcome. And definitely keep us updated on how everything goes....
I understand the question. But unfortunately that's one that I don't know the answer to!...
When I mention immune reactions to Remicade due to formation of antibodies, I'm thinking of things like rashes, joint aches, fatigue, low-grade fever, things like that....
Standard starting dose is 5mg/kg of body weight, every 8 weeks. From there, some people need to increase dose frequency to every six weeks or even every four weeks. This is often done if the person...
It's possible that lowering the dose and/or frequency of your Remicade infusions could reduce or eliminate the impetigo. It's impossible to know for sure without trying. Did you start Remicade on...
That's correct about Remicade having the best odds of success. Even though it has been out the longest, studies show it's still the most likely drug to help. Entyvio doesn't have as good of odds,...
Advantages of Remicade are that it has the longest track history of use (it's been out longer than any of the other biologics used in IBD treatment), it has lots of data supporting its use, it has...
Yes, infliximab (Remicade) can increase one's chances of developing impetigo. Remicade doesn't cause it directly (staph does), but Remicade makes you more susceptible to getting it because of its...
What exactly did the biopsy results say? Do you have a copy you can share? Where did you have the genetic testing done?...
This new drug candidate was developed by Prometheus Biosciences, a company founded in San Diego by some gastroenterologists and associates from Cedars-Sinai (Los Angeles) along with some researchers...
File an appeal with your insurance. Get your doctor to support the appeal with a note/email/letter....
Unfortunately, yes, I would say it's a poor choice - unless there are other medical concerns I'm not aware of. Entyvio might work for you, but studies show the odds aren't very good. If you have some...
Humira and Remicade are anti-TNFs. They block the action of the "help" signal TNF-alpha that is sent out by the bowel tissue. You are correct that Stelara and Entyvio are no in the same class of...
If you had no response to Humira, despite having sufficient levels and no antibodies, that means you would be considered a "primary non-responder" to anti-TNF medications. That means that Remicade is...
Hi, sorry for the delayed reply. In this situation, where you had initial response but lost it, without having antibodies or low trough levels, I'm not sure what to recommend. I'm not sure whether...
When they tested you for antibodies to Humira, did they also check your trough levels? Did you have sufficiently high levels in your body, but it just was no longer working? Or were you metabolizing...
Did you have any response at all to Humira? If you did, it's possible that Remicade will help a little more than Humira did. But if you didn't get much of any benefit from Humira, then Remicade...
Can you share more info on your history and what symptoms and test results led to the initial diagnosis of UC? Have you had tests of your small bowel (such as an MRI)? Have you ever had an upper...
Yes, it's a biosimilar to Remicade, and it should be fine....
Hi Gracie, I too have a diagnosis of UCTD. I see a couple of possibilities with your situation: 1) The original diagnosis wasn't correct. There are many reasons why ANA can be positive, including...
Sounds like you went through a pretty big surgery. But definitely sounds like it was the right decision to do it! Thanks for the updates, glad it went fairly well, and take it easy on yourself the...
I agree with poopydoop's suggestion: any time you have an abrupt worsening after a period of stability, you should have a stool test done for infectious causes, including c. diff. That should always...
That sounds like an entirely reasonable approach. Good luck with the surgery and keep us updated....
What type of microscopic colitis do you have? There are two main types: lymphocytic and collagenous. Microscopic colitis is most commonly diagnosed in middle-aged women. For some, it flares only...
When I suggested a university/academic hospital, I was suggesting one that has a dedicated IBD specialty team. Not all do. Many GIs treat IBD along with countless other gastro diseases, but only a...
Happy to hear your NP discussion is consistent with what you're reading here. I would make the choice based in part on whether or not you have other health problems or family history or risks. All of...
The risk would be if you accidentally swallowed some (or a lot), and the risk would be to your esophagus and to your stomach. It's not going to make it intact all the way to your colon and it's not...
A few comments: It's well known that some people with IBD respond positively to certain antibiotics. But it's only a temporary effect. Antibiotics do not work as a long term treatment. The thing is,...
Regarding combo therapy with an anti-TNF like Remicade or Humira along with imuran/6mp, the combination is a little more effective than anti-TNF monotherapy. It's not a huge difference but it can...
Yes, going by the colonoscopy results of 2022. That looked bad, and serves as a baseline for what you're deaing with. I don't see what the hydrogen peroxide has to do with this at all. I think you're...
Yes, you are correct that symptoms don't always correlate well with disease activity. Sometimes mild disease can have lots of symptoms, and sometimes major disease activity has minor symptoms. It...
This is a generalization and probably over-simplification, but what I've learned at conferences is that Entyvio is a really good med for UC, but for Crohn's it's less wonderful. It has FDA approval...
Also, I'm actually a little surprised that the Prometheus results came back with "Pattern Not Consistent with IBD." Of course, I don't know their precise algorithm, but your results show several...
Thanks for sharing the results. If I were you, I'd seek out an IBD specialty center in your area, perhaps at a university hospital or at a hospital in a large city nearby. Then probably get another...