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My son got very dry, red eyes as a result of Remicade, and we saw an ophthalmologist about it due to concern that it could be uveitis associated with Crohn's. It turned out that wasn't the problem, and they got completely better shortly after stopping Remicade. So, be careful about diagnosing...

Red eyes and pain can be a side-effect of Remicade, and the solution is to stop Remicade. Also if Remicade isn't working your brother should try something else. An all-formula diet (EEN) can reduce inflammation fast and give him a chance to figure out what else he needs.

So far my son has been on it for 6 months, along with a special diet which he was on before he started it (initially all semi-elemental formula and still mostly semi-elemental formula). No side effects so far. Inflammation numbers all down to the normal range from abnormal previously. Poops...

I think the widespread bias against attributing side effects to medication is the most notable thing here. I've seen this repeatedly both here and in other places and regarding other conditions. Doctors are prone to this bias as well. I think people just really *want* to believe in the...

You are getting hung up on "formal" diagnosis. Remicade caused esophagitis in my son's case, and I believe based on all of the information available to me that it was most likely eosinophilic. I do not know of any other esophagitis that Remicade may cause, but I agree that it's possible that...

All I did was post a link and you guys jumped all over it with a great deal of hostility as though the association was obviously wrong. Go back and read the OP. Have you done your own study?

As I said, I saw esophagitis caused by remicade, and I believe it was eosinophilic esophagitis, consistent with the study in the OP. It's a side-effect that people should be aware of. I would like to know why you guys find it so hard to believe that anti-TNFs can cause a number of unusual...

Westernbuddy, I would think you wouldn't want to start a biologic unless you can look at the situation before and after and be able to say whether or not the biologic is helping you. Is there something still wrong that you can monitor for improvement, or are you really in full remission already?

Ok, I'll break it down for you: Remicade caused esophagitis (certainty: 100%. Esophagitis was obvious due to symptoms, and causation was obvious due to timing and repetition.) I believe the esophagitis was eosinophilic in nature due to other allergy activation (eyes, nose) caused by the...

MLP, what's your point? Are you trying to claim that anti-TNFs do not ever cause eosinophilic esophagitis? I specifically saw this happen.

This was all two years ago. Remicade caused esophagitis despite full EEN. The esophagitis was not treated separately, but it did go away several weeks after the next dose of Remicade was due. I believe the association of anti-TNFs with EOE has not been studied before, and the paper in the OP is...

It cleared up a few months after stopping the anti-TNF, no long-term problem. Who knows if it would have become a long-term problem if he'd continued on infliximab despite the esophagitis. The fact that the study in the OP found a connection is no surprise to me--I just appreciate seeing that...

I can tell you that I have personally seen eosinophilic esophagitis caused by anti-TNF medication. MLP, this is a real side-effect.

Recent paper finding an association of eosinophilic esophagitis with anti-TNFs in pediatric IBD patients: https://www.jacionline.org/article/S0091-6749(20)32109-6/fulltext

Sulfasalazine is known to cause pancreatitis, so it's probably related to that

Calprotectin is back down below 50, yay. (The result doesn’t give a more specific number.) I really feel like we've finally gotten this truly under control, and now we can start testing foods more. It took surgery to remove about a 4 cm stricture, long-term semi-elemental EEN, and Stelara to...

Update after 3 more months: everything is about the same. Sed rate was 2 at the most recent test (it's never been truly normal before). Calprotectin was 60 a while back, and we just turned in another test. Hopefully it's back under 50. Mild brief abdominal pain about once a day, and we're...

Stelara + entyvio + een + maybe an antibiotic for a short time might be a combination to try, if they would approve it. The switch from Humira to anything else could be rough, but you probably want to keep EEN going during that time in order to avoid making things worse.

Does he have Crohn’s in other places? Is it under control there? What medicines is he on? Eosinophilic esophagitis can be a complication of some biologics.

Now seems like a good time to take him to a children's hospital ER. That would speed up the diagnosis process.