Crohn's Disease Forum » Your Story » Start Biologics?

11-11-2018, 02:29 PM   #1
Join Date: Jun 2016
Start Biologics?

From exploring the forums if one thing is clear its that no 2 patients symptoms are the same. But I find myself at a cross roads of starting biologics without having a 100% certainty I do in fact have crohns. In short since 2015 I have had 2-3 flare a year of severe RLQ pain nausea vomiting and diarrhea (loose to watery). Each flare is resolved with 2-3 weeks of steriods and diet modification. I take Lialda for maintenance but still experience RLQ pain almost daily and nausea and vomiting after I eat. Since 2015 I have lost approx 70lbs. Last colon and EGD scope was 2016 with non specific inflammation and nothing to impressive on the biopsy. My last major flare was in June after being off the Lialda for a few months at that time my WBC count was 17K and the CT showed enteritis / ileus in my small bowel with possible colitis. My old GI was somewhat leaning to IBD but reluctant to start any treatment. I felt it was best to get a second opinion, my current GI is fairly certain based on my history and CT findings that I most likely have crohns in my small bowel that is not accessible to the scopes. He feels its best to start Entyvio being that I continue to have symptoms (RLQ pain, low grade temps, nausea vomiting after eating) says he has had patients with the same story.

So my question to the forum has anyone else been diagnosed based on symptoms and non specific lab and imaging? Even though its safer of the biologics it does not come with out risk and of course the expense and want to do what’s best for myself and family.
11-14-2018, 11:13 AM   #2
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Scipio's Avatar
Join Date: Oct 2015
Location: San Diego

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I wouldn't start biologics without a firm IBD diagnosis by a skilled gastroenterologist. Biologics are the heavy artillery in the IBD arsenal and are not really "just in case" drugs that can be easily started and stopped and restarted as the story unfolds.

How about a capsule camera endoscopy to get a more definitive look at your small bowel? That's how my Crohn's was finally diagnosed after months of uncertainty.
11-14-2018, 05:42 PM   #3
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awoenker12's Avatar
Join Date: Jun 2018
Location: Chicago, Illinois

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I agree with Scipio. I would get more testing done, and see the results from your tests, and then decide. I think your doctor might have you try something along the lines of an immunosuppressant first before going to biologics. Some doctors like the bottom up approach while others like the top down approach.
11-18-2018, 05:30 AM   #4
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Join Date: May 2017

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To find evidence of crohns in your small bowel you should do an mri scan. Then decide if go ahead with bioogics. However i'd trust the GI if he is 100% sure it's crohns..

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