12 Y/O daughter with Crohn’s. Remicade failing?

[CrohnsDad24]

12 Y/O daughter with Crohn’s. Remicade failing?

Hi! I'm new to this forum. My 12 year old daughter was dx with Crohn's about 2 years ago. She's been on Remicade for 1 year and has been doing great; however, recent fecal tests have shown an increase in calprotectin (400). Our GI doc wants to do a colonoscopy to see what's going on. We hate to put her through that again and wanted to get some advice. About 3 months ago she was put on prevacid; can this increase the calprotectin? Her diet hasn't changed but does sneak candy when she can . If we do have the colonoscopy performed and it shows inflammation what do you think the doc's recommendation(s) will be? Thanks in advance for your help!

 

[my little penguin]

Prevacid affects acid in the stomach not inflammation on the intestine.
Food can not cause a flare but it can make worse for some people so the candy isn't an issue.
The colonscopy really is needed to get a good view of what is going on and how bad things are .
This can tell the Gi if there needs to be a med change or if other meds need to be added etc...
We have gone into colonoscopy procedures thinking we were changing meds and all was ok just tweaking needed.
Other times med change .
Hard to tell but always worth it in the end for DS.

Good luck

 

[imaboveitall]

Violet has had weekly lactoferrins done for many many months and on and off for years and calprotectin weekly since July.
Your boy's result is exceedingly high. He has inflammation somewhere in the gut, for sure.

V's highest lactoferrin was 5200 (normal value at her lab is < 7 yes SEVEN) and her highest calprotectin was 1015 (normal is <162).

 

[Mehita]

How about a pill cam, CrohnsDad? Scopes aren't going to show what might be going on in the small intestine. Do you know where her disease has shown up in the past?

Like MLP said, she might just need some tweaking with her dosage. Maybe she's gained weight and they haven't accommodated for that? Maybe she just needs to go from an eight week schedule to seven? Maybe add Methotrexate?

I think most GI's tolerate around 400or less for fecal cal in IBD kids. Once you start seeing 400+ then it triggers further investigation.

 

[DustyKat]

Thread created, bumping.

 

[Sascot]

Hi and welcome. It sounds like the inflammation is increasing if the calprotectin is getting higher. Scopes are not nice, but definitely the best way to check things. I would think they may add another med to the Remicade to help increase it's effectiveness. Good luck

 

[Catherine]

We had a mri for increasing faecal cal but my daughter has primary small bowel disease.

 

[SupportiveMom]

There is great promise for combo drugs like Methotrexate with Remicade. We are doing the combo of Humira & Methotrexate. Sounds like inflammation for sure though. It is possible your kid is building up antibodies to Remicade and could need to switch. A blood test can determine that, but probably adding another med like Methotrexate might take care of the issue.

My daughter is also on prevacid, to help with the crohn's in her esophagus to minimize the vomiting. It doesn't do anything for inflammation. Welcome to the forum CrohnsDad.

 

[Jenn]

Welcome. How does the bloodwork look? My son was consistenly low in protein and had high calprotectin and we repeated the colonoscopy. We added 6mp to his Humira for a year to successfully kick him back to normal. I'd also recommend doing a blood test to check for antibodies to Remicade. Simpler/faster, at least before doing the scopes. Good luck!

 

[Farmwife]

You've been given some great advice. Just wanted to stop by and say welcome.