Are there any medicines that work with UC but not CD

[slyfoxman7]

Does anyone know if there are medical therapies that work with UC but not Crohn's? I ask this because for the last 18 years it was thought I had Crohn's disease but now after a recent pathology report, it looks more like I have UC. Could my medical treatment change any for more benefit?

 

[vonfunk]

5-ASA (Pentsa, Salofalk etc) is more often used for UC as opposed to CD, it is prescribed for both but is only really useful for mild cases of Crohn's. Other than that it's pretty much the same set of meds.

 

[theOcean]

Possibly, but I would think it depends more on the symptoms that you had and the medication you were on.

What were you treated with?

 

[slyfoxman7]

I'm on Asacol HD now and have tried more or less everything else at one point or another that would be prescribed for with someone who was diagnosed with crohn's. I was just hoping maybe they overlooked something in the past that I can now try. Right now I have mild inflammation that's pretty manageable but far from ideal.

 

[theOcean]

It may also be that you have Crohn's Colitis. What about the pathology convinced you that you might have UC instead?

Asacol is a pretty mild medication, though. If you're still struggling with inflammation, have they suggested putting you on something stronger, like an immunosuppressant?

 

[slyfoxman7]

well i just had a brief phone conversation with the nurse but she said the doctor is considering it as UC after the pathology report. ill have to get more information on why he thinks that when i go see him for followup. Throughout my history, they were always waffling about it being UC or crohns. my laymans guess at this point is that he was able to remove a pseudopolyp (which ive never had before) and maybe they were able to biopsy deeper into the colon because of that??

 

[slyfoxman7]

I'm unable to tolerate 6-mp/imuran. intried humira but not cimzia so maybe that's next

 

[theOcean]

Cimzia might be a good idea if you have issues tolerating medications, yes. Report back when you hear what the doctor said! I'm curious, since I was originally diagnosed with UC and later had it changed to CD.

 

[slyfoxman7]

i think the ultimate diagnostic is colectomy so they can dissect the entire thing but ill let you know what his rationale is. also of note is i never had any fistulas or abscesses or strictures despite having severe "CD" for many years and I'd think i would have by this point. also i have rectal involvement which is more common in UC. the reason why i may prefer uc is because i think I'm ultimately headed toward collectomy at some point anyway and i would prefer a jpouch to an ostomie

 

[theOcean]

Yeah, I agree with you there. That was my thinking when I was still diagnosed with UC. Now I just have to try my best to keep myself in remission, and hope nothing else goes wrong.

 

[slyfoxman7]

so on the flip side, what made them change you to a UC diagnosis?

Edit: i mean what changed it to CD?

 

[theOcean]

Fistula, unfortunately. Even then my GI still says I have some crossover with UC symptoms, so it's a bit odd. But because of the fistula it's pretty much automatically CD.

I didn't get a colonoscopy at the time where my inflammation was more active, so unfortunately I don't know if there was anything outside of my colon (I was originally diagnosed with Ulcerative Pancolitis, so it was the entirety of the colon) or in the small intestine that was affected. In my recent colonoscopy my GI said he couldn't tell I had IBD at all because it had healed so well.

While I would like to find out... I would definitely not want to go back into flare for that to happen.

 

[slyfoxman7]

yeah definitely. there are a decent amount of cases that are done after one flare so lets hope for that.

 

[slyfoxman7]

Well the reasons he gave was because of the pseudopolyps and the inflammation was continuous then just stopped a third of the way up, not patchy. I don't think it can ever be 100% and I'm skeptical but he seems pretty certain about it anyway.