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Chronic diarrhea...5 years IBD Biologics?

Husband 65..has had chronic diarhea with blood off on for five years..recently scope revealed erosive gastritis...and severely inflamed colon. No pain. GI mentions Crohns UC and IBD. No weight loss.

Has been on Lialda, Asacol, Mesalamine, Prednisone, all types of Anti Diarrhea and Anti Inflammatory meds,, Cholestyramine, Pantroprazolol (spelling not sure) nothing works.
Has changed diet several times.
Also tried several naturals.

So the GI wants him to go on Humira or Entyvio...however, we are very concerned. He always gets the serious side effects of the meds.

He has Asthma and Hypertension...had open heart Nov 2019. He had heart stents 2007 and was put on high dose Plavix which caused the UC. One stent closed in 2008. BP med Amlodipine was increased early 2019 which induced Afib and led to Open Heart.

So now we are trying to weigh the possible side effects with the potential benefit and would like input from the Chrohns community. We are in the lighting and electrical contracting business and are still working and are in homes with the elderly nearly everyday so we have to take that into consideration.

The diarrhea and multi bathroom trips are so debilitating..thankfully we have a portable toilet in our work truck and my van and that helps.

So any info would be greatly appreciated. I have been reading this forum for a couple months.
 

my little penguin

Moderator
Staff member
Entyvio is gut specific but takes a long time 6-12 months to start working
Humira takes three months to work
My kiddo was 9 when he started humira
Age 8 when he started remicade
He was on humira till age 14
So all of the elementary grades /middle school on humira plus mtx (mtx was for juvenile arthritis )

out of my kiddos Ds was much healthier than my non ibd kid who wasn’t on biologics

He has been on Stelara since 2017 -almost 4 years and is 17 now

again no extra infections
Just a nice pink happy colon
 
Location
San Diego
I would go with trying the biologics. Serious bad effects from the biologic drugs are real but very rare. Serious bad effects from uncontrolled Crohn's or UC are real and extremely common. The risk vs benefit for biologics and Crohn's almost always works out with benefit the winner, often a big winner.

I put off trying biologics for my Crohn's for years and stuck to occiasional short courses of budesonide. Finally, terrible extra-intestinal maifestations of the Crohn's forced me to take stronger medicine. I've been on Stelara for over three years now and am in a good long-term remission. I wish I had started it sooner.
 
Wow, I finally got back on here and am so pleased to see your positive health response and thoughts on Stelara. My previous experience was quite similar to yours. I started Stelara last November, and have my third shot (self-admin) in early May. May I ask about how long it was before you noticed an improvement in your symptoms, and 2nd question would be did you continue to improve beyond that over the course of more time? My doctor did tell me that all the data they had from Europe early on during COVID, showed that IBD patients (those on Stelara) had no additional, or more serious problems, when they contracted COVID. Thanks and best wishes,
 
Location
San Diego
Wow, I finally got back on here and am so pleased to see your positive health response and thoughts on Stelara. My previous experience was quite similar to yours. I started Stelara last November, and have my third shot (self-admin) in early May. May I ask about how long it was before you noticed an improvement in your symptoms, and 2nd question would be did you continue to improve beyond that over the course of more time? My doctor did tell me that all the data they had from Europe early on during COVID, showed that IBD patients (those on Stelara) had no additional, or more serious problems, when they contracted COVID. Thanks and best wishes,
I started seeing significant improvement in my Crohn's symptoms after about a month on Stelara with full remission by two months. But I think I responded faster than most Crohn's patients. There are published data that Stelara can take several months to fully kick in.

If after several months you are still not getting the full benefit of the Stelara, you may wish to ask your doctor to measure the levels of Stelara in your blood. Some people are fast metabolizers of the drug, or have developed antibodies that reduce the activity of the drug, and thus need more frequent doses. 4 week dose regimens are common.
 
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