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Crohns flare but on Humira already

Hi everyone,
I am new to this forum but was diagnosed with Crohns 24 years ago. I was put on Azathioprine . I experienced a flare shortly after giving birth to my son in 1992 which was sorted with Prednisolone and was in remission until I had to have emergency surgery for a bowel obstruction in 1999 (spent Christmas day in a Morphine stupor) and had a resection at the terminal ileum.. Spent 11 days in hospital which was horrendously painful.
Tried various meds over the years, which I could not tolerate, apart from Azathioprine. Had to have gall bladder removal the year after my surgery which is a complication of Crohns.
Over the years I have had a few flares which normally resolved with a course of Prednisolone but suddenly around 4 years ago I ended up in hospital on an IV for a bad flare with symptoms of severe diarrhoea and bleeding, but bizarrely no pain! Unfortunately I developed a reaction to the Prednisolone this time and had to come off it (subsequent flares have been treated with Budesonide). Following that I then got started on Humira fortnightly injections which worked fantastically but unfortunately got taken off them after a year following a normal colonoscopy.
The following year I had to be taken off the Azathioprine as I had several lesions removed, one of which was cancerous! (Still under Dermatology and have had to have several lesions frozen off for early cancer! I had another flare earlier this year so got put back on the humira again, but unfortunately it has not worked like last time.. I am now experiencing another flare while on Humira. Could not get a hospital apt for another 2 weeks so have been started on Budesonide in the meantime. The weird thing is that I have now gone from up to 12 mucus/bloody toilet trips daily suddenly down to not being able to go.. I now have not had a bowel movement for 24 hours, which has never happened even when on high dose Prednisolone.. I do not have a fever but feel so weak and tired. I am only getting occasional stomach cramps.
This is all new to me as is not following previous flare patterns.
Has anyone had similar symptoms? Was thinking stricture but not been sick or experienced excruciating pain (though have been on Tramadol for severe back pain which is also associated to the Crohns.. I am also under a Rheumatologist for joint pain).. Unfortunately the Gastro dept at the Hospital are so understaffed appointments are like gold dust. My GP asked for me to be seen urgently but have had to wait 4 weeks! Nearly ended up at A&E but Budesonide has slightly helped with the nausea..
Has anyone had similar symptoms, I know everyone is different as my blood work has always come back nearly normal even in a flare, it was only colonoscopy that found it..
:confused2:
 
Oh gosh, sorry to hear about all your meds. I haven't done Humira (yet). I am always tired too, -- I sleep a lot during the day when kids are at school!
 

David

Co-Founder
Location
Naples, Florida
Hi there and welcome to the community. Whoever decided to take you off the Humira due to the normal colonoscopy should be punched in the face. With a brick. The problem there is you are MUCH more likely to develop antibodies against the Humira when they go off and then on like they have. As such, I'm not super surprised that it isn't working.

My guess is that Remicade (Infliximab) will be in your future.

In the meantime, don't be afraid to go to the A&E if you need to. That's what they're there for.

All my best to you.
 
Thanx for your response.. unfortunately the guidelines here are that if you have a normal colonoscopy one year after starting Humira then you'll be taken off it. I was symptom free for only a year after and had repeat colonoscopy that showed inflammation at the site of resection... the only thing I have not been tried on is methotrexate so options are limited. Weirdly my bloods are close to normal whenever I flare so last time I went to A&E I was put on drip for three days then sent home. I have never been offered a CT or MRI. as the Budesonide not working I will have to back to GP tomorrow.
Many thanks.
 
That is guidelines for UK for IBD cases but rheumatological cases can stay on it a lot longer?? Not sure what is going on at the moment as never been constipated and suffered diarrhoea at the same time! And not too much abdominal pain but severe low back pain and nausea.. also flu like symptoms but without fever. All very strange. Wouldnt think it would be a stricture if not having bad abdo pain?
 
Well just came out of a short spell in hospital after all but as bloods were normal as was plain xray they said it must be constipation! Gave me laxatives and took bloods. Tried to explain that inflammotory markers are always in normal range but didnt seem to sink in! Told them that this is totally different and i never normally get nauseous..Bizarrely my ALT came back at 248!! Also bilirubin at 38 so docs sent me off for ultrasound thinking bile duct blockage (I had gall bladder removed 14 yeas ago). That showed ko stiones and following day LFTS slightly lower so they sent me home with laxatives and repeat blood form! Now totally confused... dont get these new symptoms! ! Any thoughts? ?

:confused2:
 
Humira didn't work for me, was still having major flares. I just started remicade so I'm praying this helps!! Good luck on the humira Hun. Feel better
 

my little penguin

Moderator
Staff member
David
Treatment with infliximab or adalimumab may be a planned course of treatment until treatment failure (including the need for surgery), or until 12 months after the start of treatment, whichever is shorter. People whose disease relapses after the planned course of infliximab or adalimumab is stopped should have the option to resume treatment for a further 12 months.
From:

http://www.nice.org.uk/guidance/index.jsp?action=article&o=46234



The review and re-appraisal of infliximab for the treatment of severe active or active fistulising Crohn’s disease has resulted in a change in the guidance. Specifically, infliximab should now be given as a planned course of treatment until treatment failure (including the need for surgery) or for 12 months, whichever is shorter. Treatment should then only be continued if there is clear evidence of ongoing active disease. Adalimumab is now also recommended as another treatment option for people with severe active Crohn’s disease.
From:

http://guidance.nice.org.uk/TA187

So it's not just humira that's stopped.
That makes me so mad to read that they are stopping it in people that it is working for ....

I am so sorry you are going through this.
Did they do any imaging of your liver ( ct/MRI...)to rule out psc?
 
Hi. No They vaguely mentioned CT if my blood count didnt go down as ultrasound didnt show any stones just very slightly diated CBD. But reduced enough to send home with appt next week with IBD nurse and repeat blood form.. they are saying they may repeat colonoscopy but thats all.. pretty fed up now. If I had the money I would pay for private CT.. still so tired and docs keep saying just prob constipated as inflammatory markers ok. I kept telling them they are always in normal range so is irrelevant. These are symptoms I never get. They have sent me home with senna and laxido!
So frustrating!
:(
 
Hi! I go through the exact same thing! You are not alone in this! I have Crohns disease as well and on a good day I am lucky to get down to 6 bowl movements and like yours they are always mucus filled. However I can sometimes do a complete turn around and become constipated as well which is even more painful when in conjunction with our routine bouts of pain! When I have blood work as well it always comes back normal but when they do a colonoscopy or CT scan it shows that I am very inflammed to a point that I only have an opening in one section of the size of a pea, so again you are not alone! What I have found that works best for me is when I begin to see the symptoms of constipation I immediately begin taking stool softeners and that does make a difference! I hope that; although I too am with out answers and beginning to be fed up as well; my small amount of advice was helpful!
 
Thankyou for that. Will try that.. unfortunately I have never been offered ct scan all fhey did was abdo x ray which doesn't show much! Am seeing bowel nurse Thursday and am going to push for more tests. What medication are you on? X
 
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