- Joined
- Jun 9, 2016
- Messages
- 636
Says it all.....
Candace,
I wish you the best with your prep day as well. I remember those days. Yuck!
Oh no! I got sent Moviprep in January and immediately balked at the massive volume and asked for Picolax instead. Have you finished it or do you have another dose to go? Congratulations either way!! The hard part's nearly done
That dreaded day. Sending you strength!
Also I'm so in love with Cat's suggestion and am definitely doing that next time.
And they are still leaving you on Aza ?
Even though it's still not under control ???
Can't they bump you to a biologic so more damage isn't done ?
Aza reaches its peak after 3-5 months
So what you see is basically as good as it gets after 12 months .
Yes, you can continue with aza with a biologic. I am currently on Humira and azathioprine.Ok, that's not at all scary [emoji22]
I'm still quite new to it all really but I'm glad to hear that my gut instinct was right about the inflammation not reducing enough given the treatments I've had.
If they do go down the route of a biologic can I continue with the azathioprine as well? It's just it does help with my skin flare ups. What if they want me to carry on with aza alone? I don't deal very well with conflict and tend to be a doormat, particularly with doctors! I would feel like I was questioning their knowledge & experience [emoji51]
Once you get a pretty scope and have a good maintenance med
Then yes you move on with life
Crohns wise Ds is there
It's all the extras from Crohns that we are dealing with now (arthritis and Sweets Syndrome)
Parent
Ds was dx at age 7
He is now 13
If you have SpA or AS
It would be much easier to get biologics
Mtx is the first tier for peripheral joints
But spine is biolgics
Are you seeing a rheumo
If not request one asap
Tagging Maya142
They absolutely should refer you to a rheumatologist. Axial SpA tends to flare independently of IBD, so treating the IBD won't necessarily make it better. So a rheumatologist really has to treat you.
There are only two treatments for axial SpA - NSAIDs (which are out for most people with IBD) and biologics. Methotrexate and Sulfasalazine work well for peripheral joints (joints other than the spine - hands, knees, ankles etc.) but NOT for your spine.
If you are put on a biologic for your IBD, that should help your SpA. Or vice-versa.
CCFA has a good explanation for the various types of arthritis associated with IBD: http://www.crohnscolitisfoundation.org/assets/pdfs/arthritiscomplications.pdf
My younger daughter has both IBD and AS, while my older one and husband just have AS.
If you do have SpA, inflammation will show up on the MRI.
Anyway, good luck and push to see a rheumatologist if the MRI shows something!
Yes, all that means is that you don't have AS. With AS you need radiographic sacroiliitis (enough damage so it shows up on x-ray).
The issue is that it can take 8-10 years for that damage to show up. Inflammation does not show on x-rays. So that's why an MRI is needed.
If you did have inflammation in your SI joints, based on the MRI, then you'd be diagnosed with axial SpA.
I'm afraid that I don't know much about the UK system so I really can't help you with that. But I hope they will refer you to a rheumatologist if they see inflammation on your MRI.
Just FYI, seeing a chiropractor is not recommended if you have SpA. People with SpA/AS often have fragile spines (loss of bone density from inflammation, eventually fusion) and you can really get hurt. A physical therapist is a better option.
Sunday is my prep day too :/Dreaded prep day.....I have this on Sunday.....again. So not looking forward to it!
What MRI scan is needed to tell if you have SpA? I've had a small bowel MRI scan and a CT scan and no one said anything about my joints? Would either of these tests pick up SpA or would I need a different type of MRI? (Sorry to thread hijack)!!
Soph, I'm pleased to hear you are feeling better but sorry that your scope still shows inflammation. I'm in the same situation. Been on azathioprine for a year, still have symptoms and have a colonoscopy in a month. I am confident my GI will be reluctant to change my meds no matter what the colonoscopy shows. I just don't understand why it is so hard to get biologics here. Remicade has been approved since 1998! How is it still an issue to get it given all the research? I have also complained of my joint pain several times to my GI but again she won't refer to a rheumatologist and instead chooses to take a "wait and see approach" thinking it will stop when my crohns is better. Well it didn't stop after all the Crohn's was cut out after my resection!!
I think the issue is here in the UK what I think happens is you are put on a biologic and if you then go into remission after a year the biologic is pulled. I think it is dangerous to burn through biologics like this and have that inflammation cycle so up and down.Glad you had a good visit
They don't "hold out biologics " any more and let inflammation simmer
This allows damage to get worse
They use them even in very young child to wipe out the inflammation and allow the gut to stay as healthy as possible for as long as possible
There are plenty of biologics and new ones on the radar every few months
Currently there is
Remicade
Humira
Simponi
Cimizia
Stelera
Entivyio
Some stay on remicade for decades
Hope the blood tests go well
I think the issue is here in the UK what I think happens is you are put on a biologic and if you then go into remission after a year the biologic is pulled. I think it is dangerous to burn through biologics like this and have that inflammation cycle so up and down.
I don't know what the answer/solution is as really if the issue isn't metabolism then after your scopes you really do need to step up the treatment plan :-( you don't want to be backed into a corner where you are letting inflammation simmer to the point of no return, where you end up with extremely difficult to treat fistulas or surgery. You want to stop Crohn's getting to that (often inevitable) point.
This is true! I was wondering about that, does all Crohn's activity lead to fistulas eventually? The Crohn's & Colitis UK website said something about biologics treating 'fistulising disease' as if this was a separate entity from the actual Crohn's itself?! Probably just me being daft but I didn't think it was all that clear.
That makes sense then
In the US you don't stop them if your in remission which is why you can basically only need one biologic and not have the inflammation cycling back and forth
That's horrible that they stop them only to let the inflammation come back and lose a perfectly good drug
Ds has been on humira for over 5 years now and has had clean scopes for years
But requires biologics for his arthritis as well
Good luck
Not all disease activity leads to fistulas, but I believe the longer you have untreated/active (or even 'grumbling') disease the more likely you are to develop other issues. I myself had fairly moderate disease since I was 7, through my early 20's it was not under control very well and when I was in my late 20's/early 30's developed fistulas.
Thankfully for me, I was able to go on Remicade and have been on it for almost 12 years now with continued success.
No, not all Crohn's becomes fistulizing. Some people have strictures, some people have fistulas, others have both. Some just have inflammatory disease. This can change over time - for example, at year 1, most people would have inflammatory disease but about 5 years into the disease, the percentage who have strictures (scar tissue) goes up and the percentage who have just inflammation, with no other complications, goes down.
That is why it is really important to treat Crohn's early and aggressively to prevent complications.
I realize the situation with funding is different in the UK, but these drugs are not meant to be started and stopped. When they work, you are supposed to stay on them as long as they work!
So I can understand your hesitation, but on the other hand, you want to prevent long-term complications like strictures and the likelihood of surgery.
Thank goodness you were diagnosed. I hope they are able to come up with a plan soon.
As for Humira injections - I believe the new formulation of Humira is already out in the UK, so they shouldn't hurt much. They are now supposed to be much better - no burning like before. They have taken out the preservative that used to cause the burning pain when injected.
I realize the situation with funding is different in the UK, but these drugs are not meant to be started and stopped. When they work, you are supposed to stay on them as long as they work!
Something I read recently:Hey ho, I guess it's the price to pay for not putting our hands in our pockets ourselves for our treatment. (
Something I read recently:
"It's important to remember that the NHS isn't a free service, offered by a benevolent government. We have paid for it with our taxes and National Health contributions - it's a publicly-funded, national, health insurance scheme. That's why it's such flagrant theft when the government remove services or sell them to private companies. The government want us to use the term "free" to describe it. That way when they take it away it won't appear to be such a criminal act."