Freaking out about pregnancy and my UC!

[SarahLo1120]

Morning all!

First time posting here so bear with me .

I am 29, diagnosed with mild to severe ulcerative colitis in the winter of 2012, following my gall bladder removal. I'm currently on 150mg of mercaptopurine (6MP), loperamide (as needed, but let's be honest here---I have UC...I'm taking this every day!), sacchramioces boulardi (probiotics---2 per day), and at night, 2g colestipol to combat my gall bladder issues. I did a full 3 years of prednisone and various trials of every oral Crohn's/UC treatment, before finally finding a GI who didn't have their head up their butt (quite a feat in the gastrointestinal world).

My UC has been under control for about 6 months now (throwing around the word remission even, which is a word my gastro and NP don't like to use with how fickle crohn's is!).
Anyhow, I am getting married in March and am trying to think ahead as far as pregnancy goes, since I know I can't do the 6MP without high fear of birth defects. Plus, I teach middle school, so I need to be able to manage my stress accordingly.

I've read through many of the pregnancy posts here but didn't seem to get quite the answer I was looking for.

How was pregnancy with Crohn's or UC? Is there medicine that I can take to keep things under control? Has anyone done their pregnancy holistically and kept flares down?

Thanks!

 

[Lisa]

Hi Sarah -

Others should chime in soon, but for me, being pregnant actually put/kept me in remission....I felt GREAT! That being said, I got pregnant unintentionally shortly after a hospital stay (remember, antibiotics mess with birth control!!).....I did very well while pregnant, and had a healthy baby. I had a c-section as I had active fistulae and the doctors agreed it was best to not possibly do further damage with a vaginal birth.

A few months after my daughter was born, however, I did start to flare again - this happens to quite a few people as it is thought the hormones have a role in the remission and flare.....

 

[Jabee]

I've read that anti-tnfs can be used safely during the first trimester, and it looks as though certolizumab can be used throughout the entire pregnancy. My body decided to fall apart after my third child was born, so I had it easy.

 

[SammyD]

I'm sure that 6MP is safe to take in pregnancy. I'm on azathioprine which is considered safe and the drs in my country will not take you off it if its working for you. Aza and 6MP are very similar. At the moment methotrexate is the only drug not to be taken, along one of the newer biologics (only due to lack of evidence thus far - the name escapes me though sorry). Birth defects were recorded for aza and 6MP is early (and old) studies however many many newer ones show there is no increased risk.

I'm on azathioprin & humira and I flared badly at 12 weeks. I was hospitalised and on IV hydrocortisone, antibiotics and omeprazole along with fentanyl and endone. I was then discharged with a 6 week course of pred. I also had a sigmoidoscopy (safe in pregnancy however colonoscopy is not recommended unless absolutely vital). I've had heaps of meds but baby is doing great and growing well. I now need to have extra ultrasounds to make sure baby is growing well in third tri but so far he is doing very well and growth is actually a little ahead!

Humira and infliximab are usually stopped at 30 weeks but if the IBD is not under control they will keep you on it until full term. If you have to stay on biologics the baby must not have live vaccines in the first 6 months of life, however after 6 months they can have all vaccines. This is the only downside of staying on the biologics until full term. I'm now 23 weeks and the dr is seeing how I am going before determining if he will take me off or not.

It is much more dangerous to flare while pregnant than taking medications deemed safe (as most are). Baby is put at significant risk if your are ill, bleeding and/or anaemic and the rate of miscarriage, early and still birth is heightened. The drs want to keep you and your baby safe and well and the IBD under control as much as possible to reduce these risks.

Make an appointment with your dr and go over all your options, but rest assured that the current evidence does not warrant coming off most medications out there for IBD (not sure about the anti-diarrhoeals and other meds though). You can also breastfeed on most IBD meds as well and I bf my first son with aza with no issues whatsoever.

See info sheet from CCFA http://www.ccfa.org/assets/pdfs/pregnancyfactsheet.pdf

There is also a very good video done by I think the Mayo clinic (or one of the big clinics in the US) but I cant find it now. The Mayo clinic does have some good info though about pregnancy and IBD.

HTH and good luck

PS this is my second baby, with my first I was well and didnt flare during pregnancy - hopefully this is the case for you too!