Help, Advice needed

[Mumof4]

My son aged 12 was diagnosed with crohns a few weeks ago - he is on week 3 of a modulen liquid diet and was (we thought) progressing well. He has lots of energy, bowel movements were decreasing in frequency and becoming more solid. He had very little pain. Today however he went to the toilet and basically just pooed blood - quite a lot of it! (although he has had some bleeding with BM before this has not happened before). He then a bit later had a lot of diaorhea. Does this mean the crohns is no longer controlled by the nutritional therapy?

In addition his TMPT result is back and is low - 45. He was due to start azathioprine this Thursday. Does this mean he shouldnt or it should be a lower dose?

He is seeing his GI on THursday, I was able to speak to him today and he advised that if bleeding continued he needed to be seen on the ward tomorrow instead but if not then they would see him on Thursday and do his bloods to check his haemoglobin levels.

 

[Mumof4]

Anyone?

 

[DustyKat]

Hi Mum,

Generally if someone is in the low reference range of TPMT they can be at risk of the less severe side effects of the drug and the doc may also decide to prescribe a lower dose. The dosage of Imuran is normally prescribed at 2-2.5mg per kilogram.

I don't really have much experience with an elemental diet but I guess there is always the chance that this may be a one off anomaly, if it were to continue though then you would have to think that perhaps the diet isn't doing the job and something like Prednisone or Budesonide may need to be introduced.

It certainly sounds like you are on top of things Mum.

I hope things settle and you only have to attend the Thursday appointment!

Good luck!
Dusty. xxx

 

[scottmyster]

HI mum, from what i gather it takes a while for the imuran to kick in . your son may need to go on steriods for a while to calm down the inflammation especially if he is still passing blood. i don't know how long he's been on imuran but, if is been on it a long time . then it's not working then it's time for alternatives i haven't had any dealings with azathioprine, so i don't know what to tell you there . i hope your meeting with GI specialist goes well and if he scheduled to start an new treatment i hope it works for your sons sake. best wishes

scott

 

[alfredothebarber]

You may want to get your doctor's to do a stool sample test for a C-Difficile infection. I've had it many times, and it disguises itself as a terrible Crohn's flare (including lots of blood)