Humira and Flare up

[Luciana]

Hello Fellow Crohnies!

i'm quite worried at the moment as i think i am starting a flare up. I've had a little bit of blood in my stools the past few days, a lot of gas, and running to the toilet a lot more than usual. I developed a cold soar on my lip too, and in general i'm very tired. But luckily i'm not pain. Just emotionally i not ok seeing blood again when going to the toilet. i feel depressed straight away!

I guess i am a little shocked that i can be bleeding while i am on such a strong medication as Humira?
I thought it would be supressing my immune system so much that it would be impossible to get a flare up at the same time?!

I was on Infliximab for a few months, but unfortunately i developed Medically induced Lupus, so they switched me to Humira about 2 months ago now.
I'm taking 40mg injection every 2 weeks. I really don't like giving myself injections...but other than that everything was going ok.

I'm still tapering down on prednisone as well, I'm on 2.5 mg at the moment.
i was wondering is this could've triggered the blood in my stools, since i just went from 5mg to 2,5 mg?! about 2 weeks ago.

I have another concern....do you think it's possible that Nicotine has triggered this flare up that i feel coming? I stopped smoking about 11/2 years ago, but a few days ago i smoked 4 cigarettes. i was a little stressed out.

I feel this might've had a bad effect on me. And now i feel awful.

It's been almost a year since my crohns flared up for the first time after many years of peace...and it feels like i haven't managed to get it 100% under control yet. Which is very frustrating.

Any advice would be helpful!!

Have you been in a similar situation. What is the procedure? Next step in treatment?!!

THANK YOU SO MUCH FOR YOUR HELP!!!!
:heart:

Luciana

 

[cmack]

Hi,

Try not to stress, it's bad for everyone. The smoking is a bad idea but it didn't cause this. I would quit the cigarettes and phone the doctors office and ask what to do. It could have been the change in prednisone. I don't think its major trouble, but do tell the doctor and mention the anxiety that is caused by your condition. I wish you the best. Hugs.

 

[Sef0912]

Hi Luciana-
I feel like we may be in a similar situation. I am mid-flare currently on a tapering dose of prednisone, imuran daily, and hurmira every 2 weeks. My new GI, who I have only seen twice since being in the ER in June, is currently suggesting a possible switch in my maintenance medication, but stated she would not consider this until I have new scopes, which are scheduled for late August. She also stated that she has to get my previous medical records, which when I called my past GI were numerous, and sort through those because she cannot understand why I am not on a different medication due to having fistulating Crohn's and because I have had multiple surgeries in the past 5 years. It is causing me anxiety to have to wait for all of those things and think about all the possibilities of what may go wrong (or frankly be better.) It also scares me that I have lost weight on prednisone when I usually gain a lot of weight on it, especially when I am on a tapering dose during a flare, so I feel where you may be coming from and offer you support.

Even though it causes anxiety and stress, I would go see your GI again and explain to him/her your current concerns and that you feel like you are bleeding. They may be able to order some stool samples to see if there is infection that is not your Crohn's and go from there. They may also be able to order blood work to check your inflammatory markers, vitamin levels, etc. to see if there are any concerns to address that may be aiding in the flare. I don't know if you have recently had scopes to make sure there is no new inflammation or disease progression, but that may also be a suggestion. I know for me it causes me more stress to wait for the actual testing/scopes then to have answers. Hang in there, as it will get better in time, but know that others are in similar situations and are here to support you. Good luck with everything and reach out to forum if you need anything. :hug:

 

[theflightless]

a couple things.
statements
1. you will lose your response to humira over time.
2. smoking is the worst thing that you can do for yourself if you have Crohn's.

rational
1. this is unstoppable in immunonormative people because of adaptive immunity; over time your white blood cells will familiarize themselves with humira molecules.
2. this is because nicotine both shuts off your digestion and heightens your immune response. In terms of contacts your immune system then has with possibly antigens in your gut, consider them an order of magnitude greater.