I said "NO!" to Remicade... am I crazy?

[GypsyRay]

I have a stricture.

An MRI and colonoscopy by my GI confirm this.

I've never had surgery.

Through diet I've kept myself off meds for 2 years.

My GI wants me on 6-MP (aka Imuran, Aza.) and Remicade.

I've taken 6-MP before so I said "Yes" to it, but I said "No" to Remicade.

I believe I can reduce my stricture with just diet (I'm strict SCD now) and 6-MP.

Is that crazy thinking? Is it possible?

Or, please, tell me anything I should know about stricture healing.

 

[PsychoJane]

Hi Gypsy,

Let me share some excerpts of a recent study that might or might not help you make your mind regarding this; the abstract of the article goes along these lines:

While potent anti-inflammatory medications have reduced the symptoms of Crohn's disease, more than 60% of patients eventually require surgery due to the development of fibrosis. Even after the introduction of biologic drugs, the population-based rate of surgery for Crohn's disease has not decreased. We suspect this is due to late initiation of these therapies, after the fibrosis cascade is unstoppable. We review the evidence that suggests early aggressive therapy is beneficial, especially in patients diagnosed before age 40, and with ileal or perianal disease. Patients with symptomatic strictures may benefit from early surgery (before penetrating complications) followed by initiation of biologics. With increased early use of biologics and better control of inflammation, we hope to see a global reduction in intestinal fibrosis and related complications of Crohn's disease.

It comes from the article: How early to take arms against a sea of troubles? The case for aggressive early therapy in Crohn's disease to prevent fibrotic intestinal strictures published in the Journal of Crohn and Colitis of July 2013. If you can't access that article by yourself online, I would suggest you to maybe contact someone you know that is registered at university as it is generally possible to access these resources online. If need be, PM me.

To make it real real short, what it suggests is that Remicade, once the stricture process has started, won't help and can even make the condition worse. It worth being taken in order to prevent the stricture, after surgical procedure, but it won't bring an actual stricture to a better condition. It can help preventing the onset of new strictures but then on, it depends of what fight you are delivering to the disease.

 

[GypsyRay]

Thank you Jane

 

[shamrock15]

I am on remicade, and based on my experience, I would agree with Jane. I have a recurring stricture in my rectum that remicade doesn't really do much for. Luckily, my GI is able to control it somewhat with balloon dilatations. Depending on where yours is, that might be a short term option. I firmly believe that remicade has prevented further ones from forming.

 

[Justanothercp]

I had a resection about 10 years ago. My stricture symptoms returned a year later, i was put on remicade and have been on it now for about 8 years, I beleieve it has helped me put off surgery after surgery, which in my mind is good because i dont want "short gut" syndrome, multiple surgeries or a colostomy bag. Also, i just feel better on a day to day basis. So, i feel for me its been worthwhile. I still take a lot of meds and really watch what i eat to avoild blockages and keep inflammation down.
In the end, we all have to make the decisions we are comfortable with. Keep us posted and wishing you well!!