Methotrexate question

[LJS]

My son (10) is doing great on remicade finally into remission! First time in 5 years!! Seeing some weight gain and hopefully will soon see height growth as well.

He's been on azathioprine and allopurinol for the last 3 years.. and doc recently took him off and put him on mtx and folic acid. He takes 15mg mtx orally one day/week and folic acid the other 6 days.

He's only been on this regimen for 3 days now but we've seen some side effects that i wanted to ask about.

He's been having TONS of gas and gas pains and has been going to the bathroom dozens of times/day. Mostly it's just to release gas but sometimes there is some loose stool. That is not one of his crohns symptoms, as he never has diarrhea based on where his crohns is located.

Is this normal and will it go away? I don't want to keep him on a medicine that gives him symptoms he doesn't have normally but also don't want to chance the possibility of lymphoma with the aza. It is just too soon to say, he needs to be on the meds a bit to "normalize" but wondered what effects your kiddos have had.

thanks,
Lin

 

[Farmwife]

I know for Grace it did loosened her bowels up because she was a constipated kid and like your son never had diarrhea as a symptom.
She only did a bm one to two times a day though. Now she's in a flare and had gone back to being constipated.

Sorry that's not much help.

Can I ask where his disease is located?

 

[Clash]

This wasn't a side effect my son has experienced with MTX. He has been on both the oral form and the injections and really he hasn't experienced any side effects. His dose has ranged from 7.5 to 25 mg. He also doesn't experience D due to the location of his CD.

In relation to the t cell lymphoma my understanding is that the use of combo therapy with thioprines is not needed. You only need to have been on immunosuppressants at one time either before or after biologics. Also, MTX falls into the risk category as well, I believe.

Hopefully someone will be along who has experienced this as a side effect or can give you more info.

I do hope the issues resolve and things improve for him in that area!

 

[LJS]

His disease is in the very center of his small intestine (I don't recall the medical verbiage). His symptoms are more covert: lack of growth, chronic inflammation. When he's not medicated (prior to diagnosis) he suffered from more severe tummy aches/cramping, throwing up and fevers.

 

[Jmrogers4]

I know Mtx like Aza can take a few months to become theraputic. I know our boys seem to have similar disease presentation. I can't remember Jack having extra gas with Mtx, We were only on it for 3-4 months and he developed bleeding rashes on his hands and a horrific cough. I would certainly put a call in to the GI maybe they can do something about the gas pains. Poor boy, hope he gets some relief soon.

 

[CrohnsKidMom]

Hi LJS; My son has been on MTX injections since last summer. Like your son, his CD is in the mid section of the small intestine-the jejunum. My son has also never had diarrhea, but has always had constipation. It took about 6 wks for the med to kick in and it initially did loosen his stools. That was a good thing for him-he was going once to twice a day. That went away after a couple months, and he's back to his every other day routine now. The med also made him tired at first, but that also resolved after a couple months. FYI, my son is now 9 and is on the same MTX dose and folic acid routine as yours. Hope the bowel issues resolve for your son soon!

 

[Brian'sMom]

We've been on oral mtx and are now on injections. Neither has caused gas symptoms. Tired has been a symptom i've seen. I have heard that the oral mtx can have more symptoms... but I thought that was nausea.

We've had gas before the mtx was added... when he was flaring and we started EEN. It was too much at night and all the sugar was having a hey day in the bowel. Are you doing any supplemental drinks? Or lots of sugar some other way?

 

[AZMOM]

No MTX diarrhea here either. I hope it's just a coincidence. Are you tracking the stools for next doc visit? Is that soon?

I hope he feels better already.

J.

 

[kimmidwife]

We also had no side effects when my daughter was on methotrexate. Have you tried giving him OTC mylicon for the gas? It is very mild and works well. Ask his doctor about it.

 

[Ann23]

My 12 year old son has been on Methotrexate for several months. I never thought about it before but he used to be pretty constipated but is pretty regular now with the occasional instances of diarrhea, but never as often as 12 times a day. The side effect I think he is experiencing from it is increased tiredness. He is pretty much in remission since his Remicade antibodies are down significantly now but he keeps falling asleep in school (I'm amazed at the positions he is able to sleep in) and has been having trouble staying awake and focused. The school was putting him in ISS when that happened, I didn't realize how often it was until very recently, but now they are just sending him home. He will sleep for hours after I pick him up.