Need your help please

[Oza86]

Hello everyone

I have pancolitis Crohn's disease since 2009.

Current medication is 4.0 grams of asacol and rowasa everyday since 13 months and in remission since 13 months.

Recently diagnosed with a simple perianal fistula and went to colorectal surgeon and was adviced to have a simple procedure called fistulotomy, and was told that I don't need imuran or remicade for a simple fistula if my crohns otherwise is controlled with the above meds listed. Now it's been 4 weeks after the fistulotomy and feeling great. But the surgeon suggested to go on imuran.

We'll my question is is it worth it to go on imuran just because I had a simple perianal fistula but otherwise in good remission since 13 months?


I'm confused guys because I'm scared for the side effects of imuran.

Any advice or suggestions


Thank you so much

 

[MikeinBklyn]

Oza,

I had two fistulotomies and they never fully closed, Seton was kept in for draining.

I was put on Humira and the fistula closed in a few days and it has been almost 4 years now.

I do not know much about Imuran and it's side effects. I would suggest Humira to your doc as it has changed my life.

Best of Luck

 

[Oza86]

Thank you Mike, i appreciated it.

So how long it took you to find out that the fistula after the surgery wasnt closed?

also, did you had simple or complex or multiple fistula.

Because mine was just a small simple fistula.

Thanks

 

[copeland]

I've never had a fistulotomy, but my understanding is that fistulas usually come back after surgery. Remicade (and Humira) generally have the best track record of closing fistulas, but if I go off the Remicade for a while my fistulas come right back.

 

[lgpcarter]

If it was surgeon that recommended imuran, maybe ask GI what they think?

Did they explain why they were recommending it?

 

[Oza86]

To cope land

Thank you so much for ur reply

But in my case my crohns is mild and my fistula was really a simple and superficial.

Surgeon said we don't put people on medications for this types of fistuala.

With fistulotomy this fistula is cured.

 

[Oza86]

To igp carter

The surgeon recommended because I won't get a another perianal fistula.

 

[Oza86]

But the question is if i don't get one back than I will be taking medication for what?

 

[Oza86]

Or maybe I will be taking imuran just to prevent future flare ups. But my condition is manageable with asacol rowasa and canasa.

So y take that? Or should I take it?

I'm just too confused

 

[Oza86]

To cope land

What kind of fistula u had? Ur taking a biologic meaning u have to have more complex, deep or multiple fistula?

 

[Oza86]

I have asked my gi, he told me that I don't need to be on immune suppression at this moment since I'm on remission and have a mild disease. He said if I put u on imuran or remicade that would be to well at least try to delay surgery to try to delay or prevent severe flare ups. But he said by taking remicade or imuran does not guarantees that u won't have a another flare ups or prevent surgery. He also said who knows you might not even get none of the complications.

So this is the story

 

[Oza86]

Any thoughts guys please give me any opinion or advice.

Thanks

 

[Grumbletum]

Hi Oza86. Glad to hear the fistula op went well. It is quite common to be on a 'maintenance med' and Imuran/Azathioprine is often the drug of choice. Your story is quite unusual, because it is often the surgeon who says you don't need meds and the GI who says you do!
The whole med issue is a dilemma, so I can see why having contradictory advice only adds to it. How do you personally feel about being or not being on meds? Would the GI prescribe them for you if you decided that was the road you wanted to take?

 

[Oza86]

Hi grumbletum

Thanks for the reply, I appreciated.

As for my medication is concerned, I'm on the following meds

1. 6 asacol (800) mg
2. Rowasa every night
3. 50 billion probiotics
4. Turmeric twice a day

Thanks

 

[copeland]

I have 2 fistulas. I'm not really sure what type they are, as I've never had a doctor characterize mine as simple or complex, but I would imagine mine are complex as they are very resistant to permanent healing.

Good luck!