New to Forum, Could Use Some Advice

[John M]

Hello everyone, my name is John
I'm a 18 year old male and was recently diagnosed with Crohn's.

2 years ago, i started noticing i was sensitive to some type of foods, and started having stomach aches more frequently. At the time, i thought it was due to fast-food and some casual drinking on weekends, so i did an endoscopy and learnt that i had some ulcers and an infection due to the H Pylori bacteria. I did some treatment and my doctor told me the bacteria had been treated sucessfuly.

This academic year (September 2014-...), i went to college and there are alot of welcoming parties to freshman students in the beggining of the academic year. At the end of the month of October i started having diarrhea and going to the toilet more frequently. I didn't make much of it, and thought it was because of drinking and poor food choices from the previous weeks. But the diarrhea stayed for more than a month and so i went to a doctor on december 3rd. I did several blood works, urine samples, stool samples, endoscopy and colonoscopy. After the colonoscopy i was diagnosed with Crohn's on January 27th.

I started taking corticosteroids on 27th February, 60mg a day and some calcium and vitamin B12 pills. As soon as i started taking them i had severe nausea and stomach pain and was vomiting everyday. My doctor prescribed pantoprazol to try and help with the nausea and vomiting and also scheduled an endoscopy to see if there was any stomach damage. After 2 weeks of corticosteroids, stomach pain, nausea and vomiting suddenly went away. The only side effects i had from there on were severe acne in my face, chest and upper back, muscle cramps, bloating and an increase in appetite.

After 1 month of treatment, i am now reducing the corticosteroids (minus 10g every week) till i'm no longer on them and my doctor has prescribed azathioprine. i'm now taking 75mg a day just for this first week to get used to it, and am supposed to up the dose to 150mg a day. The thing is, currently i weight about 58kg, so i was wondering if 150mg a day for someone with my weight might be a little too much. I'm a bit affraid of the azathioprine's side effects, with the increased risk of lymphoma, skin cancer and overall infections. Do you guys think azathioprine's the best choice here and if so, should i stay or ask for a dose reduction ? Also, what are the main differences between azathioprine and anti-TNF ?

Cheers everyone

 

[mik118811]

Hi John, Azathioprine is one of the first go to maintenance drugs as far as I know, you should be monitored with blood tests every couple of weeks to begin with so they can keep an eye on the dosage and adjust as necessary. I think it is probably a very common drug for anyone with crohns and most people have probably used it or continue using it. I was taken off of it due to choice and am now restarting it due to a flare. I take 150mgs but I weigh 75 kilos at the moment (dropped 13 kilos since Jan.) I was on it for nearly 5 years and didn't have any side effects at that dosage except I think it effects my throat a little And I suffered longer than everyone else with colds. You should be closely monitored and if anything isn't right your dose will be adjusted or you will be taken off of it (depending what the issue is) the idea of it though is to give you the highest dose your body will tolerate. Anti tnf meds are generally the next step but the side effects can be worse than drugs like Azathioprine, I was a few months away from starting remicade 3 years ago but went into remission for three years while taking Azathioprine, at the moment it is looking like I may be going back down that road but I would rather not as it is another treatment that may not be an option in the future if taken now.

 

[Crohns08]

Hey John, sorry to hear what you're going through. To be honest, most of the concern for Lymphoma is when you combine multiple therapies such as an immunosuppressant and a Biologic. The main concern is developing an infection as these drugs make it harder for your body to fight off things like colds or the flu. Immunosuppressants are also in pill form where as biologics are injections via IV or through pens or needles.

 

[Nancye50]

This forum helped me feel so much better about taking meds. I started on Imuran but quickly progressed to Humira. Remember that inflammation in general puts you at higher risk for colon cancer. And on Aza, you blood counts will be monitored closely so they intend to catch issues before lymphoma develops. Maybe if you're concerned about the dosage, ask your dr to level off at 100 to see how it is?