New to this forum, old to Crohn's.

[Sonic]

Hello. I am a 29 year old male who was diagnosed with Crohn's disease when I was 14. I have not been on any medication for years, and have not had any major flair ups since I was 14. The worst it ever gets is very mild pain about three inches below my belly button. This pain is usually right before I pass gas.

I had a CT scan last month which showed abnormalites and a colonoscopy last week. My gastro told me that the disease is active and that he was worried about it getting worse. He gave me a prescription of Asacol HD (3 800mg pills per day) and Imuran (2 50mg pills per day).

During the colonoscopy the gastro said that he could not enter my ileum because it was too narrow. He didn't say how common this was, but did say that there was inflamation in my cecum and my acending colon. And that likely there was the same in my ileum.

I travel a lot and he suggested that he was worried I could have a bowel obstruction while on the road. I've been fine for 15 years, so I am not all too certain why he is so worried. He is a new Gastro for me. My old one retired.

Any suggestions, comments, questions?

Anything I should know about these drugs? I've been on Imuran before...I also was on Pentasa.

Any suggestion why Asacol is better than Pentasa?

I am nervous of course...I don't want to get worse.

 

[MADiMarc]

Hi.
What you are describing is what many people with Crohns have. Especially the ilium. It is wonderful that you have not had a bad time of it & I certainly hope it continues in that way for you.
I am taking Asacol HD also. I must say that I complained at first however it seems to be helping me quite a bit.
Look around in the treatment sub forums. They will give you very helpful info on the treatment side of things & the people there can answer specific questions regarding your specific medication.
You said you recently had a colonoscopy. When was the one previous to that? Has there been a change since? That is normally my yard stick.
Did you come right out & ask why he was so concerned? I get the obstruction thing. I had one once & let me tell you the pain was something I never want to go through again!
Welcome to the forum.
Michele

 

[Sonic]

My last colonoscopy was 7 years ago. My old Gastro did it. I don't have any pictures from it, but I just remember him saying that the Crohn's was still there, but it wasn't bad. The pictures I have from this one don't look too bad, but I don't know what I'm looking for.

 

[CDDad]

Hi Sonic,
My disease my manageable for about 20 years before it got out of control. Like you, I was not on medication for many years when I thought I was just dealing with my symptoms on my own. What I did not know was that inflamation was just running unchecked all those years and doing alot of damage. I ended up with a mass of pseudopoylps from all the inflamation leading to a Hemicolectomy. Soon thereafter findings of dysplasia, also from years of inflamation, leading to a Proctocolectomy.

I post this just to get the message across that meds are needed to keep things under control, even when symptoms seem managable. One family doc even said I was in denial when I told him that I was just dealing with it. He was probably right.

I found a good description of Pentasa vs Asacol below:

How does Pentasa differ from Asacol
Both Pentasa and Asacol are prescription forms of mesalamine. The difference between Asacol and Pentasa is in the outer chemical coating. Oral Pentasa has a unique formulation. The active ingredient is contained in coated microgranules, which enables a prolonged release of the active substance throughout the intestinal tract, from duodenum to the rectum. Therefore the Pentasa preparation is more useful for Crohn's patients who often have inflammation of the small intestine. The average small bowel transit time is approximately 3-4 hours in healthy volunteers.

Asacol is a delayed release enteric-coated tablets which generally releases the active ingredient only in the colon. While there are always clinical exceptions, Asacol is generally suitable for patients with colitis only (ulcerative colitis or Crohn's colitis), but not disease involving the small intestine.

 

[Sonic]

Do you think 100mg a day of imuran is tolerable? I've heard people talk about it making you tired.

I'm 6'3" 230 if that matters.

 

[ameslouise]

Hi Sonic and welcome!

Sorry things are acting up for you, but glad you have a plan with your doc for a good med cocktail!

As for avoiding an obstruction... chew like crazy. Also, low residue diet. Stay away from raw vegetables and fruits. Blend stuff. Chew like crazy. (Did I say that already? it's very important!!) Stay away from the standard Crohn's no-no's - popcorn, nuts of any kind, etc. Better safe than sorry!

-Amy