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Newly Diagnosed. How long till meds work?
- Thread starter kelly1
- Start date
DustyKat
Super Moderator
Hi Kelly1 and :welcome:
I am sorry to hear of your diagnosis :ghug: and hope you soon find long and lasting relief from your symptoms.
The medications you have been commenced on should start working quite quickly, as in days for the Prednisone and Metronidazole. Prednisone will hopefully knock the inflammation on the head ASAP and induce remission while the Metronidazole, an antibiotic, also has some anti-inflammatory properties but is primarily used to treat infection that commonly accompanies inflammation in the gut.
Pentasa is maintenance medication that works more topically than systemically. Because of this action its effectiveness in Crohn’s is questionable. It is a good drug for Ulcerative Colitis for this very reason as UC affects the top layer of the bowel only, as as such you can see how Pentasa (5ASA) loses it’s effectiveness in a disease that has the potential to affect all layers of the bowel wall.
Has it been suggested to you by the doctor that you may need something stronger than Pentasa?
Is your disease only in the perianal area or elsewhere in the bowel too?
Dusty. xxx
I am sorry to hear of your diagnosis :ghug: and hope you soon find long and lasting relief from your symptoms.
The medications you have been commenced on should start working quite quickly, as in days for the Prednisone and Metronidazole. Prednisone will hopefully knock the inflammation on the head ASAP and induce remission while the Metronidazole, an antibiotic, also has some anti-inflammatory properties but is primarily used to treat infection that commonly accompanies inflammation in the gut.
Pentasa is maintenance medication that works more topically than systemically. Because of this action its effectiveness in Crohn’s is questionable. It is a good drug for Ulcerative Colitis for this very reason as UC affects the top layer of the bowel only, as as such you can see how Pentasa (5ASA) loses it’s effectiveness in a disease that has the potential to affect all layers of the bowel wall.
Has it been suggested to you by the doctor that you may need something stronger than Pentasa?
Is your disease only in the perianal area or elsewhere in the bowel too?
Dusty. xxx
Hi Dusty
Thankyou for your reply. My gI put me on these meds last week and I have to go back 26th January for a review.
I have it in the terminal ileum aswell, have thickening of the terminal ileum.
Have been suffering for 20months with anal abscess and fistula that wont heal but now ha e answers am feeling relieved.
kelly x
Thankyou for your reply. My gI put me on these meds last week and I have to go back 26th January for a review.
I have it in the terminal ileum aswell, have thickening of the terminal ileum.
Have been suffering for 20months with anal abscess and fistula that wont heal but now ha e answers am feeling relieved.
kelly x
You lived with fistula for 20 months without being diagnosed? I have a perianal fistual for a month and undiagnosed.. were you treated for fistula alone until you were diagnosed? .. I just posted my story in other thread, If you have any insights let me know..
Hi Shankar I got diagnosed with a fistula in july 2013 and they put a seton in then. I have had repair surgeries that have failed and got diagnosed in December 2014. I currently have another seton in and in total have had 18 surgeries for this damn fistula. What is the plan to treat your fistula? do you have a seton in? x
Hi Shankar I got diagnosed with a fistula in july 2013 and they put a seton in then. I have had repair surgeries that have failed and got diagnosed in December 2014. I currently have another seton in and in total have had 18 surgeries for this damn fistula. What is the plan to treat your fistula? do you have a seton in? x
Hi Kelly,
I'm pleased for you that you have got a diagnosis (though obviously not pleased you have crohn's). I hope that with medical treatment for the crohn's you can start to get your fistula sorted now as you've obviously suffered loads with all the surgeries.
I've always found prednisone works quickly for me in flare-ups, and I've just started on metronidozole now for my fistula which has been sore since my recent curettage and it's reallly helping it to drain less and feel better.
Have they proposed biologics (Humira or Infliximab) for your fistulas now it's known you have crohn's?
I'm sorry that it's taken you so long for a diagnosis since your fistula has been so troublesome. Did you have a colonoscopy when you first got it? For me, they already knew I had UC, so it was easy enough for them to change it to a crohn's diagnosis when the fistula emerged.
Wishing you all the best xx
I'm pleased for you that you have got a diagnosis (though obviously not pleased you have crohn's). I hope that with medical treatment for the crohn's you can start to get your fistula sorted now as you've obviously suffered loads with all the surgeries.
I've always found prednisone works quickly for me in flare-ups, and I've just started on metronidozole now for my fistula which has been sore since my recent curettage and it's reallly helping it to drain less and feel better.
Have they proposed biologics (Humira or Infliximab) for your fistulas now it's known you have crohn's?
I'm sorry that it's taken you so long for a diagnosis since your fistula has been so troublesome. Did you have a colonoscopy when you first got it? For me, they already knew I had UC, so it was easy enough for them to change it to a crohn's diagnosis when the fistula emerged.
Wishing you all the best xx
Hi kat!
Thankyou, i hope so as like you said i have had a great deal of suffering and spent the best part of 2 1/2 years in 2 1/2 years.
I too found that prednisone helped and i have an appointment tomorrow as when i had my seton replaced 3 weeks ago my surgeon notice another abscess brewing so that was drained but this last week i have been having awful throbbing pain so have a feeling somethings going .
Im awaiting for a GI appointment to come through, my dr has emailed her requesting an urgent appointment as he thinks i may need a biologic. Are you on a biologic?
It wasnt until i had my repair surgery 6 months after they found the fistula that things started to be more troublesome with failure and more abscessess that they done an ultrasound and mri and noticed abnormalities that they then requestef a colonoscopy.
How long have things been going on with yourself? Are things under control with you?
Wishing you well xxx
Thankyou, i hope so as like you said i have had a great deal of suffering and spent the best part of 2 1/2 years in 2 1/2 years.
I too found that prednisone helped and i have an appointment tomorrow as when i had my seton replaced 3 weeks ago my surgeon notice another abscess brewing so that was drained but this last week i have been having awful throbbing pain so have a feeling somethings going .
Im awaiting for a GI appointment to come through, my dr has emailed her requesting an urgent appointment as he thinks i may need a biologic. Are you on a biologic?
It wasnt until i had my repair surgery 6 months after they found the fistula that things started to be more troublesome with failure and more abscessess that they done an ultrasound and mri and noticed abnormalities that they then requestef a colonoscopy.
How long have things been going on with yourself? Are things under control with you?
Wishing you well xxx
Oh, I mis-read the date on your post at the top - I'm sorry! I thought you'd only just been diagnosed. My bad.
Are you on any antibiotics for the recent abscess? If not, maybe that would help. I hope your gastro appointment comes through soon. Sounds like a biologic could be a good idea.
I am doing ok-ish. Had recent curettage of the tract in December as they said there was a lot of granulation tissue preventing it from healing up. It was a bit sore after that but feeling better since I started on metronidozole last week. I've not had any repair surgeries and honestly I'm not keen to try. Going to exhaust all the medical options first.
I am on Humira since Feb 2015, increased to weekly in October. Also on Azathioprine for 4 years, and Pentasa. I'm going to try a complete liquid diet (Elemental 028) for 6 weeks (hopefully!) starting this weekend. Will have an MRI in March to see if it's had any effect.
My first abscess was in 2011, but it didn't form an actual fistula until Jan 2015, was just a tract with no external opening. It didn't cause me too many problems until last year. UC diagnosed in 2000, but they've changed the dx to crohn's due to the fistula and also they found a granuloma at one point. It's only been in my colon so I guess that makes it harder to differentiate.
Are you on any antibiotics for the recent abscess? If not, maybe that would help. I hope your gastro appointment comes through soon. Sounds like a biologic could be a good idea.
I am doing ok-ish. Had recent curettage of the tract in December as they said there was a lot of granulation tissue preventing it from healing up. It was a bit sore after that but feeling better since I started on metronidozole last week. I've not had any repair surgeries and honestly I'm not keen to try. Going to exhaust all the medical options first.
I am on Humira since Feb 2015, increased to weekly in October. Also on Azathioprine for 4 years, and Pentasa. I'm going to try a complete liquid diet (Elemental 028) for 6 weeks (hopefully!) starting this weekend. Will have an MRI in March to see if it's had any effect.
My first abscess was in 2011, but it didn't form an actual fistula until Jan 2015, was just a tract with no external opening. It didn't cause me too many problems until last year. UC diagnosed in 2000, but they've changed the dx to crohn's due to the fistula and also they found a granuloma at one point. It's only been in my colon so I guess that makes it harder to differentiate.
I havent met any surgeon yet.. Will be meeting one in next week or so.. Then i will be discussing the options with him/her.. It doesn't really interfere with my daily activities.. I rarely have pain there like for a few mins.. Is yours a transphinteric fistula? 18 surgeries for a fistula? why? operating that many times on a sphincter would give you incontinence issues? I am kinda new here ..
Hi kat
sorry for delay in replying ive had a bad few days!
I have an appointment with my gp this wednesday so im thinking along the same lines as you and I need antibiotics, I am going to see if he can email my gi and hurry the appointment through.
Glad you are getting by, how are you feeling now? Hope the antibiotics are helping.
Have you started the liquid diet? If you dont mind me asking what made you decide on the liquid diet? Xxx
sorry for delay in replying ive had a bad few days!
I have an appointment with my gp this wednesday so im thinking along the same lines as you and I need antibiotics, I am going to see if he can email my gi and hurry the appointment through.
Glad you are getting by, how are you feeling now? Hope the antibiotics are helping.
Have you started the liquid diet? If you dont mind me asking what made you decide on the liquid diet? Xxx
Hi shankar.
Its good your going to meet with your surgeon, I always find it helpful if I make a not of things I want to ask so I dont forget.
yes mine is a transsphincteric fistula and yes ive had 18 surgeries for this which include repair surgeries, seton replacements and abscess drainage.
you are right the amount of surgeries ive had have resulted in incontinence issues.
X
Its good your going to meet with your surgeon, I always find it helpful if I make a not of things I want to ask so I dont forget.
yes mine is a transsphincteric fistula and yes ive had 18 surgeries for this which include repair surgeries, seton replacements and abscess drainage.
you are right the amount of surgeries ive had have resulted in incontinence issues.
X
Hi Kelly,
Oh, good you have a GP appointment. Yeah, take the antibiotics. Make sure the GP gives you metronidozole and poss ciprofloxacin. Mine gave me some rubbish one when I first had an abscess and immediately when I saw my gastro he said no that's not right and gave me those and they worked much better. You've probably had them before though with the amount of problems you've had
Good if he can hurry up your gastro appointment too.
I've started the elemental diet this weekend, but I had to phase it in. It's not going that great so far - you can see my post on the Exclusive Enteral Nutrition section about my woes on it.
I decided to go on the EEN because I'm not seeing that great result yet from the Humira, despite being on it weekly, and it seemed like it might be a good idea to add something else. There's good evidence that EEN can induce remission in adults with crohn's, but much better evidence for small bowel crohn's - much less for colitis and perianal, so it will be an experiment. the theory (one theory) is that it reduces the antigen load in the gut that we are supposedly having an abnormal reaction to. At the very least, it should be a period of bowel rest so it could help the fistula to heal I think.
Oh, good you have a GP appointment. Yeah, take the antibiotics. Make sure the GP gives you metronidozole and poss ciprofloxacin. Mine gave me some rubbish one when I first had an abscess and immediately when I saw my gastro he said no that's not right and gave me those and they worked much better. You've probably had them before though with the amount of problems you've had
Good if he can hurry up your gastro appointment too.
I've started the elemental diet this weekend, but I had to phase it in. It's not going that great so far - you can see my post on the Exclusive Enteral Nutrition section about my woes on it.
I decided to go on the EEN because I'm not seeing that great result yet from the Humira, despite being on it weekly, and it seemed like it might be a good idea to add something else. There's good evidence that EEN can induce remission in adults with crohn's, but much better evidence for small bowel crohn's - much less for colitis and perianal, so it will be an experiment. the theory (one theory) is that it reduces the antigen load in the gut that we are supposedly having an abnormal reaction to. At the very least, it should be a period of bowel rest so it could help the fistula to heal I think.
Hi kat!
Thats the combonation of antibiotics that i normally get prescribed and hopefully they will help. I have a really good GP and hes always helped me if needed.
Sorry the elemental diet is not going great but hopefully over the next few days or so things will improve
To be honest i think maybe this is what i could do with, i think my bowel at least needs some rest and like you say it could help the fistula heal. X
Thats the combonation of antibiotics that i normally get prescribed and hopefully they will help. I have a really good GP and hes always helped me if needed.
Sorry the elemental diet is not going great but hopefully over the next few days or so things will improve
To be honest i think maybe this is what i could do with, i think my bowel at least needs some rest and like you say it could help the fistula heal. X