Not sure why humira?

[JAY82]

I am currently waiting for the humira to come in the mail, will then have to go the my dr and do the first 4 shots in the office.. My dr has pushed humira for the last couple months and at the urging of my wife I finally gave in and said I'd try it, just think maybe it is jumping the gun.. My dr has said I really didn't have another option but the only thing they have tried is pentasa and Asacol, I have had prednisone and entocort for flares(mainly rectal pain).. The big push for it came after the capsule endoscopy that showed significant inflamation in my small intestine around 61% of the small intestine was inflamed.. but most days I am not in pain and function fine, i have some fatigue and the feeling that I did to many sit ups but that is and has been the norm for a longtime.. I really only went to the dr to address rectal pain and bleeding as that has always been my concern..

Just wondering it it really seem warranted for some who most of the time is not really in pain, and has not really tried anything other than Asacol and pentasa

 

[Lisa]

Hi Jay -

Many doctors these days take a 'top down' approach - going for bigger guns rather that starting wtih milder medications and then working up.....

Having inflammation in your small intestine and not treating that could lead to complications further down the road, such as scar tissue, strictures and even blockages. My GI used to scold me all the time because I wouldn't 'show' the amount of distress I was really in - until I would finally break down and go see him, which usually resulted in a direct admit to the hospital for a week or more to get things under control.

i have some fatigue and the feeling that I did to many sit ups but that is and has been the norm for a longtime

Right here is a sign things are not right too - and should be taken care of before it goes on much longer.

Welcome to the forum, you will find lots of great information around here!

 

[Clash]

In times past the therapeutic goal for CD was no symptoms. In recent years, the therapeutic goal has shifted to deep, stable remission(symptom wise, endoscopic and histological). The reason being the longer the tissue remains inflamed thehigher the chances irreparable damage is being done. Untreated or undertreated inflammation causes more damage. Also, GIs have two schools of thought on treatment. For a long time treatment was bottom up as far as meds start with those at the bottom of the pyramid 5ASA(pentasa, asacol, etc) then immunosuppressants(Imuran, 6mp, methotrexate) and finally the biologics(remicade, humira, cimzia). Now there are two schools of thought bottom up and top down.

It sounds like you have considerable active areas of CD with 61% of your small intestine being affected and that is probably the reason for humira. Also, asacol and pentasa are approved and effective for the treatment of UC but the results aren't as great for CD.

Hope all goes well for you.

 

[lukefarrell]

I agree with the above 2 posts completely. At the moment my symptoms are relatively 'mild', whilst they still slightly dispurt my daily life they are better than they have been in the past. However recent colonoscopys, MRI's, bloods etc show my large and small bowel are quite badly inflamed.

Therefore I also started Humira yesterday. I had 4 injections approx 24 hours ago and I have experienced no side effects so far (touch wood). So it doesnt seem all bad to be, I wouldnt be too worried as it will hopefully stop any longer term damage. I've had both a resection, and strictureplasty in the past neither of which were particularly pleasant experiences and are best avoided if possible.

all the best