Post Operative Medication?

[alexandros8]

Hello everyone,

I just went through my first resection surgery, an ileocolectomy to remove all my inflamed areas. I am fortunate that my Crohn's had just affected that one area, so now after the surgery I am without any affected areas.

My question is whether to treat my condition now with medicine or not. It appears that doctors have not concluded which is the best route. Some say to continue to treat as it will slow any recurrence down. Others say that if it comes back, it will not matter whether I am on meds or not at the time- and to treat with meds only if (or when) it comes back. So far I've seen two GI's and both say to put me back on meds, but they differ on which meds to go on (6MP v. Cimzia).

I understand that it is likely to come back at some point. The question is... do I go under treatment now? Or wait? And if I do go under treatment, at what level? Low immuno-suppressants, or the biologics? I am curious what you have heard, read, etc.

Here is a link to download a medical review I found of the current studies. It basically states that of all the studies for this scenario, there is not conclusive evidence to go one way or the other.

"Preventing Crohn's Disease Recurrence With Drugs After Ileocolectomy," Merril Dayton MD : http://files.me.com/alexandros8/cpmw9d

 

[Crohn's 35]

Hi Alex... My first laproscopic surgery, I was on Entocort only for about 7 years. Down to one pill for maintenance, but was oblivious to it coming back and didnt look after myself. The second resection was an emergency and was on Cipro and Flagyl and more... however, just recently my GI of 30 plus years are saying the new thing now is 6mp or imuran and Flagyl for 4 months. We dont have Cimzia here so I cannot comment. If I had the choice I would be on the Entocort again, low dose and take care of myself. I am allergic to Imuran, so that is from experience point of view. As we know the more surgeries you have the quicker it comes back.

Good luck, only my experience I am sure others have their opinions. Let us know what you Gi says ok.

 

[Jennifer]

I was put on 6mp after my surgery. I was also on Azacol. For me, it makes sense to continue treatment. It's an autoimmune disorder so why not slow down the process? Its most likely going to come back no matter what but a year or a day later is always better.

 

[imisspopcorn]

My disease came back with a vengeance 6 month post-operatively...I am now on Remicade...My goal is to get 10 more years before needing another resection...I say, "if you can schedule a Colonoscopy 6 months post-op so the doctor can visually see what is going on, do it!"....Some people have to come at their disease more aggressively than others. I recommend treating it now! Preserve as much bowel as you can!

 

[Nyx]

I just had surgery in December, and am not on any meds for Crohn's right now. My GI sees no need for them at this moment. But then again, I have to undergo another surgery to remove the rest of my parts, so I may go on them after that's done. I'll likely go back on Imuran if anything.

 

[D Bergy]

I went on Low Dose Naltrexone a few months after my resection. Since it is about as risk free as chewing gum, I had no problem going that route.

I really did not want to take the chance on more surgery, as I like to keep my body parts, in case I need them.

I look at it this way. My stricture was a result of the disease. My disease is not gone, because the stricture is gone. The immune system is still dysfunctional either way. Correct the problem as best you can.

http://www.lowdosenaltrexone.org/

Dan

 

[Crohn's 35]

I went on Low Dose Naltrexone a few months after my resection. Since it is about as risk free as chewing gum, I had no problem going that route.

I really did not want to take the chance on more surgery, as I like to keep my body parts, in case I need them.

I look at it this way. My stricture was a result of the disease. My disease is not gone, because the stricture is gone. The immune system is still dysfunctional either way. Correct the problem as best you can.

http://www.lowdosenaltrexone.org/

Dan

You know what this sounds like a good idea! Forgot about LDN...

BTW Dan, nice pic!!!! You gotta face.

 

[alexandros8]

Thanks for your thoughts everyone. I will research LDN and ask my doctor about it as well. We were also referred to see a doctor who is leading CD research out of UNC, so I might be on a road trip in a couple weeks.

It does make sense to treat it as if I have it, so to slow down any recurrence. Its just that one of the mental struggles I've had with this disease is that I'm basically on meds indefinitely, which I don't like. I would rather be on 6MP, as I took that drug for many years w/o many side effects. Cimzia, while helped greatly with my energy, gave me a lot of skin related side effects.

I will report back as I investigate further and hear from my GI. THANKS!!

-Alex

 

[living4today]

Hi- I just went through my own resection surgery a month ago and am currently on 6MP(100mg) and small dose of Prednisone(5mg every other day). My doctor talked about puting me on Humira but it didn't seem to help a few months ago...although I think it is because I had more obstruction than inflammation. I do agree that it is probably a good idea to be on some sort of maintenance drug. I really trust my doctor-one of the best in Seattle. Good luck!