Resection and medications

[hlmurray99]

I'm sure this has been posted before, but I didn't have luck finding it exactly.

I'll be having an iliocecal resection on the 30th. I'll put a call in to my GI on Monday, but I'm just curious if your doctors had you go off of all or some of your meds before surgery? My doctor already had me stop entocort (which wasn't helping me at all anyway and I had horrible side effects) when he referred me to the surgeon. I'm still currently on humira (last taken 5 days ago), apriso, an over-the-counter multivitamin and probiotic, and occasional tramadol for pain.

Also, were you med-free after surgery or did you start up/continue with all of your meds? Or start something different? I'm hoping to be able to be med-free, but I'm sure this isn't likely and of course will discuss it with my doc, but just curious what others experienced.

Thank you!

 

[Jennifer]

Hi hlmurray99.

Before my resection I was taken off Entocort and they started weaning me off Prednisone (I think its pretty common for them to take people off steroids). I was still weaning off it after the surgery. I was also taking Asacol and 6MP which I was not taken off of. I didn't go off the Asacol for about, well over 5 years (I forget how long, been in remission for 13 years now) I know that because my current GI didn't think it was needed anymore. I'm still taking the 6MP as maintenance to help me stay in remission. Its quite possible they will keep you on some medication after surgery as maintenance but if you do go off meds please continue to see your GI for regular checkups to make sure that you're still in remission. Even the smallest symptoms can turn into big problems.

Good luck with your surgery and keep us posted!

 

[DustyKat]

Hey hlmurray99,

My daughter was undiagnosed and her resection was an emergency so no pre op meds there. She was however commenced on Imuran post op and has been in remission since that time, six years ago this month.

My son was diagnosed when he had his surgery and he was on Flagyl and Imuran preceding it. He remained on these two drugs in the lead up to up to surgery and has remained on Imuran. He remained on the Flagyl for 3 months post op as the Crohn's specialist believes it increases the chances of maintaining remission over a longer period of time. He has also been in remission since his surgery in April of last year.

I hate that my kids take Imuran but I don't know that I have resolved myself to them coming off them, I think I fear what may happen if they do. I saw what untreated Crohn's did to my daughter but that was extreme and she was undiagnosed at the time. Ultimately it is their choice as it they are adults now and I will respect whatever choices they make when it comes to their disease.

This is how I view maintenance medication, just my two cents worth mind! :lol:...I think most would agree that Crohns is not curable at this point in time and therefore the aim is to gain remission and stay there for the optimum period of time. Sarah and Matt's surgery put them straight into remission and they have stayed there but I view Crohns as a disease that is lurking and waiting to strike when the time is right so if I can regulate that response to some extent then that's what I will do. I see Imuran as a preventative medication much like Pulmicort is for an asthmatic, it stabilises your underlying condition so hopefully you can avoid or at least lessen the occurrence of a full on asthmatic attack.

Another point I think worth mentioning is while ever they have Imuran in their system then should the need arise to increase the dose they do not have the waiting period for the medication to start taking effect.

Good luck with the surgery and with your post op recovery and may you gain remission whatever path you choose!

Dusty. xxx

 

[archie]

Hi I was on pentasa and weaning off pred when I had an ic resection. I only had the disease for a couple of months prior to needing surgery as the meds failed to work on a ft long fibrosed portion of bowel. Post surgery they stopped the pentasa and I weaned of the pred after about 2 weeks.

I'm med free now and have no active crohns since surgery nearly 2 yrs ago all tests normal to date. I would take meds if required though but consultant and GI happy at the moment to keep me off everything ( so am I). My view is that I was never troubled by crohns so must have a mild case which just suffered a complication (perforation and abscess) that required surgery.

I do get regular check ups to keep an eye on things and every case is individual so I would never recommend anyone to not take meds if needed as you might have a more active disease. You have to weigh up the benefits versus the risks. Hope this helps and goodluck

 

[Heather_D]

Hi. I was on Pentasa and Cimzia (just finished a pred tapper) before surgery for maintenance meds. I also took Fish Oil, Pro-biotic, and I think a couple other things. After the surgery I was on no meds for a couple weeks. My GI doc then had me start on Apriso as a maintenance med. Since I got 2 fistulas and a severe stricture while on Cimzia he didn't really think that was doing much. My GI now wants me to have a colonoscopy in 6 months (roughly 9 - 10 months post-op) to see if there are any early signs of inflammation. If there are the plan is to switch me to a 6MP. I'm hoping for the best and hope that everything looks good when I go! Everyone is different though and your GI should have a plan more specific to your particular issues and how agressive they believe your CD to be. Good luck with the surgery!

 

[Thermo]

I was told to skip my next dose of Humira before my surgery on the 24th. My surgery will be 3 weeks since my last injection and my surgeon said that would be fine. You can stay on them some surgeons don't mind. I watched a youtube video from a Colorectal surgeon meeting where they have conflicting data if Biologics increase complications or not. It will ultimately come down to your surgeon.

 

[jmariel]

I was slowly weaned off everything but Pentasa. Worked out great. I stopped the Pentasa on my own. Stayed in remission for 10 years. Good luck!