Terminal ileum Crohn's treatment
- Thread starter wantok
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DustyKat
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Hey wantok,
Budesonide (Entocort), a more topical type of steroid, is only released in the Terminal Ileum and ascending colon. Being a steroid it is not recommended for long term use.
As far as maintenance meds are concerned then the 5ASA’s are it as far as being location specific is concerned as they too have a more topical effect as opposed to systemic. Pentasa is designed to be released throughout the small and large bowel whereas Salofalk (Mesalazine) is designed to be released in the Terminal Ileum and large bowel only.
Dusty. xxx
Budesonide (Entocort), a more topical type of steroid, is only released in the Terminal Ileum and ascending colon. Being a steroid it is not recommended for long term use.
As far as maintenance meds are concerned then the 5ASA’s are it as far as being location specific is concerned as they too have a more topical effect as opposed to systemic. Pentasa is designed to be released throughout the small and large bowel whereas Salofalk (Mesalazine) is designed to be released in the Terminal Ileum and large bowel only.
Dusty. xxx
Thanks, DustyKat. Very useful. So why do you think the GI put me on Pentasa for a flare of Crohn's in the terminal ileum (after a lengthy remission)? It is intended both to resolve this and maintenance. The reason I asked the question is Pentasa is so expensive and I was wondering if there was something cheaper. I have a lot of trouble tolerating drugs, so maybe it was a lower side effect profile?
DustyKat
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Pentasa is considered a maintenance medication as opposed to helping you gain remission. It would be more usual to be on either a steroid or Enteral Nutrition to quash the inflammation and then for Pentasa to keep it that way.
The 5ASA’s are pretty inoffensive in the IBD drug scheme of things but they are also not very effective for the treatment of Crohn’s, especially as a monotherapy. That is not to say they don’t work for some but generally speaking they aren’t very successful.
As you say, perhaps your drug sensitivities are the reason the GI started out lightly.
What drugs have you been on in the past?
Dusty. xxx
The 5ASA’s are pretty inoffensive in the IBD drug scheme of things but they are also not very effective for the treatment of Crohn’s, especially as a monotherapy. That is not to say they don’t work for some but generally speaking they aren’t very successful.
As you say, perhaps your drug sensitivities are the reason the GI started out lightly.
What drugs have you been on in the past?
Dusty. xxx
I have never been on therapy before. I had surgery decades ago and then just stayed in remission. He did say that Pentasa helped less than 1/2 achieve remission. I tried enteral on my own while waiting for the doctor's appointment, if drinking only Ensure for 3 weeks counts. Didn't work. My symptoms aren't very bad now: diarrhea controlled with 2 lomotil and 2-4 tylenol a day for pain.
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