Treatments for Crohn’s and Colonic Ulceration

[Jandersen20]

Hello,

I’ve been posting a lot lately because I’m trying to understand this diagnosis my 17 year old got in July. GI calls it Crohn’s because the pattern of blotchy disease through the colon presents itself as that, but he also has severe colonic ulceration. The small intestine is also affected. I’m trying to understand what this even means.

Does colonic ulceration mean it has tendency towards UC? On Humira for 4 months and Symptoms right now are bleeding, urgency, and frequency. I called GI and asked about starting him on Uceris Foam hoping that will help, especially with urgency. She was okay trying it. So he’s starting tonight.

What are best treatments for his symptoms and given he has severe colonic ulcerations? I’m so confused.

 

[my little penguin]

You need to understand
Ulcerative colitis is continuous inflammation from rectum up - only affects the top layer
Crohns is patchy and affects full thickness of the intestine
Colonic ulceration - simply means they found ulcers in the large intestine which is common in crohns .
There are not specific meds for ulcers or frequency or urgency or blood
These are just all signs of active inflammation.
Biologics are treatments for crohns inflammation
But sometimes they need a few extra meds added
These are what needs discussed with your child’s Gi
Like methotrexate,formula only and oral steriods

Uceris foam only targets the rectum and sigmoid colon on the surface of the intestine .
It misses the ascending , descending and transverse colon .

please get a second opinion
And have a sit down with your child Gi on what additional things can be added to humira to reduce the inflammation burden

 

[Jandersen20]

You need to understand
Ulcerative colitis is continuous inflammation from rectum up - only affects the top layer
Crohns is patchy and affects full thickness of the intestine
Colonic ulceration - simply means they found ulcers in the large intestine which is common in crohns .
There are not specific meds for ulcers or frequency or urgency or blood
These are just all signs of active inflammation.
Biologics are treatments for crohns inflammation
But sometimes they need a few extra meds added
These are what needs discussed with your child’s Gi
Like methotrexate,formula only and oral steriods

Uceris foam only targets the rectum and sigmoid colon on the surface of the intestine .
It misses the ascending , descending and transverse colon .

please get a second opinion
And have a sit down with your child Gi on what additional things can be added to humira to reduce the inflammation burden

Thank you. Our appt with the GI is next week and will only be our 2nd appt since diagnosis. May eventually get 2nd opinion.

Is it common then to take an oral steroid such as Budesonide (Entocort) or Prednisone along with the Uceris Foam to act as somewhat of a bridge gap while waiting for other maintenance meds to kick in?

 

[my little penguin]

Wait … you child was dx in July and wasn’t seen by his Gi for 6 months
That is not the norm
Typically it’s every 2-3 months in the beginning
Especially until your child is in SOLID remission
Please do not wait to get a second opinion

 

[Jandersen20]

Wait … you child was dx in July and wasn’t seen by his Gi for 6 months
That is not the norm
Typically it’s every 2-3 months in the beginning
Especially until your child is in SOLID remission
Please do not wait to get a second opinion

I just looked at my calendar. Next week will be 3 appts since July. Did a course of Prednisone in July and then started Humira. Getting blood work done to check Humira trough levels/antibodies and that will hopefully give us what we need to decide on how to move forward.

So can you take oral steroids along side a rectal steroid while waiting for the maintenance meds to kick in?

 

[my little penguin]

You can take oral steroids with humira and with rectal foam.
Rectal foam is only topical

 

[Jandersen20]

Is it common to have a little burning/stinging sensation upon use of Uceris Foam? My son experienced that when he used it last night and this morning. Just curious. Poor guy is probably already so irritated in there…

 

[Lisa]

Is it common to have a little burning/stinging sensation upon use of Uceris Foam? My son experienced that when he used it last night and this morning. Just curious. Poor guy is probably already so irritated in there…

Yes it can be - especially if there is active disease right in that area. Hopefully it will get better as the foam has time to work.

 

[Jandersen20]

Thank you so much for your reply. Makes me feel a little better
This diagnosis is new and I’ve just been in worry mode lately trying to understand all these treatments.