Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Mayo Clinic

So they found crohn's while on humira?

GL on the steroids they made things worse for me. Well didn't do anything for my back - good or bad but it actually flared my colitis. Which happens in some people (happened even on the low/moderate dose)

They found mild inflammation at the ileum (CT enterography). The eosinophils were gone, but given the that inflammation was still present and that eosinophils are sometimes involved with Crohn's, he went with that diagnosis. He believes that it is much more likely than eosinophilic colitis, which is very rare. I'm not completely convinced, but who am I to argue with Mayo!

Now that I'm on the Humira, typically the constipation is gone in week one, and starts to come back in week 2. But last round, 2 full weeks of good bowels. This round, first week was good, second week has been a bit more variable: loose bowels / diarrhea with some undigested food one day, didn't go 2-3 days, then finally when I went, back to constipation with mucus. More Humira tomorrow night….that should make it better again.

Rather than steroids, which I'm trying to avoid, hoping the Humira will slowly heal the gut…...

Tnate, the doctor from Mayo put me on Budesonide. Is that one you have tried or something else? Honestly, my symptoms had become very mild since being on Humira, but I still have some mild symptoms, so I think he just wants to see if he can completely eliminate the GI symptoms.

David,

Did your symptoms become "very mild" immediately on the Humira, or did they get better and better all the time?

I ask because while the Humira helps, I wouldn't say things are always mild. First week, yes, usually fairly mild, but second week can still be a challenge, both with the arthritis (enthesitis, sacroiliitis, etc) and the GI constipation.

The rheumy predicted that the Humira would help more and more the longer I am on it.

Just wondering your experience?

And how often do you take it? every 14 day? or every 10 days?

I'm on it every 14 days, but the rheumy said we could do every 10 days if I wanted to. Not sure yet how I want to proceed.

Sue,

I take Humira every 14 days. I wish I could pinpoint when things really started to get better. Also, I was taking Qvar for the esophagitis and some of that steroid may have gotten further into my GI tract. I didn't even think about the Humira helping my gut issues until I was at Mayo and we started reconstructing the timeline. It became apparent that at some point after starting Humira that my GI symptoms had greatly diminished. So, I can't really say how sudden.

For the joint stuff, I do notice an improvement more immediately associated with the timing of the injection, but the GI symptoms continue to stay very mild throughout. I think (as does the Mayo GI) the Humira is helping to keep it in check.

Was it entocort I assume? I'm on Uceris myself cause a lot of my inflammation is in the rectum and entocort only works on the small bowel. I think they are good and should not flare your colitis. The properties in these topicals is different than other steroids. I think mesalamine is a bit stronger though but these are good when used in conjuction with ASA. It will definitely help though.

Those are new terms for me. I just know I'm on Budesonide. I was told that it would stay in the GI tract and not effect the rest of my body the way other steroids can.

Entocort=topical steroid prescribed for small bowel inflammation
Uceris=topical steroid prescribed for inflammation of the rectum and colon (may work on small bowel too)
They are both budesonide.
Like you said they only work in the colon so they don't cause all kind of side effects. They are gentler too.
Mesalamine helps most crohn's patients to my knowledge and is a bit stronger in my opinion.
And they work better together

Also the humira can help the GI stuff while not working on the back.
This is what happened with me last time I was on it. Healed up my GI track but wouldn't work on my back arthritis.

Found this thread of interest, so checked out the side effects - sadly, 'not' confined to gut, there are side effects and IF *anyone has cataracts or glaucoma or diabetes then must steer clear of ALL cortisone/cortisone family drugs.

Entocort=topical steroid prescribed for small bowel inflammation
Uceris=topical steroid prescribed for inflammation of the rectum and colon (may work on small bowel too)
They are both budesonide.

Side Effects :- (a very long list of side effects)

http://www.drugs.com/pro/entocort-ec.html
http://www.drugs.com/cons/uceris.html

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Cataracts (eye disease), or a family history of or
Diabetes, or a family history of or
Eczema (skin disease) or
Glaucoma, or a family history of or
Hypertension (high blood pressure) or
Infection (e.g., bacteria, virus, fungus) or
Osteoporosis (thin bones) or
Rhinitis (inflammation inside your nose) or
Stomach ulcer, active or history of or
Tuberculosis, active or history of or
Weakened immune system—Use with caution. May make these conditions worse.
Liver disease (including cirrhosis), moderate to severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.