Dr. Wants to Prescribe Anti-TNFs

Welcome to HW. You will find this site a tremendous resource.

Many of us are either wrestling with the idea of using anti-TNF's, or have been using them for quite some time.

It sounds like you've been doing not too badly up to now. It doesn't sound like the stricture you have is causing too much of a problem right now, considering the frequency of bathroom trips you speak of.

Unfortunately, it does sound the the disease could be controlled better, as Kazbern mentioned.

Have you considered, or has you're GI mentioned other medicartions like 6MP or Methyltrexate? They're a big step up over Pentasa, but not quite as scary as anti-TNF's.   

I have also taken Humira and am now on Simponi. Simponi is not authorized for CD [yet] but it has kept my intestinal problems away.

I suppose my jumping at the opportunity to go on Remicade stemmed from two things. First, my quality of life stunk. I had to use a walker to get around, needed help onto and off the toilet, could not bend to pick anything off the floor, etc. The thought I might become independent again was almost too much to hope for. Secondly, I was older. I was 54 at the time and the black box warnings didn't scare me. My children were adults and able to cope on their own. My husband was very caring and helpful but I felt I had let my partner down with my illness.

Have you read the black box warning on Tylenol? How about the one on Cipro, a common antibiotic given to those with GI issues? I actually suffered from the problem in that black box warning.

A concern for those with strictures starting an anti-TNF is if the stricture is from scar tissue or inflammation. If your stricture is scar tissue it is unlikely to reduce it. It might keep it from getting worse. There are some who have developed obstructions inspite of being on Remicade.

Also, insurance coverage for these meds varies widely. I suggest if you are considering them, you investigate your coverage. These meds are expensive. Also, Remicade is admnistrered via IV and is usually covered under the medical component of most policies rather than the pharmacy portion. Note I said usually.

It is a difficult decision. Weigh the pros and cons and how they apply to you and your situation. You ultimately make the decision. It's your body. Let us know what you decide.