Prednisone, Flagyl, Asacol not working! Whats next?

You may have to go to the next tier of drugs, the immunosuppressants (Imuran, 6MP, etc.). Usually they will put you on Prednisone or another steroid (entocort) until these drugs kick in because it can take months.

Lately though, more and more doctors are going the immunosuppressant along with biologicals (Remicade, Humira) right away.

You need to educate yourself on the different kind of treatments so you can discuss the options with your doctor based on your disease.

I like steroids for short term only, they did work for you while you were on them, the question is: can you stay on them for the months it may take for Imuran or 6MP to kick in?

Immunosuppressants have a list of side effects, but I haven't had any except for some elevated enzymes so others will have to speak up.  I like these drugs for the next tier (my opinion), before you bring out the big guns (Remicade, Humira). 

Remicade and Humira work well for many people, Remicade is limited in my opinion because most people will build antibodies to it eventually (which I did) which not only prevents it from working well, but can cause many side affects.  I don't know much about Humira as it was too expensive for me to try, but it seems to be working for a lot of people.  I do think it's pretty new, so the side effects aren't well known yet. 

All these drugs have side effects, it will be up to you to decide what you can live with, what you're willing to try. 

Hopefully one or a combination of these drugs will help you, if not, surgical intervention is always an option, but in my opinion, depending on the severity of the disease, surgery should be a last option (there are times when it's the only option, but that doesn't seem to be the case yet).  In most cases, a surgeon won't do surgery unless you've tried all/most of the other options without results (unless again, it's an emergency situation). 

 

I was on Asacol but it too didn't seem to work. (My crohn's is located between the small and large intestine) So I got bumped up on Imuran on Oct 3rd. I think it's kicking in because I am able to slowly eat more and my bm's are not swinging between C and D as much. =0)

I hope you find your right mix of meds. I really didn't want to get bumped up to Imuran because of the fact it's an immune suppressant but if that is what it takes to make this thing go into remission.... bring it on! =0)

I''ve been on imuran for many years. I'm still on imuran but it has never put me in remission. Other drugs and a resection haven't put me in remission either, so now I'm trying The Maker's Diet and probiotics. I don't do the diet 100%, but I still notice a difference.

 

If your Crohn's is only in the terminal ileum then Entocort might do the trick. My daughter has been on Entocort nonstop since July 2006 - on only one pill a day since May 2007. And is in full remission. No side effects whatsoever. She has the blessing of a Mt Sinai doc to continue on Entocort.

So we love Entocort, and will stick with it until safer meds are developed, particularly those that do not suppress the immune system. 

 

Asacol was the first drug my doctor prescribed for me as a trial. I had partial remission of my pain and he said that was because some of the asacol gets into the end of the small intestine even though its formulated for release in the large intestine. So then he tried pentasa and I had complete remission of pain. However, I felt better systemically on asacol than I do on pentasa so I wish I could still take that and have it work as well as pentasa for pain. You might want to ask to try pentasa to see if you have greater improvement based on each drug's mechanism of action. It is true that pentasa works locally because I have seen no improvement in the other problems like the tendonitis in my feet. If there was significant systemic absorption I would think I would notice an improvement or at least some kind of change.

I plan to ask about the immunosuppressants on my next visit. Pretty sad that a patient has to suggest treatments but that's the way it is sometimes so.....

I'm on Remicade right now, I tried everything else and saw no change. Ive only had 3 treatments but so far the only thing its helped me with is joint pain. My tummy still hurts all the time and I'm so tired of it!

I had an acute flare up last week that sent me to the hospital. I was dehydrated but fortunately not anemic or deficient.  Started Prednisone same day and at 10 days out finally getting some control. Decreasing dosage from 60mg/wk to 10mg. 6th week. The side affect that bothers me is insomnia. I haven't gained any weight since losing about 8 lbs. only because I 'm trying to stay on an "any free" diet, eg. Gluten, wheat, dairy, corn etc. at this time and mega doses of vitamins. It's worth a try, anything is! I am thinking about trying Probiotics in a few weeks when it all settles down.  Does anyone have any experience with Probiotics? ************************** Trudy, diagnosed with CD May, 2006. Three flare ups since, IBD at least ten years prior. Switched from 6 Asacol per day to one Lialda - a new drug in the Asacol family once a day.  Prednisone for 6 week to hopefully getting it in remission.

I don't know if this helps you or not, but I had been on Asacol for many years.  Before that, it was Dipentum, Pentasa, Rowasa and the old asulfadine (however you spell it - the sulfa drugs).   Unfortunately, during flare-ups, the Asacol would shoot through me so fast that the pills didn't even dissolve.  

Then, my gastro switched me to Colozal, which fixes that problem.  They're capsules, not caplets, so they dissolve faster and better than Asacol.  I think all of the above-mentioned drugs are basically the same, with meselamine being the active ingredient.  But I could be wrong...