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Had the scope today...not yeast at all...found a fistula

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Posted 3/15/2010 1:26 PM (GMT 0)
Its been a rough few weeks, and rough enough the past week or so where I've been off work. I went to ER last week because I was feeling so crappy and they set me up for an urgent scope that I had done today. I had myself convinced I had a yeast problem but the past few days I knew deep down it was Crohn's again. When you eat and 2-3 hours later your bowels are expanding/contracting and food is getting pushed through, you know that is a sign. Anywho, the scope showed bad reflux on my esophagus, even possible ulcers. Down in the duodenum was active Crohn's and a fistula.

Another GI did my scope today and he figures only Remicade will fix my problem. He said there is an increased risk of getting cancer but the cancer risk from Remicade is lymphomas, not adenocarcinomas which is what I had. He said my adenocarcinoma was likely a result of years of chronic inflammation. This was not news to me but makes a better case to start Remicade.

What pisses me off is after battling cancer, and at this point winning that battle, I get kicked in the n*ts by Crohn's and hard at that. Prior cancer I was on Imuran for 6+ years which was probably keeping a loose lid on my Crohn's as I never had any serious problems. But being off a long-term maintenance drug for a year and a half has probably opened the door to my current situation.

Anywho, I see my GI tomorrow morning. Hopefully we get a game plan arranged.

This post is moreso to vent. But any feedback on Remicade etc would be appreciated nonetheless.
Posted 3/15/2010 2:20 PM (GMT 0)
Dang!! Sorry you have the fistula, but I have heard that Remicade is the best med to help heal fistula's. Hope it does the trick and you get feeling better soon. Hugs~
Posted 3/15/2010 4:58 PM (GMT 0)
If your fistula is already draining.. which it probably is... you can bet on remicade to dry it up. Usually they will cut it from the inside out. but Remicade is great for fistulas. healed my ANNOYING preianal NASTY fistula.. Haha
Posted 3/15/2010 8:15 PM (GMT 0)
My husband's GI believes that Remicade is associated with Cancer usually when it is taken with other immuno-suppressive drugs such as Imuran, 6-mp or MTX. I also read an article that the CCFA published that explains the cancer risk on Remicade/Humira:
www.ccfa.org/about/news/cancerrisksexplained

The most relevant part is:
"Overall, the study suggests that the increased risk of cancer (lymphoma, skin, gastrointestinal, breast and lung) or serious infection may be three-fold and two-fold, respectively. The risk appears to be mainly in patients receiving high dose treatment (more than 6 mg/kg every 8 weeks; or adalimumab, 40 mg every other week). Curiously, the increased risk of cancer occurred early, and there was not a further increase of cancer with longer times."

My husband's GI believes that Remicade in terms of cancer, is safer than drugs such as MTX, especially for long term treatment because of this study done by the Mayo Clinic.

Remicade is probably the best drug out there for fistulas, and hopefully you won't have any side effects from it. The only side effects that Remicade has had on my husband so far (he's been on it 2 years), is a flu-like feeling with joint pain for a couple of days. He is given benedryl and solumedrol to deal with this.

I hope you get Remicade soon, and recover from this quickly, and go on with your life normally. Sending you lots of good wishes,

PV
Posted 3/15/2010 8:56 PM (GMT 0)
Thanks all for the replies, especially PV. A very informative post, many thanks.
Posted 3/15/2010 9:18 PM (GMT 0)
I don't Think MTX was part of that lymphoma risk. Could be wrong. I thought it was either 6-mp or Az.
Posted 3/15/2010 10:10 PM (GMT 0)
Just an FYI, this fistula is connecting two loops of bowel, it is not an abscess that is draining.
Posted 3/16/2010 1:45 AM (GMT 0)
Anytime you suppress the immune system, you have an increased risk of cancer. Just like other drugs that suppress the immune system, MTX also has the risk of cancers. See: arthritis.about.com/b/2008/06/22/rheumatoid-arthritis-drug-methotrexate-raises-cancer-risk.htm

BUT, the thing to keep in mind is that unchecked inflammation can also lead to cancers. So, it's best to treat the disease and hope for the best. In most cases, if you get cancers from suppressing the immune system, you can treat it (and that includes stopping the immune suppressing medication you're taking).

As always with Crohn's, you have to make a choice between a rock (immune suppressor) or hard place (unchecked inflammation = suffering,cancer,surgery). I certainly have learned to appreciate the other simple choices I have to make in life :-D

--
PV
Posted 3/16/2010 10:32 PM (GMT 0)
My GI is definitely not a fan of me taking Remicade. She said otherwise I'd be a perfect candidate for it. So I am starting Imuran.

I mentioned to her about LDN, she is going to check it out.

She also suggested I go to Toronto to see specialists there as they may have more resources than where I am located, especially given my history. She is going to get the ball rolling on that for me.
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