Husband just dx'd, questions

You sure he really has both Crohn's and UC? It is possible, but quite rare, to have both. Often people have Crohn's disease in their colon, which is called Crohn's colitis, and they mistakenly think that means that they have UC (ulcerative colitis). But those are two different entities.

In any case, whether or not he has both, or just Crohn's, the treatment is the same, so it doesn't matter too much (unless surgery is needed at some point; then it matters more).

The best starting place for info might be ccfa.org.

Welcome to HW Moon, but sorry you have to be here. You've already received some good advice but I would also suggest a couple of the books that are out there for the newly diagnosed. The one by Jill Sklar is very helpful to newbies. I hope they get his disease under control soon. And if he isn't already at a teaching hospital and has the option to do so I'd recomend thinking about that. Especially if they are into research as the docs are more up to date on current treatments.

Thanks for those suggestions, all. We had his appt this afternoon and was told that he has both crohns and UC, and that it was rare to have both. His doc was a little surprised about how well he presents clinically, as "under the scope" he looks BAD, apparently. Doc says he's definitely in the severe end of the spectrum.

Now it's time time to decide where to start with treatment - step up with salicylates first (he's on uceris now bc the effects from prednisone were horrendous) or start with biologics? Any distinct advantage to starting with one over the other? The doc was pretty clear that he didn't think the salicylates would do it, but I guess he saw no harm in trying them for a couple of months if that's where my husband wants to start. I'm leaning toward biologics only because I don't want him to spin his wheels.

He's also seeking another opinion, hopefully with a gi who can offer more than a shoulder shrug at the mention of some alrernative & complimentary treatments. Is there such a thing as an integrative gi??

Thanks, sparkleplenty; that's very helpful advice.

So, given that it's a disease that requires some trial & error for treatment & maintenance, what are the overarching principles at play? For example I have Lyme and with that we need to treat by killing microbes, detoxing, and supporting the immune system.

I get reducing inflammation and maintaining remission. What about immune support?

Thank you!

Biologics in Canada and the US as far as I know, have Patient support systems to help cover some or all of the cost depending on your financial situation and biologics will not be kept from anyone that cannot afford it but needs it (in Canada for sure) it is rare to have both, approximately 2%, very sad your hubby fell into that category, I have crohn's, IBS and lactose intolerance but my crohn's is in remission with Humira (my first remission in the 24 yrs I've had CD) but I'm still working on my IBS (I use lactaid products for my lactose intolerance) I think a biologic is definitely in order for your hubby's case since he has both IBD's and hopefully it will clear up both of his IBD's too.

I also think he really should get a second opinion just because it's so rare to have both (not denying that he doesn't have both) it's just because it is so rare that a second or even third opinion wouldn't be a bad idea, many GI's have a hard enough time DX one or the other let alone both in one patient. He definitely has a long road ahead of him so I hope he finds a great med that will get both diseases in remission!

I don't know that I've had a discussion with a doctor about reducing inflammation and immune support! I think that's where probiotics come in. I think if the inflammation is under control then your immune system can cope OK.

You might check out the UC board if you haven't already. There are a few on there into the MAP therapies and a few other new theories about IBD they might have a better handle on the balance between controlling inflammation and keeping the immune system up.

Again I think it's where everyone is different. I worked with kiddos 5 days a week (snotty, drippy, disease spreading kiddos! ) when I was on biologics and never had more than one or two colds a year, so biologics are always devastating to your immune system.

Thanks again everybody.

Yes, his dr's office is getting pre-certification for the biologics. He's done his pre-treatment bloodwork and is now just waiting.

Fingers crossed it's straightforward.