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Ulcerative Colitis
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Posted 7/23/2013 8:59 PM (GMT 0)
Do many women go into remission when pregnant? I may be going on steroids the end of this week for this awful flare. If so, I was thinking of trying to conceive after i finish steroids. Do you come off all meds when pregnant? I had no intention of children yet but everything is so uncertain right now and surgery is looking likely so I don't want to regret anything. My two aunts were unable to conceive after the surgery.
Posted 7/23/2013 9:11 PM (GMT 0)
Actually, just the opposite. Pregnancy often brings on a flare, at least early on. Some meds are safe, others can be risky. Talk to a perinatal (high risk) OB before you try to conceive so you can get advice specific to your situation.

I first had a bad flare after my first pregnancy. Flared badly early during my second, even on Imuran and Asacol. My GI was terrified the whole time because Imuran in pregnant IBD patients has not been studied much. But I have two wonderful healthy kids.
Posted 7/23/2013 9:20 PM (GMT 0)
The stat I've always heard is that if you have UC already at the time when you get pregnant, 1/3 will get worse, 1/3 will stay the same, and 1/3 will get better.
Posted 7/23/2013 9:22 PM (GMT 0)
I gotta be real with you though... We had someone on the board a few months ago in a LOT of distress because she was in an intractable flare during pregnancy and she was going to have to have surgery WHILE pregnant. She was terrified. I understand wanting to do it before surgery because of the decreased fecundity rate (not fertility -- actually, if you're willing to do IVF, the overall likelihood of getting pregnant is pretty much unchanged), but I wouldn't move forward unless you're in a stable remission.
Posted 7/23/2013 9:59 PM (GMT 0)
I'm in my first trimester and flaring. Was in remission before I got pregnant but I don't think my colon was in good enough shape to withstand the pregnancy multivitamins and hormones.

If you possibly can, get your health in great shape first and stay on the drugs you need to stay well. Plenty of people take low dose pred through pregnancy (e.g. 20mg) and better to do that than end up in a horrible flare like me.
Posted 7/23/2013 10:20 PM (GMT 0)
That's great guys, thanks. Liz, I didn't know that about the ferc
rate. Guess I've even more research to do.
Posted 7/23/2013 11:25 PM (GMT 0)
I think the bottom line is to get as healthy as possible and consult with your docs. There is no guarantee, and every situation is different. For me, I made am informed decision with the help if a perinatal specialist. Honestly, my GI doc was not comfortable with my decision, but he did everything he could to keep me healthy. I was never totally in remission - I had urgency and pain always - but I wasn't bleeding and felt relatively stable at the time. Just don't do this without lots of research and make sure your OB and GI both monitor you very closely.
Posted 7/24/2013 1:49 AM (GMT 0)
I agree with the rule of thirds, and there's no way to tell where you'll fall. Lots of meds are considered safe in pregnancy-most mesalamines, prednisone (slight risk in early weeks of cleft lip/palate developing), remicade to name a few. Run all of your questions by ob and gi as it will be rare to find someone who specializes in both.

I had flared during my first pregnancy (Dx right after), but stopped flaring shortly after giving birth. I was flaring and on prednisone when I got pregnant with my second and was able to taper off the pred as enjoy a peaceful 9 months--followed by an unrelenting 16 months and counting flare. There is no doubt drastic hormone changes can affect your IBD significantly, so just make sure you have an open dialogue with all doctors involved :) I've seen stories of both women having difficulty conceiving and of healthy pregnancies after surgery.
Posted 7/24/2013 12:23 PM (GMT 0)
I wouldn't get pregnant unless you're in a stable remission. So I'd wait a while (a few months or so) after you're off steroids, if you decide to go that route. I'd been in a very stable remission for about three years when I got pregnant. I'm not saying you need to wait that long, however! There were other "life things" that got in the way of us trying for a second before then.

And yes, I've heard the "rule of thirds," too. However, if you're in remission when you get pregnant, then that really doesn't really apply, because there's no way to get any better. ;)

I also wouldn't get pregnant just because you're afraid you won't be able to in the future. A baby is a HUGE responsibility and really is life changing, so unless you're completely emotionally, mentally, and physically ready, I think it would be more wise to wait, even if that means it might be a bit harder to get pregnant in the future. It was hard enough to be flaring with a newborn -- I can't imagine recovering from a colectomy with a newborn!!!

And no, you shouldn't come off your meds when you're pregnant!!! There's a link to a good article in the "UC resources" sticky thread that discusses IBD and pregnancy.

Good luck!
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