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Preggers and Starting to Flare-What Next?

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Posted 1/17/2016 2:43 AM (GMT 0)
Hi all!

I'm 23 weeks pregnant right now and for the past week or two, I have been building up a flare. Booooo. Just when I thought that pregnancy had put me into a nice remission!

I still have formed stools, but have been noticing more and more mucus and some slight blood tinge (only see the blood sometimes). I'm also getting some increased urgency and gas pains/bloating. Now, I'm having bms that are almost totally mucus coated.

I know that I need to tell my doctor, but am freaked out by the idea of being put on some other med during pregnancy. Right now, what I'm taking is very safe: 4 Lialda and Canasa suppositories. What do you think will be suggested next to get this under control?

There has been talk of Entyvio, but I really don't love the idea of starting during pregnancy.
Posted 1/17/2016 5:14 AM (GMT 0)
Have you tried Rowasa enemas? Maybe a little extra of the topical stuff can help ya. I used Rowasa enemas when I flared post-partum and that did the trick for me.
Posted 1/17/2016 7:06 AM (GMT 0)
Almost all Ibd meds are safe for pregnancy.
Remember that flaring is worse than the meds
Posted 1/17/2016 10:56 AM (GMT 0)
Dikid is right.
Posted 1/17/2016 1:42 PM (GMT 0)
I would try enemas first but you have lots of options should you need to go up a level. Getting the flare under control is really important. Good luck and hang in there!
Posted 1/17/2016 5:56 PM (GMT 0)
Thanks all. Definitely going to ask about Rowasa. I was onBudesonide suppositories for awhile there too (before getting pregnant) which seemed to help. Does anyone know if budesonide is truly safe in pregnancy? Maybe that would be another option.
Posted 1/17/2016 7:50 PM (GMT 0)
It would be great if you could get it managed with topicals, if not, you have a lot of options. Actually Remicade is approved for use during pregnancy. I am not sure about Entyvio. i am surprised that they would consider Entyvio over Remicade, considering the lack of information. How about Uceris if needed? That works in the colon. Might be worth asking whether it would be possible if needed. Hopefully it's not needed... I've also heard uceris is making a foam. I never tried it personally.
Posted 1/19/2016 10:36 PM (GMT 0)
So I contacted my incredible doctor who called me right away. I'm going to restart the budesonide suppositories. If that doesn't work, I'll take a medrol-pack (1 week of steroids basically). If that doesn't work, it's Entyvio. Hopeful that all I'll need is some time on the suppositories! He reassured me that, at this point in my pregnancy, none of this is harmful to the baby.
Posted 1/26/2016 9:00 PM (GMT 0)
I am currently 22 weeks pregnant and trying to recover from a severe flare. I started having mild symptoms at about 10 weeks but was hesitant to reach out to my GI for more powerful meds due to the pregnancy. Take my advice and don't do this! I let it get to the point that I had to be hospitalized after severe bleeding, dehydration, horrific pain and rapid weight loss (among all the other horrible flare symptoms.) I have been on Prednisone for 3.5 weeks and switched to Rowasa enemas and am feeling 100% better. Unfortunately, I will now be on Prednisone for the remainder of my pregnancy to ensure I don't relapse. My GI and OB have been great working together to make sure my care and medication plan are good for both me and baby.

So, reach out to your doctor early and don't feel guilty about having to take important medication. A healthy mama to grow a healthy baby is the most important part!
Posted 1/27/2016 4:35 PM (GMT 0)

AMac10 said...
I am currently 22 weeks pregnant and trying to recover from a severe flare. I started having mild symptoms at about 10 weeks but was hesitant to reach out to my GI for more powerful meds due to the pregnancy. Take my advice and don't do this! I let it get to the point that I had to be hospitalized after severe bleeding, dehydration, horrific pain and rapid weight loss (among all the other horrible flare symptoms.) I have been on Prednisone for 3.5 weeks and switched to Rowasa enemas and am feeling 100% better. Unfortunately, I will now be on Prednisone for the remainder of my pregnancy to ensure I don't relapse. My GI and OB have been great working together to make sure my care and medication plan are good for both me and baby.

So, reach out to your doctor early and don't feel guilty about having to take important medication. A healthy mama to grow a healthy baby is the most important part!

Thank you so much for saying this. You are reading my mind! To be honest, I am not seeing much improvement after restarting the budesonide suppositories 7 days ago and I have been dragging my feet on telling my GI this because I don't love the idea of the medrol-pack that is next on the list of plans. After reading your post though, I see the light. I know I have to bite the bullet and tell him :-(
Posted 1/29/2016 2:32 AM (GMT 0)
Ugh I am way worse today! Total urgency and now dripping blood. Waiting to hear back from my doc about whether I will be starting that medrol dose pack. If I don't hear back soon, I might have to get annoying and try to contact him again. I'm so worried that this is going to mess with the baby!
Posted 1/29/2016 3:05 AM (GMT 0)
If I am rendering correctly, you are a patient of doc. Rubin.
If you have the GI fellow on call paged
A) you will get advice in less than an hour from and Ibd fellow.
And B) they will let your doctor know first thing in the morning and he can always make changes. But don't suffer through the night.
For paging the fellows at u of c call 773-702-1000 and option one( you know it's bad when you know the right number to page a doc...)
Posted 1/29/2016 3:14 AM (GMT 0)

Dikid said...
If I am rendering correctly, you are a patient of doc. Rubin.
If you have the GI fellow on call paged
A) you will get advice in less than an hour from and Ibd fellow.
And B) they will let your doctor know first thing in the morning and he can always make changes. But don't suffer through the night.
For paging the fellows at u of c call 773-702-1000 and option one( you know it's bad when you know the right number to page a doc...)

Thanks for the great info, Dikid! Indeed I am one of Rubin's patients. Yes, it's bad when your u know phone numbers like that! I have his fellow's email and his direct contact. I tried going through Mychart with a message yesterday, but I don't think that goes directly to him. I agree that I should probably get moving on this stat. Not a great day.
Posted 1/29/2016 3:37 AM (GMT 0)
The my chart messaging thing is off my doc doesn't always get the messages

yup call them now make sure to tell the operator that you need the IBD fellow to be paged
they will call within the hour

good luck and let us know what happens
Posted 1/29/2016 1:38 PM (GMT 0)
Keep us posted Worriedgirl! I'm sending lots of positive thoughts your way!
Posted 1/31/2016 4:39 PM (GMT 0)
Hi all!

Here's a quick update: I'm still having the same issues. However, I was able to get in touch with my doctor who is so amazing that he called me from a conference on a Saturday night. He is going to start me on the Medrol dose pack (6 days starting at 40mg). Hopefully, this will kill the flare! He is just trying to get me through this pregnancy. If I had to guess, I'll be going on a biologic after we have the baby. Just want this current mess to calm down though!

Thanks for all of you advice etc on this so far. You're all amazing!
Posted 1/31/2016 5:57 PM (GMT 0)
Why not the mesalamine enemas? They've been suggested, but did you not ask for them? Start there with them at night and the steroid supps during the day.

How many times a day are you having bms?

q
Posted 2/1/2016 8:39 PM (GMT 0)

quincy said...
Why not the mesalamine enemas? They've been suggested, but did you not ask for them? Start there with them at night and the steroid supps during the day.

How many times a day are you having bms?

q

I asked, but it seems like I'm building some kind of immunity to mesalamine. Also, unfortunately this time, the budesonide suppositories did nothing for me. Hope the medrol works and is a one time thing for me.
Posted 2/1/2016 9:07 PM (GMT 0)
So, you're saying you didn't try them?

q
Posted 2/1/2016 10:05 PM (GMT 0)
That would be correct. This was severe enough combined with pregnancy to warrant the medrol pack. Apparently flaring is more dangerous to the baby than the drug.
Posted 2/1/2016 11:32 PM (GMT 0)
Please update. All the best to you and your child.
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