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Mouth Ulcers while on 6MP/Imuran/Azathioprine

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Ulcerative Colitis
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Posted 1/29/2013 2:18 AM (GMT 0)
Hi all,

I've been on 6MP (currently 125mg) for about 5 months now. It has been relatively successful. I'm still experiencing some inflammation (evidenced by my blood tests and that my BMs are not really well formed) but I've been averaging less than 2 BMs a day for the last 4 months. I've also had fatigue but in general I'm more level and happy than when flaring on and off etc.

However, I've had a couple of mouth ulcers and this current one is pretty persistent (5 days and no signs of healing just yet) and painful. I understand mouth ulcers are a known side effect of 6MP/Imuran/Azathioprine.

My question is have any of you experienced similar? And if so what was your approach and what did your specialist recommend? A reduction in dosage perhaps?

I've left a message with my gastro specialist today and waiting to hear back from him.

I'm using an antiseptic/numbing gel that gets a short amount of relief and i'm upping my Vit B, C, magnesium etc. But I suspect that due to being on 6MP it may not respond normally.

Cheers
Jimbo
Posted 1/29/2013 2:22 AM (GMT 0)
i should add I've never really had mouth ulcers before being on 6MP
Posted 1/29/2013 3:00 AM (GMT 0)
You may want to try determining if they are Candida related. If they are there are a number of things you can do in order to avoid having them altogether. There are natural supplements you can take, Candida diets, and even prescription meds that can help. I don't really know if this problem is related to Candida or not but if it is you can do something about it. If not you have to rely on topical meds or treatments.
Posted 1/29/2013 3:27 AM (GMT 0)
I have had mouth ulcers my whole life! In fact right before my first flare, my mouth broke out so badly I could hardly eat. 4 days after the breakout, my colon went to hell.

For the last year, I have been using Slippery Elm and have not had an ulcer since. I did get a painless whitish rash on the inside of my bottom lip while on prednisone, but that seems to have left me.

Gargle with warm salt water. For really bad ones, find some Gentin Violet from your pharmacy and dab a very very small amount directly on the ulcer. It will sting and turn your mouth purple but it will clear that bad boy up! I am serious about it turning your mouth purple.
Posted 1/29/2013 11:27 AM (GMT 0)
Wasn't this covered just a few weeks ago? Did you search the board?

Give a try to Vit B12, 100mcg and a B-complex one a day. This one helps me. In addition to that, get local anesthetic to keep it numb. Someone also mentioned some kind of local honey.
Posted 1/29/2013 1:33 PM (GMT 0)
My daughther had mouth ulcers and a rash when she started imuran. Her then GI took her off and said it was a sign of intolerance and she could not have this class of drugs. Her next GI didn't believe this and put her on 6mp. No problems but then a month or so later her liver enzymes were 10 times the top end of normal. So, her first GI was right. She apparently is not able to metabolize the drug and those ulcers were a sign. Is your blood work okay? I would say monitor it closely for a while. It may just be a side effect you'll have to live with if the drug is helping you enough or it may be a sign that your body can not tolerate it.
Posted 1/30/2013 4:42 AM (GMT 0)
Thanks guys, some useful suggestions there.

Gary - I'm pretty sure it's not candida related.

Delta - yes I did a search. I was specifically looking for ulcers related to immuosuppressor drugs not just ulcers in general. Am already taking Vit B, and numbing gel (as per my post). Have been trying manukahoney also

46 - That must really suck having had ulcers frequently. thanks will maybe try gentien violet - have heard of it. Maybe slippery elm will help - will try if they persist.

Killcolitis - that's what i was getting at. You see i've never had them before and i'm not suffering too bad from UC right now so that was what i was thinking. I'm awaiting the results of my most recent bloodwork.

I'll update once i hear about my latest bloodwork from my specialist
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