Flare after NSAID!

Having had a good two years with low level inflammation, I have flared after taking one tablet of Naproxen and the inflammation feels more systemic. I am steroid resistant so no hope with Pred. Any thoughts to add to current regime?:
Gluten, dairy free
Rectal meds daily
Balsalazide - 6 to 9 per day
Biokult

Just had a bad weekend with terrible cramps and the usual toilet carnage!

Hiya

I took the darn tablet because I fractured my shoulder and was in agony. Lesson definitely learned! My consultant has raised biologics but I desperately want to avoid them if possible due to the side effects. I take a steroid enema and a salofalk foam enema alternately. I've only been flaring for about five weeks but starting to feel really unwell. Any thoughts?

Catherine

Hi Andrina

Do you mean biologics? If so, which is the best to try first?

Best and thanks

Catherine

Before you jump on the biologic bandwagon try a different mesalomine such as Apriso. I had to switch off of balsa.

Don't try to climb the med ladder too fast.

Thanks for all the advice! Doctor wanted to hospitalise me this afternoon, but I have agreed to start on 20mg of Pred - even though I pointed out that I am steroid immune!!! I just want to stay of hospital. I am just concerned about the long-term effect of biologics and need to find out more about them. I will check out the Apriso in case the Balsalazide isn't working anymore. I've been on it a very long time. I was given Azothiaprine but never took it because I hate the idea of immune suppressants. BMs are up to 20 per day - nightmare….

Empathy extended to all fellow sufferers! Catherine

Thanks iPoop! Which has the fewest side effects and least risk? Azathiaprine or biologics? I agree that Pred is the work of the devil - it's given me diabetes.
Catherine

the risks for immunosupressants (like imuran) and biologics are actually pretty similar. although immunosuppresants can mess with people's white blood count.
because you are flaring badly the immunosuppresant meds might not be the best choice as they take quite a bit of time. biologics tend to work a bit faster or at least have an initial response whereas you cannot get any positive benefit from imuran for several weeks. if you were to take imuran you would need something to bridge you until it starts working and that is usually steroids which are way more dangerous than biologics or immunosuppresants.

usually immunosupressants are lower on the medicine ladder than biologics but having inflammation is more dangerous than the two.

in fact, many of us have started biologics and immunosuppresant meds at the same time
there are studies that show that imunosuppressants like imuran and remicade combined is far more effective than the two of them combined
one of the reasons is that they are both good UC therapies but the imuran will also help prevent you from making antibodies to the remicade

Catherine James said...
Hiya

I took the darn tablet because I fractured my shoulder and was in agony. Lesson definitely learned! My consultant has raised biologics but I desperately want to avoid them if possible due to the side effects. I take a steroid enema and a salofalk foam enema alternately. I've only been flaring for about five weeks but starting to feel really unwell. Any thoughts?

Catherine

I have had UC since 2002. I switched around all the basic meds (Apriso, Asacol and Lialda). When I flared really bad I went on prednisone and now prednisone no longer works for me. I was really against going on remicade (My doctor has been trying to get me on them for the past 3 years!!). After seeing the prednisone not working and switching my medications every several months and still no relief I gave in. I had my first infusion yesterday and I must say I feel great today. I didn't even feel tired after my first infusion, in fact I went on with my normal day. Biggest regret I have was not listening to my doctor 3 years ago and making the switch earlier. When you keep switching the basic medication the only difference is how it is released. If the medication is not working for you, plain and simple it just doesn't work.