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Posted 1/13/2017 12:47 AM (GMT 0)
Dear people,

I am 32 year old male. I have ulcerative collitis for last 6-7 years. Currently I am on uceris (corticosteroid) and 4 tab Lialda (1.2g each)
I just got flared a week ago even after so much medication sad I have diahorrea (2 -3 times a day ) and horrible bleeding. I am losing weight very fast and fatigue is catching up. Could someone please guide me what to do. It's really SOS call .. I talked to the doctor he said I should go for Humera kind of medicine but that will significantly increase my chances of cancer
. Any guidance will be much appreciated
Thanks
Posted 1/13/2017 2:54 PM (GMT 0)
Did your doctor actually say you'd have increased cancer risk or is this your idea? IOW do you have other conditions that make this possible?

Some people here say they would remove their colon before going on a biologic, something for you to do research on (surgery). My UC did not respond to oral mesalamine pills or 6mp and biologics were the next thing up the line for me and I also did not want to go there. My way to remission took years (diet modification, supplements) so can't recommend it to anyone except the most stubborn people.

Have you used mesalamine enemas? Before moving to Humira that is what my suggestion is. Use them nightly for a month and while continuing oral Lialda see if your symptoms get better.

Best of luck.
Posted 1/13/2017 3:11 PM (GMT 0)
Whenever your symptoms get worse you should first have a stool test to check for pathogenic causes to your symptoms like c diff. Have you had one?

You're a week into this flare so healing is going to take time.

It's good you're on 4 tabs of lialda. I'd also recommend a once nightly, prescription rowasa enema should also be used which has the same active ingredient as lialda. If those combined don't work then it make sense to try stronger medications. If you don't respond within 3 or so weeks. Immunomodulators (Imuran or 6mp) or biologics (remicade or humira) are often tried. It's true those medications do increase your cancer odds but only very slightly. Odds of cancer are 2 in 10,000 (or 0.02 percent) for a healthy person and 4 in 10,000 (or 0.04 percent) for people on those medications. Like I said, long odds. The Crohn's and Colitis Foundation of America is the source for these statistics:
Webcast: programs.rmei.com/CCFA139VL/presentation/player.html
Transcript: http://www.ccfa.org/assets/pdfs/risk-and-benefits-transcript.pdf
Posted 1/13/2017 5:40 PM (GMT 0)
Hi...is the uceris rectal? If not.....definitely get on rectal retenetion enemas and they can be extended to add suppositories in mesalamine or steroid...I'd suggest mesalamine enemas to start. Keep in mind they come in dosages starting at 1g....id suggest starting at 4g.

I don't see a need for biologic at this point...especially if your symptoms have improved since starting the meds.

q
Posted 1/13/2017 5:55 PM (GMT 0)
I agree with the above the 1) Humira decreases you2 change of cancer overall. It lowers the risk of colon cancer, even as it slightly raises the risk of lymphoma. 2) sudden change in symptoms mean a stool test for c-diff is a good idea.

If you have urgency with the D, then rectal meds are a good choice. Even if you do not have urgency, you might consider rectal meds if you do not get managed form other meds.
Posted 1/18/2017 4:14 AM (GMT 0)
I haven't been on humira long, but my GI mentioned when I started they have regular blood work to monitor how things are going. That way if you do fall into the percentage of people who get cancer they will catch it early.

That info helped me take the plunge to start even though hear those words are still scary.
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