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Does Humira Shots Help In Treating Crohn's Disease?
Question: Hello, I am seeking guidance regarding my 22 yr/old daughter, she was DX with Chron;s disease in July 2015. Several meds were tried with no improvement in Oct she started Humira treatment. On XXXXXXX 28 she had a open abd sm bowel colon re-section due to strictures resulting in a 16 day hospital stay. She was diagnosed with cdiff a week after hospital discharge. We have seen a infectious disease doctor who treated her during the hospital stay due to a fever she developed post-op, the cause of fever was never determined just treated with Vancomycin and Flagyl she just completed the seond round ofFlagyl last week and released by infectious disease doctor. But she is still having several episodes of diaherria, pressure in the lower abd and a lot of pain.There has been a lot of controversy between GI and Infectious disease doctor regarding resuming the Humira injections. So she has had no treatment for the Chron's since before surgery in XXXXXXX except for the immunosuppressant Mercaptopurine(M6) 50mg daily. The GI Dr has ordered a sm bowel series because he suspects another stricture and her Humira injections have been ordered. Her stool specimen was neg for cdiff last week. We are simply at the end of our rope with all of this
the possibility of another surgery is overwhelming. My daughter said tonight she doesn't feel that she is strong/healthy enough to go through that again. I am considering a second opinion by a specialist in the XXXXXXX TX area because we are from a small town an hour from the city. How do I approach our GI without upsetting him because we want another opinion. We have a good caring GI DR locally but I just feel the bigger city offers more options at University of XXXXXXX Southwestern Medical Center is where Im hoping to get her seen. In your opinion does it seem as though we should proceed with the Humira treatment again?She had a colonoscopy in XXXXXXX prior to surgery that showed the inflammation and ulcerations were improved but she wasn't getting better then the strictures were found, we were told the surgery would fix the problem.
the possibility of another surgery is overwhelming. My daughter said tonight she doesn't feel that she is strong/healthy enough to go through that again. I am considering a second opinion by a specialist in the XXXXXXX TX area because we are from a small town an hour from the city. How do I approach our GI without upsetting him because we want another opinion. We have a good caring GI DR locally but I just feel the bigger city offers more options at University of XXXXXXX Southwestern Medical Center is where Im hoping to get her seen. In your opinion does it seem as though we should proceed with the Humira treatment again?She had a colonoscopy in XXXXXXX prior to surgery that showed the inflammation and ulcerations were improved but she wasn't getting better then the strictures were found, we were told the surgery would fix the problem.
Brief Answer:
Yes, Humira should be started after consulting her GI Specialist!
Detailed Answer:
I warmly Welcome you!
Thanks for consulting at my virtual clinic HCM. Your trust in HCM means a lot to me as a Physician. I have carefully worked through your daughter's case and can well realize your genuine worries.
Yes, Humira (Adalimumab) is a very effective anti-inflammation medicine that helps relieve not only her disease processes but also reduces the chances for Stricture formation in her gut. Diarrhea, lower abdominal pressure and pain are her recent symptoms that warrant Adalimumab to be administered alongwith Mercaptopurine. Surgery fixes the problems caused in that very portion of the gut. It may be inflammation and stricture. But surgery at a portion of gut never guarantees that it is complete cure of disease. Inflammation and strictures formed at other sites of gut may need another resection through surgery.
It is difficult to change a Physician. But its your fundamental right to get the best options available for your daughter. So don't hesitate to get a second opinion from a university hospital. Best way to go for it is to ask the hospital front desk if they accept the health insurance your daughter has. Or simply ask your daughter's primary care physician to refer her to the hospital you are intended to see. It is not an issue her first GI Doctor should mind for.
Hope it helps. Please feel free to contact me anytime directly from my profile if you need further assistance. You may also add a follow-up query here.
Regards!
Yes, Humira should be started after consulting her GI Specialist!
Detailed Answer:
I warmly Welcome you!
Thanks for consulting at my virtual clinic HCM. Your trust in HCM means a lot to me as a Physician. I have carefully worked through your daughter's case and can well realize your genuine worries.
Yes, Humira (Adalimumab) is a very effective anti-inflammation medicine that helps relieve not only her disease processes but also reduces the chances for Stricture formation in her gut. Diarrhea, lower abdominal pressure and pain are her recent symptoms that warrant Adalimumab to be administered alongwith Mercaptopurine. Surgery fixes the problems caused in that very portion of the gut. It may be inflammation and stricture. But surgery at a portion of gut never guarantees that it is complete cure of disease. Inflammation and strictures formed at other sites of gut may need another resection through surgery.
It is difficult to change a Physician. But its your fundamental right to get the best options available for your daughter. So don't hesitate to get a second opinion from a university hospital. Best way to go for it is to ask the hospital front desk if they accept the health insurance your daughter has. Or simply ask your daughter's primary care physician to refer her to the hospital you are intended to see. It is not an issue her first GI Doctor should mind for.
Hope it helps. Please feel free to contact me anytime directly from my profile if you need further assistance. You may also add a follow-up query here.
Regards!
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Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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