Humira before or after resection?

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joystras
New Member


Date Joined May 2010
Total Posts : 9
   Posted 7/15/2010 7:15 PM (GMT -7)   
My husband will be having a resection next month, the issue we are running into is when to start the Humira. The PA working with the Dr. said to start it before (and wants it going for 12 weeks) surgery. The surgeon says start after. We are confused and are also wondering if Humira is overkill once the resection takes place. We know he needs to be on maintenance drugs, but are biologics necessary? He is on entocort and azathioprene.

Rider Fan
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Date Joined May 2008
Total Posts : 1445
   Posted 7/15/2010 8:18 PM (GMT -7)   
Well if the AZA and entocort isn't doing it for him I wouldn't mess around. You'd hate to go through surgery only to have it come back in 6 months because you weren't aggressive enough. If he was only on Asacol or something right now then I'd probably consider the aza as a next step before a biologic. JMHO, not a dr.
33 y/o male. Dx'ed in 1999. No surgeries.

Current meds: Humira 2/27/09. Proferrin iron pills.

Reduced gluten and dairy.


Go Saskatchewan Roughriders!


joystras
New Member


Date Joined May 2010
Total Posts : 9
   Posted 7/16/2010 6:19 AM (GMT -7)   
He was just on asacol and that is why we think the Crohns got so bad. New Dr. and and new meds so he has only been on Entocort and Azathioprene for a month to hold him over for the surgery. We know surgery is going to happen and are fine with that, I am just worried about the biologics...

Stef17
Veteran Member


Date Joined Feb 2003
Total Posts : 1811
   Posted 7/16/2010 7:00 AM (GMT -7)   
Having been on biologics for 8 years, I really don't understand what the big fear is. They have been a life saver for me, no major side effects, no negative reactions. If your husband's disease is so bad that they're actually going to do surgery, then I would seriously consider the humira.

crohnielass
Veteran Member


Date Joined Mar 2009
Total Posts : 1118
   Posted 7/16/2010 8:58 AM (GMT -7)   
Hi, I have a similar problem I had resections done last jan 09  started Pentasa but had joint pain went on the sister drug Asacol but , it gave me headaches and sickness. So since oct 09 no meds, then last week saw GI who said he would start me on Humira! went to see my GP who can't understand as well as me why he is putting me on such a powerful med when I haven't tried any other drugs besides pentasa and asacol, my bloods have come back fine so don't really know why Gp is going to speak with my GI Bev x
Diagnosed with crohns at 13 now 43
Still battling with Doc's to get me on maintenance Meds only taking
Lomotil, 20mg citalopram,VSL#3 at the moment.

“I may not be where I need to be but,
I thank God I’m not where I use to be “


beave
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Date Joined Mar 2007
Total Posts : 1091
   Posted 7/16/2010 11:39 AM (GMT -7)   
Where and how big of a resection? And why the resection?

In my opinion - based on very little info - he hasn't had enough time to see if the azathioprine is going to work. There is no need to start Humira before the surgery, and I wouldn't start it after the surgery until giving azathioprine a few months first.

joystras
New Member


Date Joined May 2010
Total Posts : 9
   Posted 7/16/2010 1:02 PM (GMT -7)   
We have been told by 3 doctors that he needs a resection at the terminal illeum because of scarring. I think it will be 3-5 inches. They will know more after a CT enterography (sp). He has been having blockages 1 every 4-6 weeks for the past 6 months and has been doing better now with a low residue diet and Entocort and Aza but has been told that it is so narrowed he is a ticking time bomb waiting to happen. We are okay with surgery but i was a little nervous about the Humira because I wasn't sure if he needed to go all out with the meds after his Crohn's was cut out...

spookyh
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Date Joined Oct 2008
Total Posts : 1342
   Posted 7/16/2010 1:30 PM (GMT -7)   
If you decide to go with Humira, you want to do after your husband is healed from surgery. Humira causes scar tissue to form when it heals you up, which you really don't need after a resection. My surgeon took me off Humira a couple weeks before surgery, and I never restarted it.
35 years old, Crohn's disease for 15 of them
Resection of ileocecal valve on 09/22/09
Current Meds: LDN, Pentasa, Effexor XR
Supplements: 3 kinds of Fish Oil, Multi-Vitamin, Vitamin D, Calcium, CoQ10, Enzymes
SCD since 12/01/08 - eating Stage 3 foods


joystras
New Member


Date Joined May 2010
Total Posts : 9
   Posted 7/16/2010 1:56 PM (GMT -7)   
Thanks all, just got off the phone, August 4th surgery date. No Humira before. I appreciate you taking the time to weigh in. this is a scary thing and it helps to hear what others have dealt with.

beave
Veteran Member


Date Joined Mar 2007
Total Posts : 1091
   Posted 7/16/2010 2:39 PM (GMT -7)   
Sounds like a good plan. Tell him good luck with his surgery!

spookyh
Veteran Member


Date Joined Oct 2008
Total Posts : 1342
   Posted 7/16/2010 4:13 PM (GMT -7)   
Yes, good luck! I had the same surgery last September (about 6 inches at the ileocecal valve), and it went really well. Here's to a quick recovery!
35 years old, Crohn's disease for 15 of them
Resection of ileocecal valve on 09/22/09
Current Meds: LDN, Pentasa, Effexor XR
Supplements: 3 kinds of Fish Oil, Multi-Vitamin, Vitamin D, Calcium, CoQ10, Enzymes
SCD since 12/01/08 - eating Stage 3 foods


Pmkrier
Regular Member


Date Joined Apr 2010
Total Posts : 69
   Posted 7/17/2010 7:30 AM (GMT -7)   
I'm currently in the same situation!!!!
Both my physician and surgeon wants me to be on Humira for 8 weeks prior to surgery. They said less inflammation before surgery is a lot better. Although, they said as Humira works it's going to cause my stricture to get smaller which might lead to an obstruction before surgery. So far I'm doing okay. Still feel like crap. I have another month to go so hopefully I can make it

I would totally take the Humira beforehand!
Crohn's Disease. Diagnosed in 1997 at the age of 10.
Currently on: Monthly B-12 injections, 6MP, Calcium, Multi-Vitamin, Vitamin D, Prilosec, just starting Humira
Surgery scheduled: August 19 2010 - small bowel resection in TI

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