I was in my early thirties when symptoms started and was fortunate to be Dx'd w/Crohn's w/in less than a year. I couldn't tolerate azulfadine and ended up having an emergency resection 2 years after my Dx. I was then blessed w/a 20 year remission so our stories are somewhat similar.
When symptoms returned, they were mild and similar, almost exact, to yours. I started on Pentasa, w/a trial of metronidazole (Flagyl). The Flagyl was a miracle drug for the symptoms, but I encountered the peripheral neuropathy side affect many do so had to discontinue it. I refused to consider prednisone at all.
After investigating Imuran, I opted to try it thru the U of M immunosuppression monitoring clinical trial. I really had no noticable side effects from it. No nausea and I am VERY PRONE to nausea, possibly some sleep effects but I just switched to taking it at night before bed. (Now I take it in the morning w/no problems).
I have been in symptomatic or full remission after starting on a combo of Imuran, Cipro and Pentasa for 6 months and then just Imuran and Pentasa. (The Cipro was in place of the prednisone or Entocort, both of which I refused).
It usually takes 3 to 6 months for Imuran to really kick in and become effective so you usually do need something such as Entocort, Cipro or prednisone to assist it until the Imuran has had time to fully take effect.
Entocort has less systemic side effects than prednisone (usually) but it is still a steroid and has the same osteoporosis risks. Cipro is not w/o risk (is any drug?) w/the most prevalent being muscle or tendon tears, mostly the achilles tendon, so you don't want to be doing strenuous muscle and tendon exercise of any type (not just formal exercises, even just "around the house and yard" straining of the muscles and tendons) as a precaution.
Like you I was leery of Remicade. MUCH MORE leery of Remicade as Imuran has been around and in use for years and 'cade was so new. Too new for my comfort. At one point I seriously considered it. I was even scheduled for my first infusion. THE DAY BEFORE my infusion appointment I read that there was a Remicade clinical trial for COPD. I have COPD. The clinical trial was ended early. THAT made me nervous. I called the company to ask why and they told me they weren't at liberty to say, to talk to my gastro and have my gastro ask them why. I called and cancelled the 'cade infusion w/o even bothering to call my gastro.
Good thing I did!!! The clinical trial was ended early BECAUSE of its serious undesirable effects on COPD.
Its taken all these years for the more serious POSSIBLE side effects of Imuran to become known and recognized. At my age I prefer to risk the possible long term effects than the short term side effects cropping up w/the biologicals the medical profession are so enamored of right now.
IF I were considerably younger and really really sick w/the Crohn's activity I might quite likely reconsider my current decision. Many people have had WONDERFUL results from 'cade and Humira, etc.
When I was started on Imuran thru U of M they did a blood draw the day before my first dose. Another blood blood draw was ordered at 1 week, 1 week, 1 month, 1 month, 3 months, 3 months, 6 months, 6 months and one year. Every 3 months the first year they also ran the Prometheus test that indicates your therapeutic level and hepatotoxicity risk.
Now we just monitor my Imuran therapy via regular blood draws for CBCs, hepatic function and I forget the other blood test.
Quite likely you have some degree of obstruction at your anastomosis. That's where mine is. The tendency to constipation is one I also experience, always have, even before Crohn's and even when the Crohn's was most active.
Anyway, this is just MY way of thinking and MY personal decision. Good luck and God bless in making your decision.
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Post Edited (CrohnieToo) : 1/10/2010 4:35:09 AM (GMT-7)