Pregnant with a flare...any suggestions?

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JEG
Regular Member


Date Joined Apr 2008
Total Posts : 112
   Posted 4/29/2008 1:21 PM (GMT -7)   
I'm pretty sure my next step according to the dr. will be to go on pred. but I'm a little concerned b/c I'm 5 1/2 mos. pregnant.  I'm assuming that is why this flare is so hard to treat!  I've only just been diagnosed in Dec 06 and since then had been in remission.  For the last 3 weeks though I've had multiple 6-8 x a day D (blood/mucus) and have developed a hemerrhoid (which makes the frequent bowel movements almost unbearable).  I'm up day and night with it (at least 2 x a night) and am afriad to go on pred b/c I've heard of all the nasty side effects it can cause (gestational diabetes, etc.) I have another dr. appt on Friday and hopefully my blood tests will show signs of improvement even though my symptoms haven't really eased.  Any other ideas? Right now I'm taking 9 colazol a day and a canasa 1000mg sup. at night. Thank you so much.  I feel better already knowing that there are people to talk to about this.  I feel like the husband and other fam/friends probably get's tired of it!  Thanks again!
3x3 colazol a day
1000 mg canasa bedtime


Beth75
Veteran Member


Date Joined Jul 2007
Total Posts : 2148
   Posted 4/29/2008 1:27 PM (GMT -7)   
Hi I am so sorry you are going through this. The only part I can offer some kind of experience with is the Diabetes. Pred has made me pre-diabetic, but only after being on 60-40 mg for 4 months, it took that long to raise my sugars and I am controlling it with diet. I don't want to say one way or the other, but just as a consideration to raise your question w/the Dr.

hope you can get the flare under control very soon and congrats on the baby!!
Beth, 32 ~ Major Flare Sept/Oct 07 ~ in remission
UC dx'd 03/00 (Proctosigmoiditis); Pancolitis since 09/07
Azathioprine 200mg 1xday nightly; Calcium and Vit D 500mg 3xday, Multi Vit, Folic Acid 400mg 2xday, Prilosec, Probiotics.
Minimal Change Disease (Kidney Disorder) dx'd 09/07 - partial remission since 03/08
Prednisone 5mg 1xday (tapered from 60 = ), Simvastatin 20mg 1xday, Diovan 160mg 2xday. Enalapril 20mg 1xday, Fosomax 70mg 1xweek. MCD may be from hypersensitivty to 5ASA drugs.  Do you have edema? If so, check your blood protien level!
Pre-Diabetic from Prednisone use - Low carb/sugar diet & exercise.


JEG
Regular Member


Date Joined Apr 2008
Total Posts : 112
   Posted 4/29/2008 1:41 PM (GMT -7)   

That's great news.  I only have 4 mos left, but I'm just looking for some sort of relief.  I go to work and go home and that's about it until this flare goes away.  Maybe small doses of pred won't effect me as bad as I've heard!  Thanks again!

 


3x3 colazol a day
1000 mg canasa bedtime


quincy
Elite Member


Date Joined May 2003
Total Posts : 30107
   Posted 4/29/2008 2:24 PM (GMT -7)   
Hi..I don't see that you should have to go on pred....you should at least try the Canasa up to 3 times a day...that could help or even steroid foam enemas during the day and the supps at night.

You have a few options.
q
*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


JEG
Regular Member


Date Joined Apr 2008
Total Posts : 112
   Posted 4/29/2008 2:34 PM (GMT -7)   
He hadn't suggested using the canasa anytime but bedtime. I wonder why.  I am using anusol 2 x a day also.  Maybe that is why.  How long does it usually take for the canasa to kick in during a flare.  i'm feeling a little better, but still definitely not back to normal.
3x3 colazol a day
1000 mg canasa bedtime


quincy
Elite Member


Date Joined May 2003
Total Posts : 30107
   Posted 4/29/2008 2:43 PM (GMT -7)   
You can use the canasa up to 3 times a day....if you're using anusol (is it the over the counter stuff?)...switch it for the canasa.

Or...request the Rowasa retention enemas or the steroid enemas.

Try not to wonder why doctors don't make suggestions....some doctors (GIs) don't even prescribe rectal meds for UC.

You're armed with information...do the research and request them from the doc. If you get to the point where you're desperate, he'll probably put you on pred. Not a solution because you still have to get off it...and with baby being born around the corner...hormone fluctions should be YOURS rather than altered by the med.

Request....it's all part of being proactive in your care.

quincy
*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


JEG
Regular Member


Date Joined Apr 2008
Total Posts : 112
   Posted 4/29/2008 3:09 PM (GMT -7)   
Thank you so much for all your help.  I will.  I see him again on Friday.  I don't want to go on steroids anyway, so it's nice to know there are other options!  Thanks again!

3x3 colazol a day
1000 mg canasa bedtime


lemonhead
Veteran Member


Date Joined Dec 2007
Total Posts : 1028
   Posted 4/30/2008 5:41 AM (GMT -7)   
I took 20mg of prednisone while pregnant. It was the only way to get my UC under control. Both my GI and my OB/GYN said that it was a "drop in the bucket" compared to what your body makes while pregnant. It helped a lot, and when my trimester changed, I felt much better. I still think my flares are caused by big changes in hormone levels. Only had 3 major flares....!st when I started the birth control pill at 19, second=pregnancy, and third when my OB put me back on birth control to control bleeding issues. There has to be a correlation. I think after you have your baby (congratulations), you will go back to feeling the way you did before your pregnancy. That is what happened with me and I hope the same for you. Good luck.
diagnosed with left-sided UC in 1997. (45cm)
Currently on 10mg Prednisone
12 caps of colazal    9 caps Colazal
2 rowasa enemas nightly
35, female


JEG
Regular Member


Date Joined Apr 2008
Total Posts : 112
   Posted 4/30/2008 7:22 AM (GMT -7)   
Thank  you for your reply!  It's so nice to be able to talk to someone who's been there.  Once you went on pred how long did it take to get the flare under control?  I'm just wondering.  I've had this flare for almost a month.  It's getting better but taking a long time.  I've been on the canasa for 2 weeks.  I just want to get it to end.  Did you have any side effects when using Pred. while pregnant?  Thanks!
3x3 colazol a day
1000 mg canasa bedtime


tums
Regular Member


Date Joined Apr 2008
Total Posts : 128
   Posted 4/30/2008 7:44 AM (GMT -7)   
Hi, I also had a flare whilst pregnant and was worried about side effects for baby rather than myself. I have taken pred every year for 5 years unfortunately and have experienced most side effects but the way I look at it is if I don't take the pred I don't get better enemas etc just are not enough to get a flare under control for me. Anyway when pregnant my doctor tried all different methods to try and not use pred whilst all the time flare was just getting worse. Spoke to my brother who is a GP (general practice doctor) who in turn spoke to one of his friends who is an obstetrician (think this is the right name - dr who looks after pregnant ladies) anyway he said that very little of the pred gets to baby. I started of on 40mg and tapered dose over 4 months during pregnancy, must admit I looked like crap - huge moon face, huge weight gain and bothered with acne but I felt good and baby was born absolutely healthy. I remember one of my doctors saying to me that really I had no choice but to go on pred as with the flare I was losing weight, not eating very much and all food was going straight through me so that obviously was not very good for the baby not to mention the stress of it all.  Hope you find something that makes you better soon as I can remember how bad it was for myself.

32 year old female
UC diagnosed 2001
Asacol 6 per day
Azathioprine 50mg started 4/08
Steroids 40mg per day


JEG
Regular Member


Date Joined Apr 2008
Total Posts : 112
   Posted 4/30/2008 7:53 AM (GMT -7)   
As long as the baby is healthy I don't care what I have to go through, which is why I've waited this long to even consider pred, but a month of this has been too long.  I see the dr. on Friday, hopefully we'll get some things resolved so I can stop worrying and feeling so awful and enjoy being pregnant and have a healthy baby!  Thanks for all your help everyone!
3x3 colazol a day
1000 mg canasa bedtime


Jules77
New Member


Date Joined Mar 2005
Total Posts : 13
   Posted 4/30/2008 8:19 AM (GMT -7)   
I just wanted to say I know exactly how you feel. I was pregnant last year and had a horrible flare and I know it was brought on by stress. My placenta became detached and so I was bleeding a bunch (out of both ends) and the baby was born at 23 weeks and only lived 2 hours. My flare is gone now but I know 1st hand how horrible the flare can be during pregnancy. I DIDN'T lose the baby from the UC - it was the placenta issue but I just wanted you to know that I've been there! The steriod foam insert was wat put me back in remission!

JEG
Regular Member


Date Joined Apr 2008
Total Posts : 112
   Posted 4/30/2008 8:30 AM (GMT -7)   
I am really sorry to hear about your loss.  That had to be devestating.  On top of that having to deal with the flare while going through such a traumatic time.  I can't imagine.  Thank you for taking time out to give me information that could help.  I really appreciate it!  If you don't mind, one more question, what is the name of that steroid foam?  I'll ask the dr. about it on Friday.  Thanks again!

3x3 colazol a day
1000 mg canasa bedtime


Jules77
New Member


Date Joined Mar 2005
Total Posts : 13
   Posted 4/30/2008 9:54 AM (GMT -7)   
I can't remember the name of it but just tell them it was a steiod foam and you inserted it at night. I didn't have any problems keeping it in and it cleared me up within a week! It did wonders!!!! Good luck! =)

JEG
Regular Member


Date Joined Apr 2008
Total Posts : 112
   Posted 4/30/2008 9:58 AM (GMT -7)   
That sounds amazing.  This canasa is taking way too long.  I may have let the flare go on too long, but 2 weeks with no end in sight is frustrating!  Thanks so much for your help!

3x3 colazol a day
1000 mg canasa bedtime


Scrap Girl
Veteran Member


Date Joined Jan 2007
Total Posts : 653
   Posted 4/30/2008 10:04 AM (GMT -7)   
I first came down with UC shortly after I became pregnant with our third child and ended up having a miscarriage. I'll never know for sure but I think it was the flare that caused it. I'd never had any problems with my first two and I was losing so much blood. By the time my OB sent me to a GI I was an absolute mess. So when I got pregnant again and started flaring my OB put me on prednisone immediately. It did really help but my flare was never really under control until the third trimester. While I hated the side effects, not to mention the pictures from that time, the prednisone did make things much better and I delivered a healthy son. So if you've exhausted all other options, prednisone might be a good choice. It's much better for the baby to have a flare under control. Good luck!
Diagnosed with UC in Feb. 2005
 
Colazal (9 a day)
Folic Acid
Biotin
Calcium
Remicade


**NiCoLe**
Regular Member


Date Joined Jan 2008
Total Posts : 39
   Posted 4/30/2008 10:10 AM (GMT -7)   
I am 5 months pregnant and have been flaring since December. I was hospitalized in Jan and in Feb. During my Feb stay, I was 6 weeks pregnant and I was on 300mg of IV steroid for 9 days! It was the only way to get the flare under control before it caused a spontaneous abortion. I was nervous about how it might affect the baby, but didn't want to risk losing the pregnancy. I was eventually sent home and continued to take 60 mg of Prednisone. I tapered off and have been struggling ever since. I now take Sulfasalazine (4 pills) twice a day and use enemas at night. I still go a lot during the day, but it's much more manageable. I also had a lot of luck on VSL #3, but couldn't stand to drink it after a while because I've been so nauseous from the pregnancy. I'm still throwing up to this day. YUCK!

I hope my experience gives you some comfort. I know it makes me feel better knowing that other woman are out there dealing with the same issues. I'm looking forward to giving birth and being able to explore other options to get my UC under control. I was diagnosed in Jan 2007 and it's been a rollercoaster ever since.

I wish you Good Luck in the upcoming months!
Diagnosed in 2007, but had bowel issues for years

Sulfasalazine - 4 pills 2x a day

Hospitalized for 9 days in Feb 2008 (IV steroid)

Was using VSL #3, but it made me throw up (I'm pregnant and nauseous)

Hydrocortisone and Rowasa enemas when needed (which is usually ALWAYS!)


JEG
Regular Member


Date Joined Apr 2008
Total Posts : 112
   Posted 4/30/2008 10:26 AM (GMT -7)   
Thankfully mine isn't quite that bad at this point it seems to be easing up a bit, but still going a lot.  It does make it a lot easier to know that there are other people dealing with the same things and to know that it is a manageable (though not ideal) situation.  Thank you for all your information.  I'll bring all of this with me on Friday to the dr.  I'll be glad when this flare has eased.  Thanks again!
3x3 colazol a day
1000 mg canasa bedtime


puffed rice
Regular Member


Date Joined Feb 2008
Total Posts : 495
   Posted 4/30/2008 11:10 AM (GMT -7)   
Hi jeg, I flared pretty bad with my first baby and I found that the cortifoam helped alot.  I used it 3 times a day and it was easy to keep it because its a foam.  It seemed to work faster for me than the salofalk suppositories that the doc initially prescribed for me.  They usually take a bit longer to start working.  I also increased my probiotic intake from 50 billion to over 100billion daily and that I found helped. 
Take Care
Diagnosed with Ulcerative Colitis 1995
Salofalk Tablets and suppositories daily
Bio-K Probiotic daily
multivitamin
metamucil nightly


JEG
Regular Member


Date Joined Apr 2008
Total Posts : 112
   Posted 4/30/2008 11:19 AM (GMT -7)   
That's good to hear.  Maybe I can switch from canasa to the cortifoam.  I'm assuming from what you said it didn't cause you problems in subsequent pregnancies?  That's good news.  I was nervous that if I did ever decide to have another baby that this would happen all over again.  Thanks for your help!
 
3x3 colazol a day
1000 mg canasa bedtime


Jules77
New Member


Date Joined Mar 2005
Total Posts : 13
   Posted 4/30/2008 11:33 AM (GMT -7)   
I also wanted to add that I was taking the oral predisone as well as the cortifoam (that's what it's called!) The oral predisone didn't kick in for me like it had in past flares but the cortifoam worked really quickly for me!!!

puffed rice
Regular Member


Date Joined Feb 2008
Total Posts : 495
   Posted 4/30/2008 11:33 AM (GMT -7)   
jeg  with my second pregnancy I went into remission from the time my body realized I was pregnant I never felt so healthy.  I was even able to eat everything and absolutely nothing bothered me it was great while It lasted.  I didn't start with symptoms until about a year after the baby was born.   Every pregnancy is different.

Diagnosed with Ulcerative Colitis 1995
Salofalk Tablets and suppositories daily
Bio-K Probiotic daily
multivitamin
metamucil nightly


JEG
Regular Member


Date Joined Apr 2008
Total Posts : 112
   Posted 4/30/2008 11:57 AM (GMT -7)   
that is all so good to hear.  maybe i'll ask about the cortifoam on friday.  that sounds like a good alternative to the canasa, since it's been two weeks and little relief.  anyway!  thanks again!
3x3 colazol a day
1000 mg canasa bedtime


shannon1
Regular Member


Date Joined Feb 2005
Total Posts : 369
   Posted 4/30/2008 12:35 PM (GMT -7)   
hi, i was dx w/ uc after my first pg. when i got pg w/ my second, i flared right away. I started pred. 40mg and tapered. At that time baby was at risk of cleft lip/palate, however u r past development stage, so yours won't risk that.

I flared after my taper and went back on 40mg and tapered to 10 and remained on 10 for the duration.

If your flare is not under control, and gets bad enough, baby is at risk of many things....(not to scare you). You might feel better by asking for a consult w/ a perinatologist (high risk pg doc). They will be better to know about how pred would affect a pregnancy.
My peri told me that he had many uc/crohns patients on pred, and also had many asmatha patients on it...so, a peri would probally be best to see.

pred made me feel better about 4 days after starting. of course, i had the "normal" side effects of pred, but i delt w/ it.

hang in there! shannon

JEG
Regular Member


Date Joined Apr 2008
Total Posts : 112
   Posted 4/30/2008 12:43 PM (GMT -7)   
I don't think it is that bad, if it were I'd imagine that my ob or gi would have put me on pred right away.  they are monitoring me with blood/stool testing bi-weekly.  i'm hoping that together they wouldn't let me risk the baby's health at all.  i may look into the high risk dr.  if this continues.  it might be the best bet for me!  Thanks again.
3x3 colazol a day
1000 mg canasa bedtime

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