London Lurker said...
Entocort only for Crohns or suspected Crohns, GP not allowed to write a prescription for it unless it says Crohns in the notes.
Have now checked, Entocort has coating that means it releases at ileum, it is different from Uceris/Cortiment that releases lower down (this is definitely what I would need), bit like the difference between Pentasa and Mezavant I presume.
Yeah, I read the other thread as well: same drug, different release mechanism. So I got it wrong about
Entocort being just as suitable for UC, when it isn't: my bad.
London Lurker said...
NCOT - I have just noticed from other posts that you have a Crohns diagnosis? We are comparing chalk and cheese. I too have not met a Crohns person who went into long remissions after Pred although I guess they are about. Surgery rates are much higher in Crohns than UC too.
Yeah, I have Crohn's, but it was mainly in the colon. And terminal ileum.
Surgery rates are much higher, but only a small percentage of those will be colectomies: the rest will be bowel resections, fistula repairs, temporary ostomies, etc.
Crohn's is much more variable than UC in some ways, but it can also overlap with UC. I had a fairly UC-like presentation, but my brother even more so: he has proctitis, of which the doctors have never seemed able to decide if it was UC or Crohn's (my brother calls it Crohn's, so I do as well). This overlap isn't even very rare: 10% of IBD diagnoses are indeterminate, because the doctors cannot tell if it's Crohn's or UC.
So when you say you have never met a person with Crohn's who went into a long remission after Pred, it surely depends to some extent on the type of Crohn's. I certainly have come across many folks with Crohn's who have been in long remissions; some were surgery-induced and I dunno about
the others. I do think people completely underestimate the extent to which IBD goes into spontaneous remission, though: if IBD can spontaneously relapse it can also spontaneously remit.*
*There might be hidden factors at work in relapse and remission, like eating cheese on the night of the full moon while werewolves howl in the background, or whatever. But until these hidden factors are identified and fully elucidated, I'm describing the process as "spontaneous".