Cronh's or Colitis during pregnancy
shafinaandkraig
member
Hi ladies,
Kind of a bummer that this is my first post here on thebump! Go figure. Aaand, I hope it's ok that I'm posting this on this page...seemed to be the right board...?
I was wondering if there were any ladies out there who have Cronh's or Colitis and took medication, or are taking medication, during pregnancy. If so what were you on?
I'm also curious if there are women out there who had flares during their pregnancy and what they did (medication/alternative therapies) to reduce them.
I have crohnes and have not been taking my medication (Asacol) since before I got pregnant. My GI doc said that if I was not in a flare before pregnancy that I would likely not flare during pregnancy. He also told me that Asacol was a safe drug to take during pregnancy even at the high dose (12 pills daily) that I am "supposed" to be taking. My midwife on the other hand thought that the high dose was well over what was thought to be the safe maintenence dose; and suggested doing whatever I felt (either reducing my dosage or not taking it at all since that was what I had been doing).
I've been feeling fine up to this point (23 weeks pg), but for the last week and a half I've been feeling pretty sick to my stomach and am getting a little worried that I may be heading into a flare. I would really like to avoid taking medication while I'm pregnant and would rather look into alternative therapies.
If anyone has suggestions or has been through this please let me know. 
TIA!
Re: Cronh's or Colitis during pregnancy
I have had Crohn's since 1998 (diagnosed in 1999). I am 34 weeks pregnant. Sorry to hear you are not feeling well.
Before getting pregnant, I was on Remicade and Purinethol. I had a Remicade infusion before I knew I was pregnant. I had a second one in the first trimester and the last one when I was 18 weeks. I stopped taking the Purinethol. I have felt great my entire pregnancy and had no problems related to Crohn's--it has actually improved. My gastroenterologist wanted me to continue with the Remicade, but I was not comfortable with it, as the studies show that in the late second trimester and third trimester, it does cross the placenta. We reached a compromise with the initial infusions.
Whether you flare or not is a very case by case thing, 1/3 stay the same, 1/3 get better, and 1/3 flare. I am concerned that your midwife is encouraging you to stop (or continue not taking) your medications. A Crohn's flare in pregnancy is very serious and can lead to many problems, including pre-term birth and health issues for you, etc.
Did your midwife explain her specific concerns regarding Asacol? Is she also a nurse and/or experienced in dealing with Crohn's/IBD pregnancies/medications? Does your midwife have a plan in case you flare or recommendations on alternative therapies that are safe in pregnancy?
By the way, 12 pills per day of Asacol is not really a "high" dose if they are 250 mg pills (that would be 3 grams/day), but I need to know how many milligrams are in each pill to really tell you, as they do come in 250 mg and 500 mg (I think 400 mg as well). (I was on 16 pills per day of Pentasa (total of 4 grams) at one time). It is out of your system so quickly, which is why you need to dose yourself several times per day.
How long have you been off the Asacol? Asacol is an anti-inflammatory and one of the weaker IBD medications (as opposed to an immune-suppressant or biologic such as Remicade). If you can maintain remission with Asacol, I think that is great. I believe Asacol is a Class B drug in pregnancy--it is generally regarded as safe and I have read studies that confirmed that. My GI doctor gave me some additional medical journal studies to read regarding studies of various IBD meds in pregnancy.
I would level with your gastroenterologist and ask him about the risks/benefits of medications and what the plan would be if you were to have a flare. To me, a maintenance dose of Asacol is less risky than going into a flare and having to be put on steroids or other medications.
I know we would all prefer to take no medications during pregnancy, but sometimes that is not an option. Alternative therapies did not work for me (diet changes can help, but alone they did not prevent a flare). Let me know how it goes or you can PM me, if you want more information. I would also search around on IBD/Crohn's forums, as many women on there have experienced pregnancies while flaring/on meds, etc.
Thanks for the advise ladies; I wish we didn't have to deal with this, but it's helpful to know there are other women out there who have been in my shoes...and who have taken meds and still had healthy babies.
I think I was being naive and just hoping that I wouldn't have a flare since I hadn't had a really bad one for quite some time but both of you are right...better to take the meds and keep a flare at bay then have to take all the meds that aren't so healthy for baby if I get really sick. I've been on predisone before and I will never ever want to do that again. Felt better but the side effects were horrible.
To answer some of the questions...I was diagnosed when I was 7 with colitis but through the years they've determined that it's more crohn's...so I've had it in some form for 23 years or so...never had surgery but every now and then go through a flare. Aside from when I was little, I've never been consistent with taking my medication. I haven't taken my meds consistently for over a year now but the dose I'm supposed to take is 400 mg 12 times a day. Seems alot to me since that was the dose given to me when I was in a flare (along with prednisone) but when I went to my GI doctor when I found out I was PG he said I should still stay at that dosage. It doesn't make sense to me though.
I see a nurse midwife but she even told me, after she said that that dosage seemed high and that the rec. dosage would be closer to 2 pills a day, that she was not an expert in this area and that I should talk to my GI doc as he would know more about what was safe during pregnancy than she. I think she just wants to support my decision to not take meds and since I hadn't been sick was probably thinking that I wouldn't become sick. I imagine when I tell her how I'm feeling she'll recommend that I go see my GI doc.
I'm going to take your guys' advice though...suck it up and call the GI doctor. And tomorrow I need to make myself start taking meds again.. I take my prenatal vitamins like clockwork...don't know why taking this has to be so much harder for me! Thanks for listening and for the advise!
I don't have anything to add... just wanted to offer my support. My husband has Crohns and it really is a $hitty thing to deal with. He had some pretty serious flares in 2007 and 2008 which led to a resection in 2008. He had complications and ended up having six surgeries that summer. Thankfully, they started him on Remicade after he recovered from surgery and he has not had any flares since.
I sincerely hope that you find the right combination of therapy to get you through the pregnancy without any flares. Good luck to you !
Thanks for the support, Daisy! I'm glad to hear your hubbie is doing much better...what a horrible time that must have been for him. Ugh...it really is a crappy thing to deal with.
I'm currently waiting for my GI to call me back with his reccomendation. I want to nip this in the bud before I start feeling any worse!
Thanks again.