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crohns-methotrexate
Anyone had methotrexate to treat their crohns? My sister has had crohns 20 plus years-2 bowel resection, multiple relapses and failed infliximab treatment her docs are now discussing methotrexate any experience/information with this treatment welcome.
Guess I spoke too soon about methotrexate keeping my Crohn's in remission! About 6 weeks ago I got severe nausea, loss of weight, no appetite and pain in my oesophagus on eating or drinking. My gastro did a CT scan (showed evidence of inflammation in the terminal ileum), MRI showed two strictures in the small intestine, and a gastroscopy showed stage 1 oesophagitis. I have been on an elemental liquide diet for the past 2 weeks, Fortijuice 3 times a day, plus omeprazole for the inflamed oesophagus and domperidone for the nausea. He has doubled my mtx injections to 25 mg weekly and the last 10 days I have also been taking Budesonide (entecort), 9 mg daily. He said I may have become resistant to methotrexate, but he has never had an IBD patient on mtx for 7 yrs, so has no precedent.
He said he cannot be sure if the oesophagitis has been caused by alendronate acid, which I was taking weekly for bone density loss - due to 30 yrs of prednisone and 4 yrs of Arimidex, (breast cancer adjuvant hormone therapy to prevent a bc recurrence.) I have stopped both bc drugs.
All in all, a bit of a mess at the moment. I am concerned that the breast cancer may have metastasised to the GI tract, which although rare, does happen. I am seeing him on Friday 1st August for the histology results on the biopsies taken at the gastroscopy, and a treatment plan. He said he will not advise surgical intervention of the strictures until we get the inflammation under control and I put on some weight, currently at 112 lbs. Additionally, he said he is not happy to prescribe one of the new anti-TNFa biologic therapies, such as Humira, Cimzia, Remicade etc., in light of my previous breast cancer and the fact that the strictures will become worse.
Since taking the budesonide and other drugs, I am feeling a little better, able to eat a low residue meal once a day for the past 5 days, so there is hope that we are getting the flare under control.
Maxipaxi - I don't know if any research has been done on whether exercise or lack of, plays any part in keeping Crohn's in remission. I played squash 3 times a week when I was in my thirties, and I still got regular flares.
Take care all,
Liz (Crohn's Community Leader)
He said he cannot be sure if the oesophagitis has been caused by alendronate acid, which I was taking weekly for bone density loss - due to 30 yrs of prednisone and 4 yrs of Arimidex, (breast cancer adjuvant hormone therapy to prevent a bc recurrence.) I have stopped both bc drugs.
All in all, a bit of a mess at the moment. I am concerned that the breast cancer may have metastasised to the GI tract, which although rare, does happen. I am seeing him on Friday 1st August for the histology results on the biopsies taken at the gastroscopy, and a treatment plan. He said he will not advise surgical intervention of the strictures until we get the inflammation under control and I put on some weight, currently at 112 lbs. Additionally, he said he is not happy to prescribe one of the new anti-TNFa biologic therapies, such as Humira, Cimzia, Remicade etc., in light of my previous breast cancer and the fact that the strictures will become worse.
Since taking the budesonide and other drugs, I am feeling a little better, able to eat a low residue meal once a day for the past 5 days, so there is hope that we are getting the flare under control.
Maxipaxi - I don't know if any research has been done on whether exercise or lack of, plays any part in keeping Crohn's in remission. I played squash 3 times a week when I was in my thirties, and I still got regular flares.
Take care all,
Liz (Crohn's Community Leader)
My daughter Risa been on Metho for almost a year after trying remacaide, 6-MP , asacol, but now it's losing its effectiveness!! Unfortunately!!
Good luck to all on Methotrexate!! I am hoping Humira will work for her next!
Crohns is really an annoying illness for her though!! Wonder if exercise or lack of plays a part in managing the disease!
Thanks!
Good luck to all on Methotrexate!! I am hoping Humira will work for her next!
Crohns is really an annoying illness for her though!! Wonder if exercise or lack of plays a part in managing the disease!
Thanks!
I do understand and empathsise with your problems. I was fortunate in my 30's to work alongside my husband in our own company, so taking time off for hospital visits was not a problem, but could have been if I was employed otherwise.
I have found, being on methotrexate injections, that the disease is kept in remission and I have only had one flare in the past 7 yrs which was due to having to stop mtx in order to have FEC chemo for breast cancer. Once the inflammation is under control, you will start absorbing your food properly which in turn will give you more energy....well, that has been my experience. I don't know anyone on mtx to compare myself to. I have no side effects such as I had on steroids. My gastro will not prescribe prednisone for me now as I had steroid induced psychosis when dx with breast cancer. I was on prednisone for some 30 yrs and it has significantly affected my bone density so I have to take a bisphosphonate weekly, and daily calcium tablets.
You perhaps should take your gastro's advice and see if you can tolerate mtx, not everyone can, so guess I am lucky in that respect. You may be too.
Why is surgery now not an option? I have PanCrohn's Colitis, with ulcers and crypt abscesses in both the small intestine and colon, and although I now have two strictures in my small intestine, they are not causing problems at present. I have never had a resection since I have always responded to medication thankfully.
I do hope you get some relief from your symptoms and lack of energy soon.
Take care,
Liz.
I have found, being on methotrexate injections, that the disease is kept in remission and I have only had one flare in the past 7 yrs which was due to having to stop mtx in order to have FEC chemo for breast cancer. Once the inflammation is under control, you will start absorbing your food properly which in turn will give you more energy....well, that has been my experience. I don't know anyone on mtx to compare myself to. I have no side effects such as I had on steroids. My gastro will not prescribe prednisone for me now as I had steroid induced psychosis when dx with breast cancer. I was on prednisone for some 30 yrs and it has significantly affected my bone density so I have to take a bisphosphonate weekly, and daily calcium tablets.
You perhaps should take your gastro's advice and see if you can tolerate mtx, not everyone can, so guess I am lucky in that respect. You may be too.
Why is surgery now not an option? I have PanCrohn's Colitis, with ulcers and crypt abscesses in both the small intestine and colon, and although I now have two strictures in my small intestine, they are not causing problems at present. I have never had a resection since I have always responded to medication thankfully.
I do hope you get some relief from your symptoms and lack of energy soon.
Take care,
Liz.
Thank you for the warm welcome and the advice.
I've spoken to a few people about MTX and so far, no one taking is employed. This scares me. I'm only 32 years old and I don't want my career to end so early in life. I know my health is more important, but I had to quit work once before due to my meds and I felt depressed and worthless. I always feel guilty when I get sick and have to miss work or can't clean the house or take care of myself; I'm not sure why I feel this way. My husband is wonderful and very supportive. My step-son is amazing and my extended family are great.
I'm also worried about kids. We're not planning to have kids right now, but we're going to talk about it again in a couple years, if my health has improved.
I tried imuran and had a horrible reaction to it - it actually caused a flare up and new symptoms that I didn't have previously. Since then, my diseased bowel has spread.
The doctor doesn't feel the capsules will work for me and wants me to take injections. I can't handle giving taking them, but not so sure I can handle the symptoms.
I've spoken to a few people about MTX and so far, no one taking is employed. This scares me. I'm only 32 years old and I don't want my career to end so early in life. I know my health is more important, but I had to quit work once before due to my meds and I felt depressed and worthless. I always feel guilty when I get sick and have to miss work or can't clean the house or take care of myself; I'm not sure why I feel this way. My husband is wonderful and very supportive. My step-son is amazing and my extended family are great.
I'm also worried about kids. We're not planning to have kids right now, but we're going to talk about it again in a couple years, if my health has improved.
I tried imuran and had a horrible reaction to it - it actually caused a flare up and new symptoms that I didn't have previously. Since then, my diseased bowel has spread.
The doctor doesn't feel the capsules will work for me and wants me to take injections. I can't handle giving taking them, but not so sure I can handle the symptoms.
Hi - welcome to our Crohn's community.
As you can see from my above post, I have been on methotrexate for 7 yrs now (steroids 30 yrs, which have also played havoc with my bones, so on a weekly bisphosphonate, alendronate, and Calcichew/Vit.D3 twice daily). I was on 25 mg tablets of mtx once weekly for 5 yrs, but my symptoms got gradually worse so my gastro changed me to 12.5 mg injections weekly the last 2 years. I am doing fine now, but you must have regular monthly blood tests as it is a cytotoxic (chemo) drug and can have serious side effects. I have not had Remicade as I also have psoriasis and my gastro is concerned about the infusion site causing it to get worse.
I am retired, so work is thankfully not an issue. I self inject the mtx injections, takes all of 2 minutes, so you shouldn't need time off work. The used needle and capsule have to be disposed of very carefully - my GP gave me a special container to put them in, and a guy from the local council comes to pick it up when full. Works like clockwork.
Methotrexate has made a huge difference to my quality of life......suggest you try it and see how you get on. As with all potent drugs, some people are intolerant or allergic to different ones - I couldn't take Azathioprine, but no problem with mtx.
Take care,
Liz.
As you can see from my above post, I have been on methotrexate for 7 yrs now (steroids 30 yrs, which have also played havoc with my bones, so on a weekly bisphosphonate, alendronate, and Calcichew/Vit.D3 twice daily). I was on 25 mg tablets of mtx once weekly for 5 yrs, but my symptoms got gradually worse so my gastro changed me to 12.5 mg injections weekly the last 2 years. I am doing fine now, but you must have regular monthly blood tests as it is a cytotoxic (chemo) drug and can have serious side effects. I have not had Remicade as I also have psoriasis and my gastro is concerned about the infusion site causing it to get worse.
I am retired, so work is thankfully not an issue. I self inject the mtx injections, takes all of 2 minutes, so you shouldn't need time off work. The used needle and capsule have to be disposed of very carefully - my GP gave me a special container to put them in, and a guy from the local council comes to pick it up when full. Works like clockwork.
Methotrexate has made a huge difference to my quality of life......suggest you try it and see how you get on. As with all potent drugs, some people are intolerant or allergic to different ones - I couldn't take Azathioprine, but no problem with mtx.
Take care,
Liz.
I'm 32 and have had crohn's disease for 11 years.
This year, my infected bowel has spread and although I've avoided operations in the past, surgery is no longer an option. I cannot go back to steroids as I've spent 7 out of 11 years on steroids and my bones can't take it anymore. I've been getting progressively worse and have tried everything but Methotrexate and Remicade. My doctor says Remicade is a last resort and wants to put me on Methotrexate, but I'm scared. I could really use some advice...
Also, for those on Methotrexate, did you need to take time off work?
This year, my infected bowel has spread and although I've avoided operations in the past, surgery is no longer an option. I cannot go back to steroids as I've spent 7 out of 11 years on steroids and my bones can't take it anymore. I've been getting progressively worse and have tried everything but Methotrexate and Remicade. My doctor says Remicade is a last resort and wants to put me on Methotrexate, but I'm scared. I could really use some advice...
Also, for those on Methotrexate, did you need to take time off work?
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