Can crohns and ulcerative colitis be pain free?

[DebE13]

Spoke with his doctor today and he is waiting to confer with my son's second GI on the transplant team to discuss how his treatment will proceed. I reiterated that if they plan to treat the autoimmune hepatitis with prednisone or budesonide, I would prefer the latter. The doc commented that a healthy young male like my son would tolerate the prednisone well and it could be a low dose but we will procede however his second GI suggests since when his liver fails, my son will be under his care. I'm thankful there's a team atmosphere and there's no God complex going on. So no matter how often I bash him, I give him credit for that.

Could I be overreacting to the suggestion of prednisone because of my own bad experience? Is there a stronger benefit of one vs the other besides the extreme difference in cost? The budesonide could also help with the UC?

Tex, the blood was a shocker. I'm accustomed to blood from hemorrhoids or irritation but nothing like this. It almost made me feel lucky to have MC. Aside from the discomfort of one particular hemorrhoid that I've had for over two years, I am relatively pain free in the MC department.

[tex]

Deb,

Yes, unfortunately UC is a more severe disease. And the sight of blood in stool is never good news.

Whether or not budesonide would be a good choice depends to some extent on the location of the UC inflammation in his GI tract. It normally begins at the distal (rectal) end, and spreads upward. If it's still in the early stages, I wonder why his doctor didn't suggest Uceris.

Uceris is budesonide, but it's formulated to become active only in the colon so that it has absolutely no systemic effects (according to the manufacturer). By comparison, up to approximately 20 % of Entocort can be absorbed systemically, because it activates beginning in the ileum.

If the UC has spread into the small intestine, especially above the ileum, then Prednisone might be a better choice, because it can treat inflammation anywhere in the GI tract.

Tex

[DebE13]

Thanks Tex!

I soooo appreciate your insight!