Questions Answered By Expert
Sasha Taleban, MD
Arizona Health Sciences Center, Assistant Professor of Medicine, Director of IBD Program
A: These are all good questions. There are no consensus recommendations on spacing our the COVID vaccine with infusions. I advise my patients to leave at least 3 days between the vaccine and an infusion to better decipher if one or the other is causing new symptoms. Three days is generally enough time for any symptoms from the vaccine to resolve. There is nothing to indicate that postponing the infliximab infusion will be helpful for the vaccine. In fact, it may put you at risk for a flare of your UC. We do not yet know if medications like infliximab blunt the effects of the vaccine but this is an active area of study. I advise my patients to get the vaccine and continue their therapies as scheduled until more information is available hide answer
A: Thanks for the question. Before adding additional supplements to your regimen, it may not be a bad idea to stay on high dose Vitamin D and B12 shots for 3-6 months and then rechecking these vitamin levels again. If you have already done this and your levels are still low, you may need to be on higher doses of Vitamin D and other causes of B12 deficiency should be evaluated. hide answer
A: The decision on the “right medication” is a very common scenario. The best therapy for a specific person with Crohn’s disease is going to be based on several different factors. Therefore, it may be different for you versus someone else with Crohn’s disease. I would discuss the risks and benefits of each of the therapies being considered with your gastroenterologist and together, determine the best option for you. hide answer
A: There are multiple appropriate reasons to do a colonoscopy in a patient with UC. One of those scenarios is to evaluate symptoms, particularly if they have changed from before. For you, it sounds like you may have had mild symptoms that went into remission on mesalamine initially but now are having symptoms despite the use of mesalamine. It is not unreasonable to repeat a colonoscopy at this point. Having said that, it sounds like you had difficulty prepping for the previous colonoscopy. There are other noninvasive markers like stool calprotectin and stool lactoferrin that can also measure inflammation in the colon with a stool test. Additionally, if your disease involves the left side of the colon, a sigmoidoscopy, which does not require a traditional prep, may be a viable option. I would encourage you to discuss these options along with a colonoscopy with your gastroenterologist to determine the best decision for you. hide answer
A: Thrush is not something we typically see with vedolizumab or Crohn’s disease. I would discuss other causes for the thrush with your PCP. hide answer