Expert Q&A

Search our library of questions and answers below, or submit your own question to our panel of experts.

Questions Answered By Expert

Expert Image

Heba Iskandar, MD, MSc

Associate Professor, Director of IBD Clinical Research

Q: I’m currently on stelara every 8 weeks which is working well for me, however I am also 19 weeks pregnant. My next injection will be when I’m 22 weeks which is fine, but the following will be when I’m 30 weeks and in the third trimester, is it still safe to take this injection at 30 weeks and then stop treatment? I may be induced at 39 weeks so would one at 38 weeks would be out of the question?

A: Keeping the inflammatory bowel disease under control is the most important goal in pregnancy. It is safe to take the injection at 30 weeks, but waiting one week to take the 38-week dose seems reasonable given that it’s possibly very close to your delivery induction date. I would recommend taking that dose immediately after delivery. That said, if your IBD is active, or you tend to flare easily, the dose does not have to be held or changed. As always, involving your GI and OB physicians is key as they are familiar with the details /severity of your IBD. hide answer

Q: I have recently been diagnosed with Crohn's and have started Humira. I know that it will take several weeks to see any changes. In the meantime, I have had a flare-up with symptoms lasting more than 7 days. I don't have a lot of diarrhea; however, I do get a lot of burning and 'gurgling' (sounds like a coffee pot percolating) in my stomach. I take Pepcid, which makes the burning feel better. Is it okay to take an antacid with Humira? What is the gurgling?

A: Yes, it is okay to take antacids with humira. Gurgling is a very nonspecific symptom of feeling food or gas go through your GI tract It can be associated with inflammation, narrowing of the intestine, food intolerances like lactose intolerance, bacterial overgrowth or gut sensitivity Please contact your gastroenterology physician becasue as a new humira patient, you may need to take a short course of a steroid (like prednisone or budesonide) if the symptoms are bothersome while the humira takes effect. hide answer

Q: I am a 39-year old male and was diagnosed 6 years ago with left sided ulcerative colitis. The affected area remains at the last 25 cm of the colon. I take mesalamine and rowasa enemas. I find myself with mild flares every 6 - 12 months. I use Uceris to control the flares. While the flares are mild, I cannot retain long remissions. Can I do anything else to help with treatment? Moving up to the Immune Modifiers and Biologics seem to be an overkill and not sure if it is worth the risks.

A: I recommend discussing moving to a biologic therapy, perhaps considering vedolizumab which has a safer side effect/lower risk profile to prevent flares. I also recommend asking your gastroenterologist if your colon is healed on just mesalamine by mouth and the enemas. If there is still active inflammation on colonoscopy between flares it is prudent to add a biologic to achieve the goal of mucosal healing. Achieving healing of the colon can prevent further flares and minimize the risk of development of precancerous changes in the future. hide answer

Q: Tengo la enfermedad de Crohn y me gustaría saber si está bien tomar probióticos. ¿Hay algún riesgo de tomándolos junto con mi medicación habitual de Crohn? (I have Crohn’s Disease and would like to know if it is ok to take probiotics. Are there any risk of taking them along with my regular Crohn’s medication?)

A: Si bien no se ha demostrado que los probióticos sean adecuados como tratamiento de Crohn, algunos pacientes notan un beneficio de los síntomas al tomarlos. No hay riesgo de tomarlos con la medicación habitual de Crohn. (While probiotics have not be shown to be adequate as a Crohn’s treatment, some patients notice a symptom benefit with taking them. There is no risk to taking them with your regular Crohn’s medication.) hide answer

Q: I have 30+ year history of Crohn’s Disease. I have been on Humira for last 8 years with deep remission. I now have excessive and sudden joint stiffness and pain along with minor skin rashes. Can this be related to the medication or just another possible autoimmune issue?

A: Either one is possible. It could be the medication or another new autoimmune issue. I recommend consulting with a dermatologist and rheumatologist to discuss this and start an evaluation together with your gastroenterologist. hide answer

PREVIOUS NEXT