Hello. I was diagnosed with MC 15 years ago, took Asacol for about 6 months and have been in remission ever since. I had some slight trouble over the years but would take Pepto and it would go away. I am now 16 weeks pregnant have have had chronic D with horrible stomach pain for the last 2 weeks. (just had ultrasound and baby appears fine). I went to GI and he prescribed Budesonide (Entocort) 9MG a day. He said the drug was safe during pregnancy as it was non-absorbing. I looked it up and saw it is a Class C drug and should not be used at all when breastfeeding - seems like it must absorb somewhere! I read that there have been issues in fetuses in animal studies and there were references to possible supressed neural systems and hypoadrenalism in human babies. I asked him about Asacol but he thought this was safer. I am 42 years old and already in a high risk category due to age so I am very nervous about everything! I have started to lose a little weight so I am worried I am not getting enough nutrition to the baby. I wonder if the medication is worth the risk or is Imodium and diet might be safer. Unfortunately both years ago and now it seems I have problems no matter what I eat!
Is anybody else pregnant with active symptoms? If so, how are you managing? Also, has anybody had a baby after being on Entocort?
I appreciate any available information and am very glad to find this group.
Vtalley
MC and Pregnant
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Welcome VTvalley,
I'm so sorry your MC symptoms have returned with such a vengeance. I'm surprised it would happen at 16 weeks, when your immune system tends to be suppressed during pregnancy. Is there any chance you might have a GI infection instead? Giardia? Lysteria? Cryptospiridium, etc? I assume your doc did stool cultures and Ova and parasite exams before suggesting meds? Pregnancy also changes your Ph and makes you more prone to yeast infections/yeast overgrowth. Myabe the pregnancy alterations in your gut flora got things going again?
You said you have problems no matter what you eat. Have you tried an elimination diet of at least a week this time around? Removing minimally gluten, dairy and soy to see if anything changes?
I'm so sorry your MC symptoms have returned with such a vengeance. I'm surprised it would happen at 16 weeks, when your immune system tends to be suppressed during pregnancy. Is there any chance you might have a GI infection instead? Giardia? Lysteria? Cryptospiridium, etc? I assume your doc did stool cultures and Ova and parasite exams before suggesting meds? Pregnancy also changes your Ph and makes you more prone to yeast infections/yeast overgrowth. Myabe the pregnancy alterations in your gut flora got things going again?
You said you have problems no matter what you eat. Have you tried an elimination diet of at least a week this time around? Removing minimally gluten, dairy and soy to see if anything changes?
1987 Mononucleosis (EBV)
2004 Hypomyopathic Dermatomyositis
2009 Lymphocytic Colitis
2010 GF/DF/SF Diet
2014 Low Dose Naltrexone
2004 Hypomyopathic Dermatomyositis
2009 Lymphocytic Colitis
2010 GF/DF/SF Diet
2014 Low Dose Naltrexone
It started on a Monday afternoon two weeks ago basically out of nowhere and has not stopped! Dr. is performing blood and stool samples and I am not starting the meds until I get the results. He seemed very doubtful for some reason. I was surprised by the sudden onset at this stage too as so much of what I have read talked about people staying in remission or even improving during pregnancy!
I am just starting to eliminate foods this time around - before I never really identified anything other than obviously bad stuff like greasy pizza, but I realize things might have changed for me. I was drinking a lot of orange juice and V8 juice for nutrients during pregnancy since I am not a super healthy eater and both do not seem good on my stomach. It seems I get some relief from Greek yogurt and went and bought some probiotics at lunch that I hope might offer more relief.
I am just starting to eliminate foods this time around - before I never really identified anything other than obviously bad stuff like greasy pizza, but I realize things might have changed for me. I was drinking a lot of orange juice and V8 juice for nutrients during pregnancy since I am not a super healthy eater and both do not seem good on my stomach. It seems I get some relief from Greek yogurt and went and bought some probiotics at lunch that I hope might offer more relief.
Hi V,
Welcome to the board. Statistically (according to the literature), it appears that roughly half the women who become pregnant after developing MC find that their MC symptoms improve, and the other half find that their symptoms become worse. Hormonal changes can have a big effect on MC. We have a number of members who have been through pregnancy with MC, but there seems to be no way to predict which way their symptoms will go when they become pregnant. It's my impression that as far as the members of this board go, most find that their symptoms become worse during pregnancy.
Your doctor is not quite correct about the potential for Entocort to be absorbed into the bloodstream. According to official trials conducted by the manufacturer (AstraZeneca), from as little as 9 % to as much as 21 % of budesonide in Entocort may be absorbed into the bloodstream, so obviously this varies by the individual.
http://www.ncbi.nlm.nih.gov/pubmed/15355126#
There's a similar but much newer drug available for treating UC (it was approved in January of this year), and many GI specialists are prescribing it for treating MC because it does not become activated in the ileum (where Entocort typically becomes activeated). Instead it is activated only in the colon, so the potential for absorption into the bloodstream is indeed claimed to be extremely low, according to trials.
The drug is called Uceris, and unfortunately, based on the results reported here by members who have tried it, it does not seem to be as effective for treating MC as Entocort. That may be because contrary to what many GI specialists have been trained to believe, MC is typically most active in the ileum and right-side colon, so the failure of Uceris to treat the ileum may turn out to be its Achilles heel, as far as treating MC is concerned. I have no idea how it is rated according to use during pregnancy or lactation, but hopefully your GI doc should be familiar with it. It's possible that pregnancy and lactation risks have not yet been established for this drug since it's still relatively new.
http://www.centerwatch.com/drug-informa ... rugID=1248
http://www.drugs.com/cdi/uceris-extende ... blets.html
One of the best things that you can do to insure the health of your fetus (especially regarding immune system development), is to make sure that your vitamin D blood level is adequate (because MC and other IBDs tend to deplete vitamin D levels). I believe the Vitamin D Council recommends a daily vitamin D supplement of around 5,000 IU, during pregnancy.
Again, welcome aboard, and please feel free to ask anything.
Tex
Welcome to the board. Statistically (according to the literature), it appears that roughly half the women who become pregnant after developing MC find that their MC symptoms improve, and the other half find that their symptoms become worse. Hormonal changes can have a big effect on MC. We have a number of members who have been through pregnancy with MC, but there seems to be no way to predict which way their symptoms will go when they become pregnant. It's my impression that as far as the members of this board go, most find that their symptoms become worse during pregnancy.
Your doctor is not quite correct about the potential for Entocort to be absorbed into the bloodstream. According to official trials conducted by the manufacturer (AstraZeneca), from as little as 9 % to as much as 21 % of budesonide in Entocort may be absorbed into the bloodstream, so obviously this varies by the individual.
http://www.ncbi.nlm.nih.gov/pubmed/15355126#
There's a similar but much newer drug available for treating UC (it was approved in January of this year), and many GI specialists are prescribing it for treating MC because it does not become activated in the ileum (where Entocort typically becomes activeated). Instead it is activated only in the colon, so the potential for absorption into the bloodstream is indeed claimed to be extremely low, according to trials.
The drug is called Uceris, and unfortunately, based on the results reported here by members who have tried it, it does not seem to be as effective for treating MC as Entocort. That may be because contrary to what many GI specialists have been trained to believe, MC is typically most active in the ileum and right-side colon, so the failure of Uceris to treat the ileum may turn out to be its Achilles heel, as far as treating MC is concerned. I have no idea how it is rated according to use during pregnancy or lactation, but hopefully your GI doc should be familiar with it. It's possible that pregnancy and lactation risks have not yet been established for this drug since it's still relatively new.
http://www.centerwatch.com/drug-informa ... rugID=1248
http://www.drugs.com/cdi/uceris-extende ... blets.html
One of the best things that you can do to insure the health of your fetus (especially regarding immune system development), is to make sure that your vitamin D blood level is adequate (because MC and other IBDs tend to deplete vitamin D levels). I believe the Vitamin D Council recommends a daily vitamin D supplement of around 5,000 IU, during pregnancy.
Again, welcome aboard, and please feel free to ask anything.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thanks for the response and information Tex. Dr. actually gave me samples of Uceris but prescribed Budesonide. Both are Class C drugs but very little info on the new one. I'm not starting anything until I get the labs back to make sure it's not some sort of infection - but I am doubtful about that. This feels too familiar! I'm continuing my internal battle of if I should try the medication or deal with symptoms the best I can through pregnancy and pursue medication after if I need to. I have changed my mind a bunch of times already! I just bought some Vitamin D because I was concerned about that. I had low levels in the past but it got back to normal - probably not now. Dr. did full panel so I should be able to see that also.
Again, thanks for the info and the time.
vtalley
Again, thanks for the info and the time.
vtalley