Remicade ----Crohns and Fistulas and Abcesses---Can we talk?
What Is Remicade? Remicade is a monoclonal antibody that binds to the inflammatory agent called tumor necrosis factor (TNF). By doing so, it blocks the activity of TNF and results in healing of the inflamed bowel wall. It has proven to be one of the first drugs to be effective in closing enterocutaneous passages (abnormal connections or tracts between the bowel and the skin).
What Is TNF?
Tumor necrosis factor (TNF) is an important mediator of inflammation. Overproduction of TNF can result in excessive inflammation, as is seen in Crohn's disease and rheumatoid arthritis. Remicade, an anti-TNF antibody, blocks the effects of TNF resulting in decreased inflammation.
Are There Known Side Effects Of Remicade? Reported side effects of Remicade have included headache, nausea, abdominal pain, fatigue, fever, chest pain, shortness of breath, and suppression of the immune system. Occasionally, treated patients have developed autoantibodies and a Lupus-like illness. Lymphomas have been described in patients treated with Remicade, but a causal relationship hasn't been proven. There was one case of lymphoma in a Crohn's patient and two in a non-Crohn's patient treated with Remicade. The treated population is known to have a higher risk of development of lymphoma and other malignancies, therefore we don't know if Remicade played a role in the development of the malignancy. In the studies performed on Crohn's disease patients, approximately 5% of patients discontinued the infusions of Remicade due to an adverse experience.
More and more I here from patients who are recieving remicade as a treatment for "severe" Crohns Disease or Fistulizing Crohns.
Severe Crohns disease consist of disease that does not respond to other medications. As some of you will know, no matter what they try the symptoms seem to stay the same. These are the people recieving Crohns.
Fistulizing Crohns... Oh.... this is truly a pain in the Butt (pun intended).
These lesions are a source of great distress to most patients. The offensive odour and the appearance of a fungating lesion can evoke feelings of embarrassment, shame, disgust and isolation. Fungating lesions require attention to counteract the odour and are frequently painful.
WHAT IS AN ANAL FISTULA? An anal fistula, almost always the result of a previous abscess, is a small tunnel connecting the anal gland from which the abscess arose to the skin of the buttocks outside the anus. WHAT CAUSES A FISTULA? After an abscess has been drained, a tunnel may persist connecting the anal gland from which the abscess arose to the skin. If this occurs, persistent drainage from the outside opening may indicate the persistence of this tunnel. If the outside opening of the tunnel heals, recurrent abscess may develop.
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