Crohn's disease (CD) is an inflammatory bowel disease that can affect any part of the gastrointestinal tract, but most commonly affects the end of the small intestine (ileum), colon, or of them. It is not curable, but you can work towards remission of the disease with effective treatment.
If your Crohn's treatment is not working as well as you would have hoped, your doctor may recommend trying organic products. These are drugs made from living cells that target the inflammatory response. They are most often used for moderate to severe Crohns who do not respond well to conventional therapies.
Like most drugs, biologics have benefits and risks. They can reduce your inflammation and by doing so slow your Crohn's progress. However, they can also put you at risk for infections and certain cancers.
Some doctors recommend avoiding the risks associated with biologics by keeping this treatment when other therapies don't work. Other doctors advocate a "top-down" approach in which you try organic products as soon as possible to stop the intestinal damage before it starts.
Your doctor will help you weigh the risks and benefits so that you can make an informed decision about whether to start treatment with biologics. Knowing what to expect can make the transition to organic products easier.
1. BIOLOGY CANNOT BE TAKEN ORALLY.
Your biological medicine should be taken by injection or intravenously because your stomach acids will destroy the delicate complexity of this medicine.
Biological products are injected subcutaneously. This means that the medicine is deposited in the layer of fat between your skin and your muscle where it will be slowly absorbed. You can be trained to have your own injections or have them done by a healthcare professional.
Intravenous doses are administered by infusion in a clinical setting. This method can take several hours. Wear comfortable clothes, bring snacks and entertainment, like a book, and organize a return home afterwards.
2. BIOLOGY MAY CAUSE SIDE EFFECTS.
You may feel pain at the injection site or changes such as:
itching
redness
ecchymosis
swelling
pain
fever
chills
urticaria
headache
3. BIOLOGY HAS RISKS.
Organic products carry risks. These include:
Infection. Your ability to fight infection is reduced.
Cancer. There is a small increase in your likelihood of developing lymphoma.
Changes in liver function. Your liver may be affected negatively; tell your doctor immediately if you have jaundice.
Arthritis. You may develop joint pain.
Lupus type reaction (LLR). You may experience a rash, fever, muscle pain, and joint pain.
Depending on your case, the possible benefits of organic medicine may outweigh these risks. Your doctor can tell you more about the risks and help you make an informed decision about whether to take them.
4. ONCE YOU BEGIN BIOLOGY, YOU WILL CONTINUE TO TAKE IT, EVEN IN REMISSION.
If you stop taking organic products, they may not work as well when you start taking them again. This is because your body can build up antibodies that make the medicine less effective. This is one reason why doctors recommend continuing to use biologics even if your Crohn is in remission. Another reason is that biologics are effective in maintaining remission by protecting you from the reaction to flare-up triggers.
In some situations, your doctor will recommend that you take a medication break, such as before surgery. In most cases, however, expect your doctor to recommend consistent use of organic products.
5. YOU MUST HAVE ALL VACCINATIONS BEFORE BEGINNING BIOLOGY.
Live vaccinations like measles, mumps, rubella (MMR) are not recommended once you start biologics due to the risk of infection from this medication.
6. YOU WILL NEED TO DISCUSS PREGNANCY PLANS WITH YOUR DOCTOR.
Organic products are relatively new. For this reason, the long-term effects on infants exposed to biologics during pregnancy are not known. Experts believe the risk is low and conclude that the risk of fetal malformations when using biologics during pregnancy is close to that of the general population.
You and your doctor will need to discuss the risks of stopping biologics during pregnancy versus the potential risk to your baby. It may be appropriate to take a medication break during your pregnancy, depending on the type of biological medication you are using. Babies exposed in utero to certain biological drugs may need to avoid being vaccinated with live attenuated vaccines until they are at least six months old. Even then, they should be watched closely for signs of infection.
THE TAKEAWAY
Biologics work by targeting and suppressing the inflammatory response that can trigger Crohn's flare-ups. However, these drugs have side effects, including a reduced ability to fight infections. They require a subcutaneous injection or an intravenous infusion.
You should continue to take your biologic even in remission, unless directed by your doctor.