@CTBarrister posted:The 2 step approach is generally indicated over the 3 except In patients that are acutely ill (anemia, weight loss), have a high body mass index (BMI), are on high doses of steroids (Prednisone), taking immuno-modulators (Imuran, 6MP) and/or biologic agents (Remicade, Humira, Cimzia, Sumponi), or who require surgery to be performed emergently. In such cases it may be safer to treat the colorectal disease in three stages. The reason should be obvious, it's always ideal to have 2 surgeries instead of 3 because things can go wrong whenever surgery happens.
I was considered a borderline decision as between 2 and 3 steps due to being on a high dosage of prednisone and having a very advanced disease. However my weight was good, so I decided on 2 step based on the latter theory. When my colon was removed, my surgeon reported it dissolved in his hands due to the advancement of the disease. However the ileum, at that time, had no disease and there was no problems creating the J pouch and I had takedown 3 months later as is normal. The situation in the ileum has since changed, but is now controlled with Remicade.
Are you on Remicade now because of Crohns disease?