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new guy intro and ascacol absorbtion question

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Ulcerative Colitis
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Posted 5/9/2008 3:29 AM (GMT 0)
First of all I tell a lil about myself : 29 M - fitness fanatic (6 days a week weight training) enjoy playing basketball and watching pretty much all sports.

2 years ago diagnosed with UC.  Never really took the disease too serious.  Never took the Asacol.  about a year after initial diagnosis, I had a "flare up" - doctor said I needed to take the Asacol for maintenance, not just in the midst of a flare up.  He also prescribed Flagyl (500 mg) 3X day, Prednisone, and Pamine (5mg) twice dailly.  Responded very well to medication, and began regularly taking 9 Asacol daily.

Fast forward to March 08 began having major flare ups : blood, stomach pain, etc.  I was going to the bathroom 25 - 30 times daily.  Urges were unbearable.  Doc prescribed Pred, and Pamine.  Immediately symptoms improved ( was down to 10 -12 bathroom breaks daily).  When my progress plateaued, I called Doc and asked him what gives? Why are my symptoms still present ( I had yet to discover this message board ).  He prescribed the Flagyl, but by then I had cycled off the Pred, and I had to be admitted to the ER.  They put some Flagyl and anti-inflams in my IV, and called in some more Pred.  That was this past Sat.  Symptoms have seemed to progressively improve, but I have come to find out that this "disorder" is so hit and miss, I never know if I am making any headway. 

Sorry for rambling, my question is this - Today during a bathroom break, my stool was more firm then usual with less blood and mucous, and I noticed a red "pod" Upon further investigation, I uncovered a Asacol tablet (still fully intact - and the powdered medicine safely inside the skin) I found another one in the same condition in the same bowel movement.  What gives?  Has anyone ever experienced this?  There is no doubt in my mind that this has happened before.  I eat sweet potatoes, and in the past I can see where I may have dismissed this as just the potatoe skin.  Any thoughts?  Also thoughts on Lialda?  I see my doc Monday, and I will bring all this to his attention, as well as possibly a switch to Lialda.

I am very sorry for my essay.  It's just that I am very new to this.

Posted 5/9/2008 5:34 AM (GMT 0)
Pretty much everyone that takes asacol finds the casings in the toilet looking like it's a whole pill but apparently it's just the casing the medicine is in so although you can definitely talk to your doc about it for reassurance don't lose any sleep over it, I'm sure the meds are still getting into your system...asacol is meant to release in the colon and this is why many find the casings in the toilet.

It's great that you exercise regularly and even during flares...I'm sure you are well aware that even during flares it's best to tone down (no pun intended) your work-out routine if you find you're having issues with symptoms rather than quitting exercising all together (if you can avoid doing that at least...afterall some get sick enough that mild yoga is about all they can handle, still better than nothing as you know).

:)
Posted 5/9/2008 11:53 AM (GMT 0)
thanks for the reply. as stated, believe it or not these were undisolved casing. i broke both open and the white powder seeped out.

any comments on the lialda?
Posted 5/9/2008 12:08 PM (GMT 0)
I experienced the same thing with the Asacol not being dissolved. I really checked it out and it wasn't just the casings, the casings were full................I had no improvement at all and ended up switching meds. After taking the Asacol for 2 full years, for the worst flare I ever experienced, it didn't help me at all. And how could it be helping if they weren't being absorbed. You should tell your Doc, and let him know that you "really" check it out and they weren't just casings, they were full. My Gi told me that the company that makes Asacol takes this into consideration, but still, it can't be working if it isn't dissolving. I started on Azulfidine and after 2 months, I went into remission. I don't think that's a coincidence, 2 years of Asacol, no improvement.......2 months on another med and remission.............Good Luck..........
Posted 5/9/2008 12:28 PM (GMT 0)
If I recall right, if your gut doesn't have a certain PH level then the Asacol will not break open properly and get dispersed. That is when another med option should be considered. I was on Asacol for 12 years before I switched to Colazal. I have had great success with Colazal and I never saw the capsule in my stool unlike with the Asacol. I can't comment on Lialda since I have never been on it, but sometimes you just need to find the right med that works for you.

Oh and btw, welcome to Healingwell! :)
Posted 5/9/2008 2:57 PM (GMT 0)
thanks for the welcome and thanks for responding. that is exactly what i wanted to hear. as for the asacol, i will definetly talk to the doc about switching medications.

thanks again
Posted 5/9/2008 8:41 PM (GMT 0)
Maybe ask for Imuran, that's suppose to be a pretty good maintenance drug for colitis.

:)
Posted 5/9/2008 11:27 PM (GMT 0)
Gym,ask your doc aobut Colazal. They are capsules,not tablets. When I was taking asacol,i also noticed casings in my stool. Lialda is pretty much the same thing as asacol,just the dosage is different. They are timed-release. I was taking only 2 in the morning,as opposed to 2 asacol in the morning and 2 at night.
Posted 5/10/2008 2:30 AM (GMT 0)
Pb, Imuran though should only be used if all other maintenance meds fail to work or you become steroid dependant. Since both Imuran and 6mp suppresses the entire immune system, it's best to take the "least" amount of med to see if that works first.

Gym, if you do decide to switch to Colazal - just be prepared for a size shocker! :) Colazal is sooo much bigger then Asacol. Oh to not to mention the bottle they come in is larger too. Good luck!
Posted 5/10/2008 2:54 AM (GMT 0)
It's not always just the casings. Sometimes it really is the whole pill intact. This has happened to me numerous times. I told my doctor about it and he said that happens sometimes and not to worry about it unless it's happening all the time. It seems to happen to me more often when I'm flaring badly and everything is moving through my system quickly. I would discuss it with your doctor. Sorry, I don't have experience with Lialda. And welcome to the forum. It's a great bunch of people here and lots of information.
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