help with request from doctor.

well ya'll please help if you can.....been in a flare for most of the year.  been on pred for 4 months or so, supposed to be tapering, but still struggling some.  I take 2 lialda a day, which pass right through me undissolved.  I don't think the doc believes me, but i see them all the time still hole in the stool, so they are really not doing anything for me.  I use rowasa nightly, which sometimes i hold all night, sometimes not too long at all.  I am supposed to be at 15 mg of pred, but cheated yesterday, took an extra 10 cuz not feeling very good.  I have friends coming down late next week for a few days and i wanna feel good while they are here if possible.  Doc is pushing 6mp, which i have resisted thus far.  Are there any other meds i can request either to replace the lialda which i am passing whole or should i request steroid enemas as i taper the pills.  Is there something else that i am unaware of that i can take in conjunction with the rowasa.  I don't know if he will fulfill my requests, i don't see him enough to have a super repoir with him, but I would like to at least have a plan of action to talk to him about monday.

I made a huge improvement when I went from Asacol to sulfasalazine, and Lialda is a different variation of Asacol, if I'm not mistaken.  Asacol/ Lialda use an acrylic covering that dissolves at a certain ph.  Sulfasalzine breaks apart by bacterial action.

The first few weeks on sulfasalzine, I had some headaches, but they went away.  One can also start with a low dose and build up to prevent thise side effect.

Hi lucas..are you taking the Lialda on an empty stomach or with food?

It's possible the pred changes the ph or however the Lialda needs to help dissolve the outer capsule in order to dispurse.

Are you taking it with the pred? You might want to consider taking it at night instead of in the morning....one's digestive system tends to be a bit less active at night..it might have time to do its thing then.

I think the fact that you're on pred....maybe while tapering, you could switch to the steroid enema and start adding the Rowasa when you're closer to a much lower dosage of pred.

Is this the first time you've been on pred or was that the initial choice by the doc since you've been diagnosed?

Hang tough...hopefully you'll get the right combo of options to try.

quincy

Yes, Azulfadine (Sulfasalazine) is another ASA. It's an older drug that has a sulfa component the other ASAs don't have. I also did better on sulfasalazine than Asacol. And Elaine Gotshcall recommended sulfasalzine as her drug of choice. (You're on the SCD, right?) There is some school of thought that the sulfa component is actually very helpful.

I also agree that the steroid enemas might be a way to help you taper off oral steroids with less systemic side effects.

You may also consider looking for another gastro doc: one who listens when you tell him the meds are not dissolving and one who respects or supports your wishes for treatment.