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Lialda's no longer working, What next?

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Ulcerative Colitis
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Posted 5/24/2010 11:56 PM (GMT 0)
I have been taking Lialda for the last 9 months or so.

I am having a flare up and just underwent another colonoscopy. My GI says that the Lialda probably won't help me any longer and he prescribed me 3 weeks worth of cortenemas, but told me to keep taking 2 liada/day.

So, my question is, has anyone had Lialda stop working for them? What should I expect next? I have had UC for 10 years, initially on Rowasa and then went several years without meds. Bad, I know, but I was younger and avoiding the whole situation. I have always had symptoms, but now the severity has increased.

I just don't know what to expect. What other meds might I need to take?
Posted 5/25/2010 12:31 AM (GMT 0)
So, what did the colonoscopy show? inflammation in the lower parts (rectum, sigmoid, etc.)?
Posted 5/25/2010 12:43 AM (GMT 0)
Yes, I have heard of tihs happening. I think it happened to me & I am still trying to get things under control. I have cort-enemas tooo, they aren't helping as much as I would like. Have you ever taken prednisone? That is usually the next course of action if you flare while on 5ASAs. You could also try changing to another 5ASA like Colazal. Colazal is supposably better for treating left-sided colitis. It didn't make much difference for me. If you have used prednisone and still can't stop the flare, they may offer you 6mp or Immuran. Both are immunomodulators. You have options but I know it is scary and stressful. I hope you find a solution soon.
Posted 5/25/2010 1:07 AM (GMT 0)
Hi Guys,

Thanks for the quick replies.

My colonoscopy showed inflammation in the last 15 cm of my colon, so basically my rectum. My colitis spreads into my sigmoid colon. My Dr. took biopsies all over the place, up to my small bowel.

I am really scared of taking steroids because I have some bone pretty bad bone thinning in my mouth. I don't know if this is related to colitis or not. I'm getting a bone density test to see how things are looking in other areas. I don't know if this is related to colitis or not.

I have been doing research and I feel like steroids seem like a treatment option or drugs that affect the immune system directly. I don't know which freaks me out more.

It seems Lialda is a pretty strong mesalamine and I hope there is something that can replace it other than steroids. I will ask my Dr. about colazal if he doesn't mention it.
Posted 5/25/2010 1:39 AM (GMT 0)
Mesalamines don't really do much of anything for me. Colazal stopped working. Asacol made my flare worse. And Lialda gas me horrible gas. Added turmeric to my foods and taking Boswellia supplements helps calm my colon much more than mesalamines have.

There is a study that says that the risk of flaring is less for those who take mesalamines every day. It would be interesting to see the results of a study on turmeric and inflammation and to compare those results with the mesalamine study. Of course, it won't happen though. There isn't enough profit in selling turmeric for IBD maintenance purposes.
Posted 5/25/2010 2:49 AM (GMT 0)
Well, that's good news that it's the last 15cm! My experience with the cort enemas was very positive. I didn't feel any side effects and they worked very well for me. Very little of the rectal steroids gets into your blood stream. The problem for me was that my colitis had spread above where they reached. So, I had to go on oral prednisone. When I had my colonoscopy my doctor actually said that the lower part where the enemas did reach looked good. So, I hope you have success with those! You might consider going back on Rowasa enemas for maintenance after you are done with the cort one. Again, I hope they work for you!
Posted 5/25/2010 4:36 AM (GMT 0)
The whole problem is that you didn't continue on maintenance dosage of the Rowasa. Actually, the doc could have put you back on the Rowasa rather than the steroid enemas.

If you're not comfortable taking the steroid enemas, call the doc and ask to go on the Rowasa again...

Personally, I don't think you need to change the Lialda at this point.

q
Posted 5/25/2010 5:49 AM (GMT 0)
I've always taken my maintenence meds and I still ended up flaring. I don't think the same tactics work for everyone. It's worth it to try to resolve this with 5asas, whether it is enemas, suppositories or oral but let's be realistic, it may not help. I see so many people here who are not helped by 5asa medication.
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