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Has anyone gained remission by just taking Asacol orally?

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Ulcerative Colitis
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Posted 11/19/2010 6:17 PM (GMT 0)
I've only been on Asacol 400mg for 5 days. I take 3 pills, 3 times a day = 9 pills. I have noticed that my urgency is basically gone and the rumbling in my gut/colon area has drastically reduced. I have been only having 1 bm a day for the last 4 days, but there is still some blood and mucus. I understand that some think I should be on rectal meds, but my GI seems to think the Asacol will reach far enough down the colon/rectum. I have 45cm of UC starting from my rectum on upward. From what my wife told me after the scope (since I was still out of it ), the GI didn't want to exceed the maximum amount of mesalamine by adding rectal meds at this time and thought the Asacol oral alone should be sufficient. I believe he said 12 - 400mg asacol pills was the max you could have in a day. I take 9 and have an appt. in 3 weeks to discuss progress and possibly up the Asacol to max dose if I'm still bleeding etc. He said I should see results in 8-10 days. Has anyone gained remission by just taking Asacol orally? I am all for taking rectal meds, but I'm trying to trust my GI since I just started seeing him and he comes with great feedback from others (although he may not be right for me in the long run). Thanks for reading.
Posted 11/19/2010 6:55 PM (GMT 0)
For me, they would only help maintain remission.
Once I had a flareup, I always needed a rectal med.
Posted 11/19/2010 7:01 PM (GMT 0)
how often did you have to take the rectal med?
Posted 11/19/2010 7:46 PM (GMT 0)
It did get me into remission and helped me maintain remission for about a year. After that I went into a flare up while on Asacol. I tried adding rectal meds and I tried other 5ASAs but nothing helped. Now I am taking 6mp.
Posted 11/19/2010 8:15 PM (GMT 0)
I have acheived remission by using Asacol alone. However, each successive flare-up required an increase in dose until 2001 when I added Rowasa to my arsenal of UC meds. I had a bad flare-up last Feb-June which required me to finally, after 24 years of 5ASA's only, try steroids; specifically Cort Enemas. As far as the Asacol, I have been on as many as 16 per day with no adverse reaction.
Posted 11/19/2010 9:41 PM (GMT 0)
A lot of people probably can, but I believe that the enemas will get you there faster and keep you in remission for longer. My GI initially started me on 12 Asacol only and I saw a teeny, tiny bit of improvement (I was in a severe flare). After a week, we added in the enemas and I got a LOT better right away. I think I would have gotten into remission using those two alone, but got a tummy bug and it threw me back into the flare, so ended up having to use prednisone.

I personally think it's better to use the enemas. Several studies have shown that people who use them (only twice weekly) in addition to oral meds stay in remission for longer than those who only use oral meds. It sounds like you're really improving with the Asacol, but you could get better much more quickly with the enemas added in.

As for exceeding the maximum dose of mesalamine, songlady has taken as many as 16 asacol a day with no ill affects, as prescribed by her GI. My GI had no issues with me using 12 asacol a day plus an enema nightly. He said that mesalamine is very poorly absorbed by the colon, so it's hard to get too much of it.
Posted 11/19/2010 11:12 PM (GMT 0)
Did I hear my name? lol I've been on 16 Asacol a day for 8 years, and I do Canasa or Rowasa in flares. I asked my new GI about this and he said "it's really hard to overdose on 5-ASA since to a large extent it works topically."
I'm also overweight, a "big person", so if body weight has anything to do with the dosage, that may be why I can tolerate so much.

When I was first diagnosed, I did come out of a flare or two by use of oral alone (back then it was sulfasalazine.) But my experience has been like AussieDogMom's - over the years it's taken more to squelch the flares.
Posted 11/20/2010 3:55 AM (GMT 0)
I used orals alone for my very first flare 10 years ago. but since then oral mesalamine has only been useful for maintaining. as two other posters have experienced, i have had to use ever increasing doses of mesalamine to induce remission and have had to slowly move on to using steriods.
Posted 11/20/2010 7:48 AM (GMT 0)
Try it and find out for yourself.
I can only offer the almost 22 years experience with them.  I did improve with just the asacol before my c-scope a few weeks after taking them.  Not enough to hit the rectum, however.

5ASA meds..oral and rectal are used for treatment and can also be tapered and continued for  maintenance.   They can be used for long term....forever possibly.  I'm hoping, anyway.


Yes, one can have too high a dosage...a lower dosage to start and increased.  A high dosage can actually cause side effects of a worsening flare where one can believe the med's not helping...not realising a lower dosage might be the key.   The lower dosage to start will aleviate most of those side effects.

Not much oral medication would be able to sit in the rectum...think about it.  You might not need a high oral 5ASA but maybe only need a 2g dosage of the enemas.  If that's not enough you can increase.

I'm actually sick of hearing docs who don't treat their UC patients with rectal meds.... One can ask for them and even say to start with the lowest dosage,etc.   In other words...being proactive and part of the care.  Not like one is asking for an addicting med .... or handed out like prednisone for goodness sakes.

Seems many GI-docs are arse-med phobic.

Yep, makes me gut-wrenching sick.   Wonder if there's a rectal med for that??lol.

q

Posted 11/20/2010 11:03 PM (GMT 0)
Thanks to all for the info and suggestions. I will push for rectal meds at my next gi appt. if my bleeding/mucous does not stop. It's frustrating asking your gi for rectal meds more than once when he does not believe they are necessary at the moment and he's the one who just did your scope. Like I said in my intro post above, I'm trying to give my gi the benefit of the doubt since I've just started seeing him. I have a backup gi just in case, but it's still early in the game and I'm not quite ready to go through the hassle of switching docs. Hopefully the Asacol will do it's job. Previously, I did 2 rounds of hydrocortisone enemas and they really didn't help much or stop my bleeding for more than a half day. Although I was only on 4-400mg Asacol pills a day, so that may of been a factor. Who knows. Something has got to work sooner or later. Thanks again - all the info/posts on this forum has made things alot clearer.
Posted 11/21/2010 10:45 AM (GMT 0)
Ilive in the UK and have had Colitis for 16 years. My specialist prescribed two 400mg asacol 3 times a day (6 tablets in all) which cleared the problem in about two weeks. The specialist advice at the time was to continue the treatment for 3-4 years.
Due to the amazing result I stopped the medication within the first year which was a mistake. I have had a few minor flare ups followed by a recurrence of the full blown problem in 2006. Once again Asacol has cured the problem although it took a lot longer.

I recently had a minor flare up which i firmly believe was due to drinking large amounts of coffee.(office meetings etc). Coffee is not my usual drink. I have stopped the coffee completely and things are back to normal.

I must stress that the advice to take the medication for 3-4 years was given 16 yrs ago, and may not apply today.

Hope this helps.

colpatient
Posted 11/21/2010 1:25 PM (GMT 0)
I just wanted to chime in.  I took Asacol for many years, 10 years, while my colitis got worse and worse.  Over the course of 15 years of being treated by various GIs, 4-5 different ones, not once did any GI recommend, push or even mention rectal meds. 

I now have a GI doc who I am very happy with and is more aggresive with my UC not just to be aggresive but because he wanted to get control of it.  He place me on Canasa right away when he saw there was a stubborn patch of inflammation in the rectum. 

I told of my experience or I should say my lack of experience with rectal meds in the past.  He said it's probably due to a training bias.  My current GI doc went to medical school in Ireland.  He said in Europe there is definitely a favortism towards rectal meds.  In fact he said most colitis patients would start there treatment with them.  He said he has found US trained GI docs to be very reluctant or hesitant to use rectal meds in the first place.  My GI doc doesn't understand why, the only thing he can come up with is that in the US there is some wierd thing about sticking things up one's but.

Just my two cents

MyUC

Posted 11/23/2010 5:29 AM (GMT 0)
I am on lialda only (pretty mcuh same as asacol, no?) & really feel as though I could consider myself in remission...I hope it stays that way!
Posted 11/23/2010 3:59 PM (GMT 0)
Hey 'Meemers', I hate to cut in on this thread but had an important question to ask you. You posted this on a previous "smoking" thread and your history and mine seem to be mirror images. Could you elaborate a little on this, or maybe just msg me privately, much appreciated. " I am an e-cig fan...I was a 30 yr smoker, but my first major flare was over 3 years after I quit..? I honestly was only nicotine free for about 2 months, I then started using nicotrol inhalers..and more recently tried an e-cig..one puff & I was smitten, all those endorphines started buzzing in the brain. Not all ecigs are equivilent! I use blu e cigs, there are major differences in quality. I also use tasty vapor for e cig liquids."

Again sorry for jumping on this thread, i didnt know how else to contact you.
Posted 11/24/2010 12:14 AM (GMT 0)
Hi Msobo, I can Pm. or you me..or will others possibly benefit from our conversation? I don't care either way, or I can add my email contact to my profile? Your call!
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