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Posted 6/25/2011 2:39 AM (GMT 0)
Does anyone know if I can take Metamucil with Sulphasazaline?
It says not to take it with aspirin and I believe Sulphasazaline is aspirin like. And both may cause bleeding which makes me a little nervous to take both at the same time.

Any advice would be appreciated. Thanks.

Post Edited (woggin) : 6/24/2011 8:44:47 PM (GMT-6)

Posted 6/25/2011 3:22 AM (GMT 0)
What is the it that says not to take with aspirin? Metamucil?
Is it on the label?
  State or show where you see this.
q
Posted 6/25/2011 3:41 AM (GMT 0)
I found this link regarding possible fibre supplement interactions with sulpha meds...

http://www.umm.edu/altmed/articles/fiber-000958.htm

There's no mention of sulpha meds interferring with fibre supplements.

Sulpha (5ASA) are completely different from asa OTC meds like aspirin, advil, ect which can cause bleeding in the intestinal lining unlike 5ASA meds which don't (they instead aid with inflammation, for some people).

Posted 6/25/2011 5:35 AM (GMT 0)
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000092/#a601104-precautions

"Do not take digoxin (Lanoxin), salicylates (aspirin), or nitrofurantoin (Macrodantin, Furadantin, Macrobid) within 3 hours of taking psyllium."

http://ibdcrohns.about.com/cs/sulfasalazine/a/azulfadinefaq.htm

"The drug sulfasalazine is a 5-ASA compound, and is the combination of two substances: sulfapyridine and an aspirin-like compound."

Also I have read somewhere not to take sulphasazaline if you are allergic to salicylate


I guess I just assumed that it is a blood thinner because it says not to take with aspirin and helps with high cholesterol. So that may be a pretty wild assumption.
And maybe I am just paranoid and over analyzing this. But I am pretty sure my body is saturated with sulfasalazine at this point. And I don't know if waiting 3 hrs would make a difference.

I am not sure how Psyllium works. But I think I could really use something more than just a stool softener. And I think I need it longer than a week.
Posted 6/25/2011 5:41 AM (GMT 0)
Thank you for the link pb4.

Are you saying they list not to take it with aspirin because aspirin can cause bleeding in the intestinal lining?
Also I still have bleeding somewhat. Should I not take it if I still have bleeding?
Posted 6/25/2011 7:56 AM (GMT 0)
Sulfa is NOT 5ASA. Sulfasalazine is sulfa and a 5ASA..not all 5ASA meds have sulfa.

Sulfasalazine contains a 5ASA..which is a salicylate. If you're allergic to aspirin, you might be allergic to 5ASA..so don't take sulfasalazine,.

If you're allergic to aspirin or salicylates it doesn't mean one is allergic to sulfa.

The suggestion to not take aspirin or the other mentioned meds within 3 hours of taking metamucil is only that it can possibly REDUCE the effectiveness of those medications because they can be absorbed by the metamucil and one may not get the proper dosage. The suggestion would possibly be for those taking daily low dosage of aspirin to thin the blood.

5ASA is not aspirin...it's in the same family. It's not a derivitive of aspirin, it's a different type of salicylate...
For some it can cause increased symptoms of UC....but it's used as an antiinflammatory for UC. A topical medication that's released in either just the colon or in the terminal ileum and colon to treat inflammation of the lining.

You're not overanalysing it...you just don't have the facts clear yet.

You're having constipation at this point? That could be a symptom of rectal inflammation and part of UC symptoms. Stool softener is OK, but using metamucil taken with meals will act like your food, so it's fine to take the meds with it (since it doesn't dissolve in the stomach anyway.

Are you on rectal meds? If not..you should be.

When taking metamucil...I would suggest to not take the sugar-free. I find the capsules the best.

q
Posted 6/25/2011 3:58 PM (GMT 0)
So would it not matter because salicylate is not the active ingredient for UC?

I am not on rectal meds and my GI doesn't like them. Originally I had a lot of rectal inflamation, but my GI didn't know what he was doing as far as UC and then had to have surgery and was out for a month. So I was forced to switch GI while in a flare...

Now my rectum no longer feels inflamed so I didn't ask for any rectal meds. And only my right side feels inflamed. Also I am up often at night with a new baby.

I have horrible constipation. And the stool is very very compact.

Can I take Psyllium on and on, even though it says only take it for a week? Do I need to increase it slowly? And how much do you think I should take?
Posted 6/25/2011 5:57 PM (GMT 0)
Oh my, your GI doesn't like rectal meds???? Guess he's never had proc*** cuz I'll tell you when my proctitis acts up then corfifoam is my very best friend...I'm stunned that your GI of all people would be against rectal meds...it's like a hairdresser that refuses to use a curling iron/hair straightener on their clients (it's just weird).

Quincy has explained it well above...bottom line is, for IBDers it's not recommended we use aspirin, advil, aleve, ect as it can promote bleeding in the bowels and that's basically the bottom line...hope you find relief and I also use the cap form of fibre supplement. Keep in mind that it does take the body time to adjust to fibre supplements, excessive gas/bloating can often be part of the adjustment period but it is sooo worth it and it's key to stick with it indefinitely as my GI advised me a good 7-8 yrs ago now.

Good luck!
Posted 6/25/2011 7:10 PM (GMT 0)
woggin....it's explained pretty clearly, and you need to get on rectal meds.

Your rectum is inflamed and you need meds.

Metamucil, take it with food...it'll enhnace the fibre aspect of it....

Maybe get off the sulfasalazine and get on Asacol. It doesn't have the sulfa in it.

Get on rectal meds. If your doc doesn't like them, who cares...REQUEST THEM. I would suggest you get on the mesalamine retention enema. If you're in the US, it would be Rowasa. If you're not...it would be Salofalk or other depending on what country you reside.

Educate yourself further to formulate a question... doesn't make sense regarding salicylate being an aspect of UC.

q
Posted 6/25/2011 7:32 PM (GMT 0)
OK I was only worried about the sulpha interacting with the metamucil because I couldn't find info on why aspirin and metamucil can't go together. And by bleeding, I originally meant blood thinning. I know, not the same thing (except when flossing your teeth or having a baby). You answered my questions, thank you.

I will call my GI. I don't know why they don't like rectal meds. My new GI was recommend by a CCFA site and I have to drive an hour away. But he is better than the other GI who I got the feeling I was the first person with UC he had ever seen.

Post Edited (woggin) : 6/25/2011 1:49:16 PM (GMT-6)

Posted 6/25/2011 7:50 PM (GMT 0)
So when do you take your metamucil and which metamucil do you use?

You have no idea if your rectum is inflamed or not unless you've had visual inspection. Remember that constipation is a symptom of inflammation.

Inflammation happens in degrees and location changes...think of a thermometer. From the bottom is where it starts and where it ends. It's not all there and then vanishes like it's been faded out.
And while it's in process, your symptoms will vary.

Only makes sense to have rectal meds since that's where UC starts....and can remain limited there slowly simmering and never being treated. It will change the functioning of your bowe...so treating with rectal meds then tapering to mainenance is a good process.

How do you know your doc doesn't like rectal meds...how did that conversation go?

q
Posted 6/25/2011 8:56 PM (GMT 0)
Well, it isn't really accurate to say he doesn't like rectal meds. He said people don't like rectal meds so that he doesn't even prescribe them.
By the time I got into see him I was down to blood and mucus a few times in the morning and 3-4 times in the evening. And he said I wasn't having a flare because I didn't have D and I wasn't even on the standard dose of Sulphasazaline.

I was concerned because he said he wouldn't prescribe prednisone, since I am "not in a flare" (which I would rather not take anyway). But that narrows my options. I asked him what he would do if increasing the Sulphasazaline didn't work. Because I didn't want to waste time finding a new dr if I needed to. I want to be able to nurse my baby if it is possible.

The doc said he would add 6-mp or Imuran. I told him I do not want to add one of those. Doc said most people would rather add an immunosuppresent than take an enema. If I call and ask, I think he will prescribe an enema

I would rather not take a rectal med, but it is better than being full of sh** all the time. And it is better than taking 6mp or Imuran. I am not that bad off I should not have to go on those.

I have not taken Metamucil yet. I have a bunch of different samples a GI gave me a long time ago. wafers, capsules, powders and different brands.

Post Edited (woggin) : 6/25/2011 3:09:57 PM (GMT-6)

Posted 6/25/2011 9:15 PM (GMT 0)
Well, it sounds as though you're justifying things on a continuum...yes, no, but, whatever..etc.

You have decisions to make, look at it for a lifetime. and basically, your doc is a bu**shi**er.

You're flaring, plain and simple, and if you do make the perceived sacrificing decision of using the enemas, it's a commitment to use them until you're better and hopefully tapered to a maintenance. 

Remember some cannot use them...that would remain to be seen if you are OK with them regarding reactions, allergy, intolerance, etc..

So, make the decision because you want to in order to get better because it's the best decision to make to treat your disease.

Did I mention it's a lifetime? What you do now will influence what you do in the future.

But in saying all that...we all have waxed and waned and probably denied many times during the process of dealing with UC.

Sorry to be blunt...you see, I've been at this for a long time with absolutely undeniably good results with oral/rectal 5ASA. I had NO internet or accessibility to anyone else except my doctor and many outdated books in 1989.

I did the research, formulated good questions to get the answers I needed....oh, and I knew I had a good doctor with MY interests at heart...not his own.

Seeing that doctors are remiss in treating their patients with the basic meds that require commitment seems to be the way today. Patients want instant results with little commitment and the docs are more than happy to do the path of least resistance.

I, for one, see independence and power in knowing what to do for my self with my doctor's guidance and signature for consistent refills. If I didn't want to use those meds, however...he would definitely have me climb to the next level of meds. Of course, that would be after he picked himself up off of the floor in shock.

quincy

Posted 6/25/2011 10:15 PM (GMT 0)
So are there different dose amounts of Rowasa? What would be a flare amount? or a maintenance amount?
Posted 6/25/2011 10:52 PM (GMT 0)
Rowasa comes in 2g and 4g dosage. I would suggest the 4g. It's retention and used nightly until all is normal...then continued for another week...if all is good, then to every second night.

the 2g can be used for maintenance or for treatment if one is somewhat sensitive to 5ASA.

There's also a sulfa-free (metabisulfite as a preservative) one...I would assume special prescription is required.

My opinion, and as usual, it's a strong one...don't waste time using only suppositories.

Give youself at least 3 weeks to a month on nightly.

All of this suggestion is based on my own experience and the observance of others' experiences using the enemas.

This is only a generalisation, for if your butt isn't finished flaring (and some rectal inflammation can take a while or even never improve)..you'll require longer.

Keep us posted.
q
Posted 6/25/2011 11:08 PM (GMT 0)
What do you mean by this:

"don't waste time using only suppositories"
Posted 6/26/2011 1:28 AM (GMT 0)
Not enough medication for proper treatment....like using a bandaid for a broken finger.

This can be whether one has limited to rectum or not.

Again, my opinion from experience and observation.

The supps can be used for maintenance or support of the enemas or for tapering the enemas.

q
Posted 6/26/2011 3:47 AM (GMT 0)
OK I will look it up. I know zero about rectal meds.

Thanks for your help.
Posted 6/26/2011 7:54 AM (GMT 0)
welcome..

They'll soon be your new best friend.

keep us posted.
q

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