Newby to the forum - Need some encouragement

I am a 44 year old male who is now experiencing a rather severe flare up of UC.
My 1st bout was a brief episode at age 20, 2nd bout age 30, 3rd bout age 40.
Had another round 2 years ago....Had a colonoscopy and was told I have UC
MD prescribed Asocol but I never took it it

about 3 weeks ago I started experiencing a flare-up and starting taking Asocol and hydrocortisone (sp?) enemas - Unfortunately the symptoms have not improved. Switched to ROWASA enema last night and had a HORRIBLE night sleep with gas, urgency all night long, and this AM I had more blood than ever before....

I am thinking of going back to the Hydrocortisone enemas as they seemed to help with the urgency and I could sleep a little better...
I also discovered that the Asocol Rx was from 2 years ago. Is it possible the efficacy of the medication is no longer valid?

I'm getting very discouraged - All 4 past episodes were resolved quickly (within a week) by using enemas but this one doesn't seem to want to go away.

Is it possible the efficacy of the medication is no longer valid?

Yes that is possible. The coating is formulated to dissolve in a certain area of your gut, that that could be one reason for failure. And of course the meds could have lost potency. My opinion: you should get a fresh Asacol Rx and give it another try because if it worked for you in the past you would be giving up one of the safer long term meds by going with something else instead.

I speak as someone who Asacol did not help but wish that it had. Once you determine that Asacol is or is not helping then you can discuss alternatives with your GI. That's too bad about the Rowasa enemas(I assume they were fresh, if not try fresh ones).

The lesson you are learning is that you need to keep up with maintenance meds, especially since they worked for you, to avoid stronger meds in the future.

Good luck.

Hello & welcome. You have a lot of options worth trying. There are other medications similar to Asacol that may be more effective for you. Speak to your GI about trying different formulations of mesalamine, you can a lso try Canasa if you're not doing well with Rowasa. It is the same drug but in a suppository. Many of us use Canasa in the monrning and hydrocortisone enema or foam in the evening when we are flaring. You really should stay on Asacol (or whatever works for you), even when you're in remission. It can help to keep you in remission. I hope you're feeling better by the holidays.

I am very physically active (high intensity interval training ala "Insanity" and P90X typically 4-5 times per week
Since my flare-up last week I've backed off as I'm afraid the intense physical activity is making it worse?
Diet-wise I eat fairly well - In the past 3 weeks I had been eating a breakfast of steel-cut oatmeal - I cut back as I was somehow thinking the fiber would make it worse?
THoughts?

optimist12,

You might want to cut out the steel cut oats until things calm down,  oats make my symtoms much worse.

As for fibre you do need fibre but not from high fibre foods they tend to make most of us more gassy and worse during a flare.

Metamucil is the kind of fibre you should be taking daily with water.  I take it at bedtime just in case it causes gas. 

I work out daily, I find it helps me.  But when flaring I do try to rest when possible and not do as intense of a workout.

I prefer the Hydrocortisone enemas over the mesalamine, they tend to work quicker to decrease the inflammation and help the urgency.  When you are inserting it squeeze the medicine in and slowly pull it out but continue sqeezing the medicine.  This way it coats right to the end of the rectum, which is the hardest to heal.

Are you taking probiotics daily?