Need help figuring out next step

Hello,

So i was diagnosed with UC (pancolitis), over 3 months ago, and so far my only medication has been Asocal HD 800mg 2pills 3x daily. I tried prednisone but got very sick and doctor took me off it. Anyways its been over 3 months and my symptoms have improved minimally, i still have blood, mucous, and urgency. Last time i met with my GI, a few weeks ago he said just keep doing what your doing stay on the Asocal. I meet with him again this week and really want to try something different or add something to my Asacol. I've read on many posts that most people take some sort of enema or suppository and have very good success, but since my colitis is throughout my entire colon will these have any effect? Is this a normal next step from starting just oral meds, or do you think my dr. is going to want to put me on one of those immunosuppers that i dont really wanna try yet?

22/male
dx pancolitis
asacol hd 2@3xdaily
probiotics, iron, slippery elm, vitamin C 1000mg
eating healthy avoiding sugar and dairy

I too had pancolitis. In my case confirmed by scoping, Lialda (a 5-asa similar to Assacol) cleared my right and transverse colon over 18mo, but my symptoms actually got a bit worse because my sigmoid colon and rectum got more inflamed. There was an abrupt transition near the top of my left colon between the section Lialda had cleared and the parts Lialda did not seem to be effective. Since asa's are topical and everything eventually exits the rectum, I figured things were moving too fast in the left/sigmoid colon for the asa to do much good.

The I used a rotation of hydrocortisone and Rowasa enemas and they helped a lot with the urgency and discomfort and accidents. I think that when I am scoped again the line (I think of it as the oral 5-asa front) will be much further down my left colon, and below the line will look a lot better due to the rectal meds.

thanks, kazbern some sort or rectal med is what i was kinda leaning towards even though i've heard there not that pleasant to take, i really don't wanna start taking immunosuppers though. Is the rectal mesalamine the most effective, and is there any major side effects from them?


22male
dx pancolitis
asacol HD 2@3xdaily
probiotics, iron, slippery elm, vitamin c 1000mg
eating healthy avoid sugar and dairy

Having read a lot of literature lately on the immusupressive drugs, if I was in my first year after diagnosis and issues and no results from Prednisone I would not hesitate to try them. The more reading I am doing the more comfortable I feel about the safety of these drugs and most importantly i'm seeing recurring comments from doctors and researchers that it may be more beneficial to get on the immunosuppressive drugs earlier as they could potentially alter your disease progression early on, for the better. And the earlier you get on these the better apparently. I just started Imuran 2 weeks ago, 7 years into my diagnosis, I doubt I will get much by way of disease progression altering but i'm hoping this buys me years of remission at the very least. Hope that helps a bit.

Thanks everyone for the input, i am going to see if my doctor will start me on the mesalamine enema to get this better under control. One more question though, how long does it usually take to see results from enemas?

kloe0038 thanks for the help thats exactly what i was thinking, i've been on asacol for 3 months now with little improvement and last time i saw him he told me it just takes time too see results so just stay on my normal dose. I see him again this week and i am really going to push for him to try another treatment, which will hopefully be some sort of enema because i dont feel like i need to start any of the immunosupprers yet.

Post Edited (moose2012) : 7/9/2012 9:08:28 PM (GMT-6)