Improvement at day 28 with nicotine patch

Here's an update at my attempt at steroid-free remission of an active UC flare (I'll link back later to earlier stuff on this, if that seems useful). At present I'll call it a partial success.

*note: this post is not about smoking. Its about using nicotine patches to reverse a UC flare, and I don't recommend that anyone resumes smoking. There are other ways to deliver nicotine without smoke (several posts on that elsewhere).*

I was in a major flare and had to go on a business trip (airplanes, long days, working dinners etc). I did not want steroids. Despite being a nonsmoker, I tried nicotine patches (there is some data indicating it works just as well) along with Rowasa, which I've been using for maintenance ~5 years. The flare was the kind that usually requires steroids (7-10 BM per day, mostly blood and water).

I stepped up the dose gradually: 3.5 mg 2 days, 7 mg 1 day, 14 mg 7 days. Now I'm on 21 mg/day.

Results: I saw immediate, but mild improvement on day 2. Decreased to 6-8 BM per day, still bloody. Day 4 was the start of the 3 day work trip, which I survived, though still had some pain about mid day (had to go 10 hours with no bathroom breaks). Got home and stepped up the dose to 21 mg. After about a week I could routinely work 8 hours with no breaks (2-3 BM per day).

Now its been 28 days. In the last two weeks the disease has been what I'd call mild (2 BM/d). In the AM the Rowasa comes out (after an overnight retention), sometimes its pink, followed by a formed stool and some loose stool. No BMs about 6-8 hours after that, then a formed stool at night. Still some blood, but no D.

Patch side effects:
1. The most annoying is it irritates the skin. Using Aloe Vera for that.
2. Vivid dreams - not sure this is a bad thing. I remember my dreams and they are more 'realistic' than usual.
3. When I put the patch on I get dizzy for about 20 minutes (so I do it at night when I'm sitting down). This is not a big deal but the first week it was important to step up the dose slowly.

Questions:
1. Has anyone else tried to gain remission with patches?
2. If it worked to gain remission (aka, a miracle), did you keep using it or taper off of it after remission?
3. Any ideas for the skin irritation besides Aloe Vera?

Ive always suspected that my dad's pack a day habit has kept him in remission. He has mentioned to me many times about trying the patch because i have asthma. Im open to it and will try anything. Its great you feel so good on it. There is a lot of info about it online. I read 15 mg is kind of the sweet spot.

I've been wondering if the patch would work instead of smoking so thank you for sharing your experience.

ICRed I was wondering how you're doing. My dr tday suggested that I try nicotine patches for a flare that won't quit. I thought he was off his rocker! But then I googled uc and nic and found lots of material suggesting it may just work.

I am a former smoker. Quit 19 years ago. Last summer I tried patches when I started a flare. Got crazy dreams and not sure if they did anything else because I was on colozal the entire time plus added generic rowasa, and 5asas worked for me in the past. I did have major withdrawal and will probably not try it again.

Are there any long term side effects to using the patch. Does HBP normally occur when taking it?

@indycat - Don't know if there are long term side effects. After 5 months I've not noticed any. I have read that nicotine can increase blood pressure, however mine is fine (possibly due to exercise and that I've been able to keep my bodyfat ratio out of the danger zone). I'm somewhat worried about the possibility of nicotine addiction, but so far I don't have any compulsion to use patches other than paranoia that the UC might return.

@rbatalo - I've never smoked, and don't intend to do so. There was published evidence that this works for nonsmokers so I tried the patches (see earlier posts for more details).

@wodin - The nonsmoking patients in the published reports apparently had a high rate of noncompliance due to the annoyances of the patches. This perhaps made the evidence for maintenance less strong, and as you indicated, perhaps few biomedical researchers would want to face the fire by claiming nicotine could be beneficial, for two reasons: 1) smoking is bad for you, and no one wants to encourage it 2) nicotine cannot be patented and sold as a UC remedy. Another thing is that clinical trials cost money the longer they run, and the trials were preset to run for a relatively short length of time. Planning a longer trial would be very expensive and it is unlikely that grant funds could be obtained for such a long trial, particularly if a number of patients drop out due to noncompliance.

My current opinion: I don't believe in miracle cures. I expect that nicotine has its place in inducing remission, and may even be useful during maintenance, but eventually one has to lower the dose so your receptors don't adapt. The drug probably works by triggering nicotine receptors, and they are likely to adjust their expression levels by feedback mechanisms to achieve a new baseline, rendering the drug ineffective over time.

Post Edited (IcRed) : 1/9/2014 10:36:06 PM (GMT-7)

for those of you that used/are using nicotine patches, does it help with the UC pain as well?

Could nicotine help someone who has never smoked before? I have a lot of intestinal/anal pain but never smoked cigs before. Wondering if nicotine could help me achieve remission. Thank you.

miserable, my GI never mentioned it either. at my apt a few days ago, i TOLD him that was what i was doing haha he knew all about it, too. sorry you never got a chance to try it. since your j pouch makes you miserable, do you think nicotine could help it now? why not give it a try?

Additionally, I feel for you. I'm in pain all day with my colon, but at least I have it, and perhaps surgery could relieve the pain for me one day. I'm sorry surgery hasn't worked for you thus far.

I started my first 14mg patch last night. Boy did I have vivid dreams! It was kind of a turbulent sleep, and I do feel sort of hung over today. Not too much pain today. Here's hoping!

Icred, do you sleep with the patch on?? Its almost 3 am and had to rip it off because im wide awake and could run a marathon with all the energy i have. Granted, my gut has been baby calm, whatever that means, all day and i even missed my saturday simponi shot. So i know its working amazingly!! Gonna call my gi for a prescription for patches in the morning. My dad gets 30 patches for 20 bux a month from his family doctor writing him a script.