My instincts told me for years that it would be a combination of medications, and not individual ingredients, that would do the trick. I should have listened much sooner!
I have been using a combination retention enema of mesalamine, NAC, Budesonide, and Lecithin.
Mesalamine - 1.2 grams (equivalent to one ground up Lialda)
N-Acetyl Cysteine (Sprouts, house brand)- 600 mg.
Entocort EC (Budesonide) 3mg (ground to a fine powder)
Lecithin Liquid (Fearn or NOW) - 40 ml
SUCCESS! I had been on prednisone for months prior to beginning the therapy, and was able to wean off after a time using this combination. Now, I'm about
4 weeks in, and I have experienced tremendous improvement.
UPDATE 4/13/14 - Using the combination in a maintenance dose every other day, or every third day.
I learned of this after being invited to join the clinical trial in my area, but could not participate due to my prednisone use at that time (I was in a terrible, long term flare-up).
There are a few papers out there which describe the use of 5-ASA and NAC in combination that describe the power of using the two together, and their supposed action in the colon. I want to note that I did NOT receive any benefit from taking NAC orally.
The additional ingredients, Lecithin and Budesonide, are used for their own benefits. In German studies by Stremmel, et. al., phosphatidyl choline from lecithin is vital to intestinal health.
Problem. Liquid lecithin is about
the consistency of molasses. It is VERY hard to push through a syringe. I had to take a drill to the tip of the syringe and bore out the nozzle to make it manageable for myself, but many will not be able to do it. There is probably a better way, perhaps someone will make a suggestion. I do use a 60ml oral syringe (Baxa) with a rectal applicator tip. I do it at night before bed and hold it as long as I can.
I mix everything in the syringe prior to application. I begin by pouring 20ml of Lecithin into the base of the syringe (with the nozzle plugged to prevent escape). Then I add the mesalamine powder, Budesonide powder and NAC. Then top it off with another 20ml of lecithin. Then I use a plastic chopstick to mix the ingredients, scraping what sticks to the chopstick into the syringe after mixing. Putting the plunger back into the syringe without pushing out the mix is a bit of an acrobatic act, but it can be done. Then I clear the air from the syringe, let the ingredients sit for about
an hour, then instill it rectally before bed. I have occasionally had my body reject it, but most nights I have no problem. Personally, I have found that the faster I push any medication rectally, the better the chance that I will expel it. Since this mix is so thick, it is very hard to push quickly.
Three days in, I began to see improvement. A week in, most bleeding had stopped. At this point, I see no blood at all and I am having normal, regular stools. Now I am working on how long I should do it nightly, before moving to some sort of maintenance dose. (4/13/14 - Now on a maintenance dose every other day or every third day)
I have tried everything, been in clinical trials, and have read of your (dear readers) successes and failures. Pretty much everything I have tried has been effective for awhile and then lost effectiveness. This might be the same way. But right now I feel different than I have while on other therapies. More normal, if that makes sense. We will see how it all works out. I hope someone else might benefit from this information. Good luck.
ADDENDUM: You might note that I am using a dose that is reduced from what is contained in the pharmaceutical product and used in the clinical trial. What I have been doing is HALF the pharmaceutical dose. Even still, I have had a superb outcome. There should be nothing that stops anyone from trying the full 4:1 ratio that is in the actual product.
Post Edited (UCBob) : 4/13/2014 9:56:55 AM (GMT-6)