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Need help controlling UC, Diet and Medication options?

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Ulcerative Colitis
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Posted 3/21/2014 5:40 PM (GMT 0)
 

I am having trouble taking the mesalamine family of drugs.  (tried Liada and Apriso) Both increased my blood preasure and heart rate signifigantly.

I had been taking Prednisone 20mg a day and trying to taper.

I have beend on the most strict Paleo diet the last 4 weeks and have lost almost 20lbs and my stool has been normal for a couple of weeks.  I started to taper the Prednisone by 5mg a week and this week I am down to 10mg a day.

Now for the past 2 days it seems my UC symtoms are coming back as a flare and I already have blood again.

The doctor only recommended Imuran but after reading about it I don't want to take it.

I really thought this modified strict diet would help but now I'm at a loss.Thinking about switching GI doctors to get a second opinion but this might take weeks.

Should I step my Prednisone back up to 20mg a day to keep in remission?

Can I control this disease with Diet or am I fooling myself?

 

Posted 3/21/2014 5:48 PM (GMT 0)
Some can control it by diet but most are fooling themselves. Many who have success with diet also take meds too. You can increase the pred back up to get back to where you were but unless you have a good maintenance plan that works you're in trouble because the pred will not put you into remission when tapered off and you can't take it for too long or it will mess up your entire body. You have to get off it at some point.
Posted 3/21/2014 5:48 PM (GMT 0)
I think it is the pred that is causing the BP and heart rate issues. The stress of illness can cause both those problems too. Somebody else would know better if you should up the dose. I would ask the doctor.

I would ask the doctor about high dosage oral mesalimine and also using mesalamine enemas. You can give it a try and hope the safer drugs work
Posted 3/21/2014 5:50 PM (GMT 0)
I also wonder if it is the pred doing things with your blood pressure and heart rate. Pred does that and that is not normally associated with the mesalamines.
Posted 3/21/2014 6:25 PM (GMT 0)
"Some can control it by diet but most are fooling themselves"


for myself and others out there, would you mind explaining that statement -
Posted 3/21/2014 6:27 PM (GMT 0)
I have Apriso and Lialda at home.

Is Lialda the more prefered mesalamine?  I think the Apriso was much cheaper but I want what works best.

Should I ask for Ascol HD?

I am willing to give the mesalamine another shot but the blood preasure and rapid heart beat scared the heck out of me.  I have been on the pred by itself for 3 weeks with no issues.  Only having the UC symptoms now that I am trying to taper.

What is considered long term Prednisone use?

Thanks for everyones help1

Posted 3/21/2014 6:46 PM (GMT 0)
The mesalamines are pretty much all the same IMHO but I do know that Asacol HD is labeled for high dose (4.8gr) so the doctor might be more likely to write a scrip on request. I am pretty convinced that mesalamines are really safe even compared to OTC drugs. Most other UC drugs are kind of scary. Pred has far more negatives and hypertension is a listed common side effect.
Posted 3/21/2014 6:55 PM (GMT 0)

AZYooper said...
I would ask the doctor about high dosage oral mesalimine and also using mesalamine enemas. You can give it a try and hope the safer drugs work

I agree. I am also a firm believer in diet modification but sometimes that isn't enough. I am allergic to the mild maintenance meds so I supplement my diet with supplements such as Probiotics, vitamin D, and psyllium seed, etc.

Even though you are having trouble with Lialda and Apriso, you might be able to try mesalamine enemas used as needed since they work locally and are not systematic.
Posted 3/21/2014 7:01 PM (GMT 0)
I'd be more afraid of Prednisone then I would be of Imuran. Predisone has immediate side effects and over the long term it can give one osteoporosis, glaucoma, diabetes, and lots of other nasties. Whether or not you need Imuran is another thing entirely, that is between you and your GI to decide.

You need to weigh the risk verses the benefit when considering any new treatment for uc. Imuran/6mp/Aza have helped a lot of people into remission and improved their quality of life. Imuran has very statically low odds of side effects. The one side effect that worries people the most about Imuran is the odds of getting lymphoma. The odds are 4 in 10,000 (or 0.004%) not exactly something I'd loose sleep over. I recommend you read "Balancing the Risks and Benefits of Treatment For Inflammatory Bowel Diseases" by the Crohn's and Colitis Foundation of America:

http://www.ccfa.org/assets/pdfs/risk-and-benefits-transcript.pdf
Posted 3/22/2014 11:27 AM (GMT 0)
"Some can control it by diet but most are fooling themselves"


for myself and others out there, would you mind explaining that statement -



anyone wanna take a shot ?
Posted 3/22/2014 7:24 PM (GMT 0)
It takes incredible discipline and adjustment to your social life to maintain the kind of diet that will actually help.

For example, I think that the best hope is to never eat anything non-organic or processed. I have a friend who does that for her sickly children and brought them back to health. But it is very very hard to do and have a life too!
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