What my GI said, very rude and I'm upset

I told my GI I stopped Lialda (still taking uceris)because I know that and all 5 asa make me have urgent poop (always always always in the car) I know this because I have stopped and started the medications before and I never have accidents if I don't take the 5 asa, maybe something in the coating of the medication?? I don't know.

Anyways, I asked for Steriod Enemas and he said no, he doesn't believe they will help they only are topical and wouldn't help that I'm to increase canasa to two a day and take 4 Lialda at bedtime instead of the morning. He said sit on the toilet until I go after every meal. Well I can't poop on command!! LOL

He said I can be on uceris for months and months he has no problem with that.

Do I start taking Lialda at night? Maybe I will try it?

He said If I don't listen and do what he says, I might as well find another GI. He has been nice up until now. I wanted Steriod Enemas, he said if cansasa at two a day doesn't work, then we can try the steriod enemas in a month. I've never had remission. My blood isn't horrible he said, the c reactive protein was really really GOOD! Normal.

Just thought I would share and vent. Thanks!

In his defence, I would be pretty pissed off if every day I heard so many of my patients not taking their meds as directed : p

Not sure what the issue with the enema steroids only being topical is...5-ASAs are only topical and in UC it is only the mucosa that is inflamed...kinda suspect

I don't like the sound of him at all...how awful for you! I would definitely start looking for another GI, just in case things become worse between you, which seems likely as he is not a doc that listens.

kazbern

I wasn't suggesting long-term steroid enema use but since they have fewer side effects than oral steroids and the OP thinks she has melamine sensitivity shouldn't she be allowed to try them to get over the hump into remission?

Uceris is pretty much topical. Canasa is pretty much topical. Lialda is pretty much topical. His reasoning there doesn't really make any sense unless he has different reasoning that he just didn't tell you. If you are having trouble taking 4 Lialda in the morning I don't see where taking 4 Lialda at bedtime is going to be much different. I will say that when I first switched to Lialda, taking all four at once made me worse but when I switched to taking 2 in the morning and 2 at bedtime, I got much better. I can empathize with a doctor having a hard time treating a patient because of the patient's noncompliance to their treatment plan but maybe this doctor went too far.

your doc sounds like a dickhead - and not a very smart one either -

you know I havent liked that idiot since day one.

therearemiracles said...

He said If I don't listen and do what he says, I might as well find another GI.

I dumped mine and the new one ? Yeah she told me the same thing - go see another doctor if you wont go on biologics or have surgery.

Why ? Because thats how they make money not writing scripts for 5-ASAs and enemas.

Why ? Because every day more people have this disease and they dont need 'fussy' patients who think for themselves.

That's frustrating that he's not willing to work with you or listen to you. If lialda makes you worse, you should be trying other routes. Have you tried colazal? I don't see the harm in giving you steroid enemas. I used them for a while and they didn't help much even though the majority of my inflammation was on the lower parts. I was surprised. I thought it was going to help a lot... It is worth a try though. You should see a different gi, this one doesn't sound very reasonable. Are you inflamed in the rectum? That's really the only place Canasa will help, otherwise you need something with more volume.

This is the information I found online concerning the treatment plan you are on.
While the benefits of mesalamine can be seen within 3 to 21 days of starting therapy, it may take up to three to six weeks for the enemas and suppositories, six weeks for the tablets, and eight weeks for the capsules to have maximum effect.

Maybe you need to be more patient with your plan? I am on lialda and it worked rather quickly for me less than a week I saw improvement with bowel movements when first diagnosed. I just had a very serious flare that ended me in the hospital and now I am on 4 Lialda and Uceris. So far I still have some diarrhea not very urgent like you though.

I must agree it was a little rude what he said to you but as some other mentioned stopping and starting your medication without consulting him first must be frustrating to him. It can also take a toll on your UC. At least that is what I have read in all the UC informational packets online and got from different offices.