Does anyone feel Asacol HD doesn't work as well as original Asacol

Are you using rectal mesalamines at all in conjunction with the Asacol HD?

How are you taking the HD compared to the regular? With the regular you took it several times per day. Do you still do that with the HD or do you take it all at once? I believe I remember reading back when that two 400mg Asacol pills did not equal one 800mg HD. Don't remember what the difference was though.

Ditto that you should try the other ASA's and that you should add in mesalamine enemas.

Like I said in your other thread, it's true that the enemas only reach part of the colon, but they generally do a better job at treating that part of the colon than oral meds do. My first GI once said it's a shame that it'd be impossible to retain an enema that's a big enough volume that it would treat the entire colon because of how effective it would be.

Also, just because you were diagnosed with pancolitis doesn't mean that subsequent flares will always involve the entire colon. I recently had a very mild flare, and I'm sure that I did not have inflammation throughout my colon, because my symptoms were so mild. It sounds like it's possible you don't have inflammation throughout, as your symptoms seem quite mild at the time.

Most studies with mesalamine enemas have been done with left sided and distal colitis, but I did find one study that looked at using enemas in conjunction with oral meds in patients with pancolitis, and patients who used both reached remission more quickly than those who only used oral meds.

I feel that a lot of my problems began after asacol was no longer available. We tried a few different meds, and eventually were on Asacol HD--two pills 3 times a day. I can't help but think that it's not as effective.