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meds to help with urgency?

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Ulcerative Colitis
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Posted 12/2/2014 3:08 PM (GMT 0)
hi all,

haven't posted in a while as i've been doing really well. right now just taking asacol (2 pills twice a day - although i am seeing shells on a daily basis so i wonder if this is even helping at this point) & psyllium husk powder with lunch & dinner to hold things together. i very rarely see blood - and when i do its usually because i've gone overboard on the cheese, so figuring its an allergy/sensitivity there.

however i do still have some issues with urgency. it tends to get worse if i am nervous, or forget the psyllium husk powder for a couple of days. i have a doctors appointment tomorrow, so i'm wondering if there is any sort of medication i could ask to be prescribed? just something to help out in those times where i'm nervous/traveling/etc & may not have quick access to a washroom?

i do take imodium in some of these situations, but it doesn't always help with the urgency issues. and sometimes it makes me pretty gassy!

any advice would be appreciated. thanks!!
Posted 12/2/2014 3:35 PM (GMT 0)
Urgency is generally due to rectal inflammation. Often, the oral mesalamine-based meds (like Asacol) don't do a great job at treating the rectum. I recommend you ask your doctor about mesalamine-based rectal meds. They come in both enema (Rowasa is brand name, but there are generic versions) and suppository (Canasa) forms.
Posted 12/2/2014 3:39 PM (GMT 0)
Pentasa and salafalk also good mesalmine based enemas.
Posted 12/2/2014 4:02 PM (GMT 0)
I second the rec to use melamine enemas (not suppositories). Really gets right to the area of urgency causing inflammation. I use generic Rowasa.
Posted 12/2/2014 4:20 PM (GMT 0)
Ditto rectal meds.
Posted 12/2/2014 4:41 PM (GMT 0)
you need to decide the route things are taking

stress--> greater rectal inflammation --> urgency

stress --> IBS/motility issues secondary to IBD --> urgency

in the former, rectal meds make most sense.

in the latter, something to reduce motility or something to reduce anxiety and stress-response - might even some behavioral stress management technique.

good luck
Posted 12/2/2014 4:57 PM (GMT 0)
Yep...salofalk retention enemas asap. Were you on any in the past?

Exactly what metamucil powder are you using? And how much.

You are obviously having a flare...be it ever so mild. But it sounds as though you're accepting some symptoms as function rather than dealing with them sooner.

the enemas will help get you back on track. If you aren't able to use the salofalk (retention, sensitivity), then a steroid foam can be an option.

just to throw in the question if the bleeding possibly happens around period time?

q
Posted 12/2/2014 9:38 PM (GMT 0)
i have used both mesalamine & steroidal enemas nightly for up to months at a time before...didn't seem to have much effect on urgency, but i will give them another go since so many people suggested it. things have stabilized more since then so maybe this time around will be different.

quincy...no, bleeding doesn't seem to come in relation to my period. the only time i definitely notice it is the 1 - 2 days after giving into temptation at an event of some sort & eating too much cheese. other than that i am blood free.
Posted 12/2/2014 9:41 PM (GMT 0)
i use the "now foods" brand of psyllium husk powder. 1 tablespoon before lunch & 1 tablespoon before dinner, mixed in a glass of water.
Posted 12/2/2014 9:54 PM (GMT 0)
Do any of your Asacol pills come through unused, or is it just empty shells? If some are unused you may seriously want to consider switching to a different oral asa.
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