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What medicin to request?

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Ulcerative Colitis
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Posted 1/27/2015 3:58 AM (GMT 0)
Doing this on my phone so I will keep it short and to the point. Diagnosed kind of 2 years ago after 10 month on and off symptoms. Colonoscopy showed very mild inflammation of the rectum. Told could do nothing take Canasa or pill. Took nothing and started to flare. Canasa nocked it down but came back when I stopped. Went on canasa full time started to flare a few months later after 6 weeks meslamine enema. This has kept me mostly in remission 15 months with enema at night and canasa in the morning. During this time I had thin stool and slight constipation. Flex sig in July came back clean. But no urgency or blood. 3 weeks ago I started have some looser stool and slight urgency little blood. Called gi and he told me to give it a week and see how it progresses. Stayed same and even seemed slightly better till today. Was ok in morning but this evening have gone 8times mostly just a little liquid. Going to call tomorrow.
1. Meslamine pill?
2. Steroid enema?
3. Both
4 have not been on any antibiotics since this all startedworth trying?

Thoughts
Thanks
Posted 1/27/2015 4:16 AM (GMT 0)
canasa is mesalamine -

you should be on both oral and rectal - are you ?
Posted 1/27/2015 4:28 AM (GMT 0)
Just rectal with canasa and enema. Was put on sulfasalazine when I requested it but did not react well.
Thx
Posted 1/27/2015 4:37 AM (GMT 0)
What country are you in? UC is a disease that almost never gets better by doing nothing. I question your doctor's knowledge when you start having symptoms and his game plan is to wait and see how it progresses.
Posted 1/27/2015 4:47 AM (GMT 0)
Colorado. I think there' was very little inflammation as I was not flaring when I had my colonoscopy. Just went for a 2nd opinion with similar results.
Posted 1/27/2015 2:27 PM (GMT 0)
Many people can't tolerate sulfasalazine. I think you should try adding an oral mesalamine, like Apriso, Lialda, or Asacol HD. Go ahead and stay on the mesalamine enemas and suppositories.
Posted 1/30/2015 11:37 PM (GMT 0)
So Doc today prescribed asacol HD. Of course much to my displeasure he did not order it till today so the pharmacy will not have it in till Monday. Staring on 1 pill for three days 2 pills for another 3 then 3 pills. Hoping this will be the answer for a long term remission. I would love to cut back on not having both canasa and rowasa daily too. I will keep you posted

Thanks
Deeppowder
Posted 1/31/2015 12:12 AM (GMT 0)
that dosing, at least to my little brain, seems a bit odd - don't recall ever seeing it prescribed that way -

normal dosage I believe is 4800 mg/day - most folks tolerate it very well -

i'm all for the less is better route, but this dosing seems light even to me -

your doc sounds kinda dopy rolleyes

hang in there dp !
Posted 1/31/2015 12:32 AM (GMT 0)
I think he wants to start it light just to make sure I have no adverse side effect. Seems to make sense. Is 2400mg not the correct dose?

Thanks

Mike
Posted 1/31/2015 12:45 AM (GMT 0)
well, as far as "correct" , i'm not sure what that would be - but 2400 seems reasonable given your symptoms -
Posted 1/31/2015 12:47 AM (GMT 0)
2400 is just a mtnc dose. Most docs start out at 4800 and if you go into remission they will cut it back to 2400.
Posted 1/31/2015 12:51 AM (GMT 0)
Good to know. Symptoms are not too horrible and hopefully with the canasa and rowasa I will be back to 100 percent.
Posted 2/12/2015 1:46 AM (GMT 0)
So little update and questions
So Im on day 4 of 3 800mg pills a day. Symptoms do not seem better(slightly worse). Still have some liquid in the morning then semiformed after that then a little liquid. Little blood every couple of days. Just wondering how long it took for most people to start to feel any effects on asacol or those type of drugs? I know this is a low dose but hopefully it helps.

Also if thing do not improve I going to switch GI. I did get a 2nd opinion but im wondering if I should try to see someone in a top notch program. Im live far from everywhere but would look at Denver GI, Phoinix or Salt lake city. Any suggestions?

Thx
Posted 2/12/2015 1:59 AM (GMT 0)
For what it's worth, a GI once told me that the oral meds can take about three weeks before they start on a flare, this why I was sent home with asacol plus enemas plus suppositories.

I'm concerned by your doctors "wait and see" theory. In contrast, I was just in to see my GI for regularly scheduled appointment and I mentioned the last couple weeks I am slightly flaring, 3xday diarrhea, no blood (I would say most likely LESS severe than the state you are in) and he told me to max out my oral meds and do enema nightly to "snuff it out before it gets worse"

I believe:
Max dose as asacol is 4.8/day
Max dose of pentasa is 4g/day
Posted 2/12/2015 2:21 AM (GMT 0)
I agree as well; not a good idea to wait and see. My first GI doc had similar conservative treatment ideas and I did not do well.
Posted 2/12/2015 4:12 AM (GMT 0)
I know. Not sure what to do. I did get a 2nd opinion a couple of weeks ago but he was not great either. I get the feeling that my doctor does not believe my symptoms are that bad. Its hard because the nearest major city from me is 7 hours and my GI doc is 2 hours away(the 2nd doc I saw is 3 hours). I guess I should give it at least another week and see. Might have to bite the bullet and try to find a doc in a major city.
Thx
Posted 2/12/2015 6:01 AM (GMT 0)
See if you can get a phone consult from an IBD expert since you are so far away from a major city. He/she could give you an idea of how they might manage you before making the drive.
Posted 2/12/2015 12:59 PM (GMT 0)
I just want to add do not let them under medicate you and let it get worse, it's harder to tame. It can't hurt you to up the meds to the amt suggested here and then see how it goes. But double check. Good luck
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