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Lialda causing gas and not working, what is my next step

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Ulcerative Colitis
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Posted 9/15/2015 7:55 PM (GMT 0)
Hello all :) first time posting, long time lurking here. Great community for people with uc! I was diagnosed with uc 3 years ago, left sided and I think 20 something cm of inflammation. I was put on Asacol which did nothing for me but I was able to get over the flare up with just using glutamine. Amazing for me back then. Now I'm on a flare up that just won't go away. It's been around 4 months of fighting this flare and it's draining! I was put on lialda 8 weeks ago and it has helped but I feel I will never get remission from this drug because I still have small amounts of blood and lots of gas. Two weeks ago my doctor wanted me to start prednisone but I was too nervous to start but I regret that now. It seems like mesalamines are not the answer to remission, so what is my next step?

I have read a lot on enigmas and they seem to work wonders for some and I would be willing to give them a try but my doctor was hesitant on those for some reason.

Oh! Also, my diet is very restricted, very little to no sugar, no milk, gluten, caffeine, or alcohol. I do eat corn where as most avoid that.
Posted 9/15/2015 8:40 PM (GMT 0)
Actually! Writing this up I realised that the corn is what is causing the gas, at least most of it. However I still think the corn isn't holding me back from remission but I could be wrong.
Posted 9/15/2015 10:07 PM (GMT 0)
I would ask for some rectal meds either Rowasa enemas or Canasa suppositories. I would do those before resorting to prednisone.
Posted 9/15/2015 10:29 PM (GMT 0)
What is the difference between those two medications?
Posted 9/16/2015 1:01 AM (GMT 0)
They are the exact same medicine but one is an enema which will reach farther up while the other is a suppository, which will only reach the most bottom part. When your colon is really inflamed the mesalamines are often not enough to get you to remission. That is why prednisone is often prescribed. The prednisone should work very well at helping to heal your colon. It cannot be taken long term though so once you get to remission the pred is tapered back and hopefully the mesalamines are good enough to keep you there once you are already there. If you really want to knock this flare in the butt I would take a short course of prednisone, oral mesalamines, and both enemas and suppositories. If that doesn't do the trick then it really is up the med ladder.
Posted 9/16/2015 3:35 AM (GMT 0)
That's a lot of medication at one time! I'm still debating on what to do but I've been in this flare for so long now that steroids seem much more appealing. Thank you for the replies
Posted 9/16/2015 4:25 AM (GMT 0)
I would add the enemas and prednisone as soon as possible. Are you on the full dose of Lialda? I honestly have no idea what that is since I stopped taking it in 2011- it did nothing. I was in your shoes and my disease quickly spread. From January to August, it went from left sided UC to pancolitis. I ended up on IV prednisone, cipro, flagyl, Canasa, zofran, Prilosec, IV iron, 6mp and remicade during my August hospital stay. 130-90 lbs. please don't let it get out of control!
Posted 9/16/2015 6:20 AM (GMT 0)
Wow. I say it every time but I find it so incredible that doctors will move on to harsher stuff (in this case prednisone) without even trying mesalamine enemas.

I suggest you need to study up on UC because it sounds like you might not even understand what asacol and lialda are. Asacol/lialda/rowasa are the same thing: mesalamine, the primary drug of choice for UC. Asacol/lialda are oral mesalamine pills, while rowasa is rectal mesalamine enema. Both drugs are trying to topically treat the end of the colon.

By taking mesalamine in enema form, you are directly squirting the medication right where it needs to go. With pills, even though they are designed with a special coating to dissolve in the colon, you are still crossing your fingers hoping they survive the entire digestive tract but then dissolve right at the end. Which do you think sounds more effective?

I agree with others here, you really need to try rowasa (mesalamine enema). If you've had UC for 3 years without mesalamine working, and you've been actively flaring for 4 months, then it's probably also a good idea to try a steroid enema at the same time. Again, same story: the enema will put the medicine right where it needs to go. As a bonus, a steroid enema will have fewer side effects than systemic oral prednisone. As far as oral mesalamine goes, I'll just give you my story: lialda never worked for me, rowasa worked instantly and completely, so I was able to fully stop lialda without a problem.
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