Balsalazide for proctitis

The max dose of Lialda is 4 tablets/day. When you started flaring they should have increased your dose instead of taking you off. You can be on max dose indefinitely or you can taper down to 2 tablets/day as a maintenance dose.

Sounds to me like your doc didn't say you couldn't be on rectal meds long term -- just that you didn't have to be. My recommendation is to ask for 4g mesalamine enemas and use them daily until you are in a good solid remission an then you could slowly taper to less frequent use. At the SAME time you should also be on max dose of oral meds. If you were on Lialda for 2 months before you started flaring it sounds like you could go back on that at the MAX dose. Or you could give the basalazide a try. Either way, stay on the pills even in remission.

Don't ask ... TELL your doc what you would like to do before they bump you to more powerful drugs. Not saying you won't need more powerful meds in the future, but it doesn't sound like you have fully explored the first level of treatment (mesalamine meds).

If you have a lot of diarrhea Uceris may not work. It's designed to release the med in the colon, but with D things are moving too fast for it to fully dissolve. Same can be true for Lialda. That's why you also need the enemas. Canasa only reaches the rectum. Your inflammation is higher so that's why you need the enemas.

Basalazide has a different release mechanism and I don't know much about it, but it may actually be a better option for you if you have a lot of D. Max dose is 3 capsules 3X/day.

Yes...what everyone else said!

q

Again....remember that most often the enemas are tapered to a maintenance dosage and increased when flaring. I've done it for 28 years, so you need to be firm on what yiu want. Give it a year. Make sure yiur prescription reads at night without a limit of time. And get refills and an appointment to see the doc in a month.

This is a treatment that's been around for a looooooooong time. She has no reason to limit your possible success with it.

Remember....tell her you want to do it...don't ask if you should.

q

Good luck, you've gotten some good advice. I'd gice the mesalamines 3 or so weeks and if they aren't making a big difference then they probably won't. Some of us have more severe cases of UC that require the stronger meds like imuran. I wishbthe mesalamines were everyone's solution but unfortunately they're not. Look for results!

Your doctor has NOT allowed you time to even let the meds do their thing. Again....you have been undermedicated rectally. Take that information and give them a fair chance.

q

I have been using Balsalazide for my proctitis for well over a decade now. Combined with Imuran, that combination has kept me almost symptom-free, except for the once a year or so flare ups (usually associated with high stress). Originally diagnosed in 1988, I used Asacol and sometimes prednisone to battle the condition. Asacol alone did not keep my symptoms in check, and I did not want to take prednisone any longer, so my doctor changed my treatment to Balsalazide and Imuran. Imuran, typically used as an anti-rejection drug for transplant patients, for example, works very well. It tricks the colon into accepting much of what travels through it, rather than reacting and flaring every time you eat something. This has worked for me very well.