Newly Diagnosed

Welcome to the forum but sorry you have bowel troubles like the rest of us do.

First things first, internal healing takes months assuming your doctor got your medication right the first time. Treating UC involves a great deal of trial and error, no solution works for everyone universally. Prednisone quickly makes us feel better, but it's only a temporary rescue med used while our other medications are given time to work. Sometimes our symptoms get worse as we taper pred down to low doses. Then additional meds must be added.

Blood can be the very last symptom to go away for some people. No knowing when, but like i said fully healing (that is remission) can take months.

You should be on an oral mesalamine pill, like apriso, lialda, or delzicol in addition to your current treatments. It's the same active ingredient as your rowasa.

Mild cases can spread and get more severe. Don't take them lightly. It also really depends on how well you respond to treatments. Some of us have mild, well mannered cases, others have difficult cases, and some of us find surgery fast. No knowing what cards you're dealt. Hope for the best.

For most of my 17 year battle with UC, I was always considered a "mild" case. The basic meds always kept me under control. I now have no colon due to all meds failing me over the last few years and my quality of life being reduced to nothing. Try and find a med treatment that works and stick with it. It's very hard to get a flare under control once it starts. Prednisone is a horrible drug but sadly it works for most but isn't meant to be a long term treatment, the side effects are terrible. Everyone will be different, it's a matter of finding what your body responds to and works well for you. There is a lot of trial and error. The best advice I can give is find a GI who will take the time and work with you and not rush you out of the office. I had mine for 17 years and he bent over backwards to help me and I couldn't be more grateful

Prednisone can stop symptoms often within a couple days but you still have to heal which is a slow process. Prednisone essentially masks your injury (kind of like adrenaline lets you run away despite a big injury), your body produces cortisol (prednisone is synthetic cortisol) and adrenaline in response to injury.

The rowasa should make the biggest difference within 3 weeks.

Lialda is a big horse sized pill, difficult if you have issues swallowing. Delzicol comes in a capsule that can be openned with smaller pills inside that are easier to swallow. Colazal comes in openable capsules, that you can sprinkle over apple sauce or yogurt and then eat.

Hi....welcome to the forum! I would suggest you find out other options regarding oral mesalamine and get on it asap. The possibilities could be pentasa capsules which can be opened and the spheres swallowed (although not chewed).
I think there's an asacol HD in the US, but not sure.

I would also caution you to not overtrain while flaring.....while exercise is good, for some it can trigger the immune system into high gear and the autoimmune reaction will follow.

Please keep us updated.

q

soynomore said...

KevinCC said...
I was initially prescribed Lialda as well, but I have extreme difficulty (esophageal stricture) swallowing large pills. I plan on speaking with my GI about alternatives.

just curious - could you expand on this a bit - how long, past and current treatments, etc. ?

I have a hiatal hernia which causes part of my stomach to creep up into the esophagus. I have difficulty swallowing certain foods and pills.

The esophagus can be stretched with a balloon-like device, but there is a (very) small risk of rupture. My current GI has advised me to get this done.

I just spoke to the nurse at the GI's office. It turns out that I WAS supposed to be on an oral Mesalamine as well; apparently there was confusion on the pharmacy's end. I asked her about some of the options you all just shared with me. She said she would check with the pharmacist about this as well.

Thank you all so much! I just joined the forum this morning, and you've already been of great help!

Post Edited (KevinCC) : 2/13/2017 12:43:32 PM (GMT-7)

Breaking up lialda is wasting medication and asking for an upset stomach. The delayed release coating must not be broken to get the medication to your large intestine.

We do get posters once a month who have trouble swallowing large pills, it's not incredibly rare or anything. Always check with your doctor or pharmacist but this is my understanding.

Mesalamine-based medications have a red/orange delayed release coating, like your lialda. That coating cannot be broken. It is a PH based formula that releases once the large intestine is reached. The instructions say to throw away broken or damaged pills as they cause stomach upset when damaged.

Delzicol comes in a large clear capsule, and inside are smaller red/orange pills. The clear capule can be opened and really serves no purpose.

Pentasa granules are available in some countries, open a packet and swallow the red/orange small grains. Pentasa capsules can be opened and contain orange/red grains.
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Colazal comes in a colored capsule that can be opened. The directions say that it can be sprinkled over yogurt or apple sauce and eaten.

Sulfasalazine can be crushed. They aren't mesalamine, but rather a more complex molecule that your gut bacteria cleave into mesalamine and a byproduct once it arrives within the large intestine.

Dipentum® (generic Olsalazine) should be the same process as Sulfasalazine.

Breaking lialda up is a real, real bad idea. It will be systematically absorbed within the stomach and small intestine and go straight to the liver. If you don't throw up due to nausea then it greatly increases your risk of side effects. The half life of 5ASA is 7 hours, digestive transit times 24+ hours, so that mesalamine would never reach the large intestine in a usable state (anything that isn't sent to the liver). I saw some poison control entries on this...

"5-ASAs (5-aminosalicylic acids) are a group of medicines commonly used to treat inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis. They require specific coatings to reach precise affected locations in the GI tract for direct application to the intestinal mucosa. Otherwise, they are absorbed by the body overall, potentially resulting in an increased incidence of adverse drug reactions"

Absolutely do not....NOT break the Lialda. I made the suggestion for Pentasa capsules for a reason, and YES....they can be taken apart and the spheres swallowed. Take them in something that can be easily swallowed such as yogurt or apple sauce or whatever you like that you don't chew.

keep us posted.

q

Just checked.....apparently no. You need the capsule to get past the stomach.

q

Good to hear you have an option. Didnt realise delzicol was in capsule form with spheres that could be taken alone. Good to know. Yes, the Pentasa oral would cover the colon, but probably not so good to trust it for rectum. None will. Hence the suggestions for rectal meds.
It's another possibility should you have to revisit the oral meds.

Keep us posted how the Delzicol works for you.

q.