HealingWell
Search Close Search
☰

Left sided colitis - looking for advice on mesalazine

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 3/21/2017 9:41 PM (GMT 0)
I have UC up to the splenic flexure diagnosed recently via colonoscopy. The Doctor wanted to start me on oral mesalazine the same day but when I explained the reaction I had to the mesalazine enema (diarrhea worsened and severe abdominal pain) he said I might not tolerate the oral mesalazine either. I am still waiting for my follow up appointment with a GI Consultant to start a proper treatment plan and my GP is concerned about the length of time this is taking. I have been taking predsol enemas for several weeks and recently the Dr who did my colonoscopy switched me to the budesonide enemas which I've had some difficulty with.

In the meantime my GP has contacted the IBD Nurse at my local hospital who is going to give me a phone call tomorrow. Apparently she wants me to stop the steroid enemas now, which I'm really nervous of doing because they have worked really well in stopping bleeding etc. And she wants to start me on Asacol orally but wants to check what my reaction was to the mesalazine enema first.

Just wondering what the best type of mesalazine is for left sided colitis and maybe that would have the least side effects?

From what I've learnt on this forum there are quite a few different types ie asacol, pentasa which I have been trying to read up on but cannot find any information on what the differences are between all the different types.

Sorry I am asking so many questions recently but this is all very new to me and I have received such excellent advice on here which I am very grateful for smile smile
Posted 3/21/2017 10:41 PM (GMT 0)
The mesalamine enemas contain sulfa as a preservative which is an allergen to some. The pills do not contain sulfa. You might very well have had a reaction to the sulfa than the mesalamine. After all, Sulfa allergies are more common then mesalamine allergies. So, I'd try the asacol or pentasa at a low dose as a precaution. Take one pill a day for several days, then take 2 and so on.
Posted 3/21/2017 10:50 PM (GMT 0)
with left-side, later release, like lialda, might be a little better, but the one to try 1st is not clear-cut
Posted 3/21/2017 11:25 PM (GMT 0)
I have an allergy to sulfa, I bet that's why the enemas aren't working for me anymore. Here I thought it was the generic brand that I was getting. Rowasa does come in a sulfa free formula - at least I remember seeing it one time. I have yet to get my hands on it.
Posted 3/22/2017 12:04 AM (GMT 0)
I've recently reacted to both the enemas and oral 5-ASAs, so it was the mesalamine that caused my reaction, but for what it's worth, balsalazide (Colazal) is supposedly very effective for treating the left side.
Posted 3/22/2017 12:47 PM (GMT 0)
John and Trixy, yes I'm hoping it's the sulfa I had a reaction to and not the mesalazine. Good idea to try a low dose initially to see if I can tolerate it and then build it up, I'll mention that to the IBD Nurse when she calls later. DBwithUC thanks, I'll ask the IBD Nurse about Lialda.

Fletch10 sorry to hear you reacted to mesalazine. Do you mind me asking what reactions you had? For me with the enema it made my UC worse. I will ask the IBD Nurse about basalazide. I'm a bit gutted they want me to stop the steroid enemas because they really help. I've only been taking them for 3 weeks.
Posted 3/22/2017 1:03 PM (GMT 0)

Trixy's Got Butt Trouble said...
I have an allergy to sulfa, I bet that's why the enemas aren't working for me anymore. Here I thought it was the generic brand that I was getting. Rowasa does come in a sulfa free formula - at least I remember seeing it one time. I have yet to get my hands on it.

Yes there is a sulfate-free version called "sfRowasa" but I often read about people having trouble getting their hands on it. Specialty pharmacies and mail-order pharmacies often have much better luck than our local, brick-and-mortar pharmacies.
Posted 3/22/2017 1:28 PM (GMT 0)
Loulou - the enemas caused significant abdominal discomfort, pain and nausea/bloating - I was having a very difficult time sleeping while taking them. On two occasions (when I was able to retain them) they caused more bleeding and also diarrhea (not a normal symptom for me).

The Balsalazide started with bloating and discomfort which I felt I could tolerate. But then the bloating got bad enough that nothing could touch my abdomen without pain and it became a major struggle to eat enough to even take medication. Finally, after I'd been on it for two weeks, I had a very sudden worsening of UC symptoms - 10 trips per day up from 1-2, bleeding and constant tenesmus. We think I could have also been reacting to birth control at the same time but difficult to tell.
Posted 3/22/2017 2:56 PM (GMT 0)
Thanks, Ipoop! I can't even get Rowasa anymore. They only have generic at all the pharmacies I check, even Cigna Home Delivery can't get it. UGH!!
Posted 3/22/2017 8:04 PM (GMT 0)
Fletch10 definitely sounds like you had a bad reaction to mesalazine. I am nervous to start the oral mesalazine after my reaction to the enema but will give it a go starting 1 tablet a day as Ipoop suggested.

The IBD Nurse called back and said to wait until I have my follow up appointment with the GI before starting the oral tablets and to try and taper off the steroid enemas to see what happens which I am really nervous about doing because I'm worried the bleeding will start again. Will have to see how I go.
Posted 3/22/2017 8:39 PM (GMT 0)
LouLou, good luck and smart to try the cautious approach. Just be vigilant about your symptoms and if your UC seems to get worse, stop smile I'm starting Remicade sometime this week and though I didn't expect to be thinking about a biologic so soon after diagnosis, I am at peace with our decision.

Regarding the steroid enemas, I have been on prednisone (now 25mg) since diagnosis in early February, and just added Cortifoam this week. Is there a reason they're pushing to get you off the steroid enema so soon? I understand the rectal steroids can be used for a longer period of time more safely than oral prednisone?
Posted 3/22/2017 9:31 PM (GMT 0)
Thank you for the moral support Fletch10 smile I don't know much about Remicade other than its a stronger medication. Will you be able to take that long term to get into remission and stay there? I know what you mean about making decisions re medication, sometimes it takes a long time debating what to do but once you've made that decision it's kind of a relief because you know what the plan is going forward.

I'm not sure why the IBD Nurse is so keen for me to stop the steroid enemas because when I had my colonoscopy the Gastroenterologist told me to carry on taking them for 2 more months at which point I should have my follow up appointment. I've got an appointment with my GP on Friday so might ask her if I can carry on taking them.
Posted 3/22/2017 9:37 PM (GMT 0)
Thanks, LouLou! Yes, this is a long term medication - for remission (hopefully!) and then maintenance. My understanding is that I may/will develop antibodies to it at some point, at which time they will increase dosage or switch to another biologic. There are several of them being used to treat UC right now, and more medications coming through clinical trials, so hopefully there will be many options to choose from before surgery - hopefully, though, Remicade will work! My fingers and toes are all crossed.

Smart to double check about your steroid enemas. I think it's good to be a strong advocate for yourself, especially if you think something doesn't sound quite right!
Posted 3/22/2017 10:23 PM (GMT 0)
Fingers crossed for you with the Remicade, if it's a stronger medication hopefully it will get you into remission quickly. Let us know how you get on smile
Posted 3/22/2017 11:38 PM (GMT 0)

loulou82 said...
DBwithUC thanks, I'll ask the IBD Nurse about Lialda.

In some countries lialda is known as mezavant. Same company makes them both, essentially the same med but named different.
Posted 3/23/2017 12:55 PM (GMT 0)
Thanks John, the Nurse knew about Lialda but said it is called Mezavant here in the UK. I've basically got to wait for my appointment with the gastroenterologist before staring oral medication so I am collating a list of questions/options. So far I want to ask them about mezavant and basalazide whichever works best for left sided colitis and also if I can start on a low dose initially ie 1 pill per day. I also want to ask how long I can stay om the steroid enemas for, is there a time limit and should I taper off them etc
Posted 3/23/2017 1:25 PM (GMT 0)
until you get something oral figured out, please ignore the nurse and continue with the enemas -
Posted 3/23/2017 2:46 PM (GMT 0)
Soynomore thank you for that advice smile something just didn't feel right about the Nurse saying to stop the enemas when I haven't been given anything else to take. Going to pick some more up tomorrow, I've only got a couple of predsol enemas left.
✚ New Topic ✚ Reply