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Maintenance - Rowasa, Canasa, Lialda

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Ulcerative Colitis
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Posted 10/3/2017 11:47 PM (GMT 0)
Hi all,

I was diagnosed in April with proctitis going up to the sigmoid junction, and after a bit of a difficult time getting off prednisone in June, I'm thrilled that I've been doing well on Lialda and Rowasa.

I'm currently taking 2 Lialda daily and Rowasa 3x a week. I've been a little afraid of tapering the Rowasa, so I have been using the Canasa on the nights I don't use the enema. So far, so good with this regimen. Ideally, I'm hoping to maintain on Rowasa 2x weekly and the Lialda.

What would be a better idea, to taper the Rowasa to 2x a week while still using the Canasa or should I see how I am without the Canasa on the 3x a week Rowasa schedule first? Just not sure how to move forward.

Also- has anybody maintained on the Lialda and Canasa alone? Rowasa seems to be preferred through most of what I've read.

At first, I wasn't sure that I was quite ready to taper the Rowasa because my morning BM has continued to be a little urgent, but I noticed on the days that I take the Canasa, I have much less urgency in the morning. So I'm assuming the urgency is due to the extra liquid in the colon from the Rowasa?

Thanks in advance for your feedback.
Posted 10/4/2017 12:24 AM (GMT 0)
I'd say as a proctitis patient you could maintain a remission on just canasa suppository. Using lialda in addition is a good precaution to help reduce the odds of your proctitis becoming a left-sided/proctosigmoiditis like mine. Rowasa is good for proctosigmoiditis/left-sided as it does go further.
Posted 10/4/2017 12:53 AM (GMT 0)
My advice is to use is to stick with the Rowasa/Canasa regime that you are on (with Lialda too). I had started with mild proctitis and Canasa worked for a bit then stopped. I eventually got in remission with Rowasa but didn't add oral pills until I was already feeling good. I was in remission for 6 months on Rowasa 3x per week /Canasa in between and 4 balsalazide per day. Then out of nowhere I went into a flare and my inflammation didn't start until 50cm. The doc told me that the mucosa was healed wherever the Rowasa had reached up to. I don't even know if Canasa did anything (I also used it in between the Rowasa enemas) but the Rowasa kept the first 50cm of my colon normal. I only had inflammation from 5-20 cm last December. Now I have it 50-70 per a sigmoidoscope from last week. I had proctitis like you but it was spreading without me knowing it. The Rowasa saved a good portion of the left side for me. Stick with everything you are doing at least until you are in remission for a year. Now I am on prednisone, 9 balsalazide and nightly Rowasa ugh
Posted 10/4/2017 1:39 AM (GMT 0)
Thank you both for your replies. It's such a tricky disease not knowing how our bodies will respond or what lies ahead.

iPoop- I plan on continuing the Lialda indefinitely. I don't think it did much (or anything) as far as helping me get out of a flare, but hopefully a preventative measure at least. I'd love to use the Canasa instead and maybe in time I'll be able to get to that point.

Countess- I'm sorry to hear you went into a flare! Good luck getting off prednisone, and I hope you reach remission soon. Are your symptoms much different being that the inflammation is higher and down low is healed? I do appreciate your advice and will heed your warning of waiting longer before considering further tapering. It's a helpful reminder since I'm still new to the game and it's easy to think you'll stay healthy when you're feeling well.

My husband and I are trying to conceive our second child and im just hoping to be on the least amount of mesalamine that my body will allow but don't want to get ahead of myself. I didn't have this worry with our first since the diagnosis came after our daughter was born.
Posted 10/4/2017 2:04 AM (GMT 0)
Yes...you can eventually get onto a regimen of using canasa for maintenance.
Did you go from nightly rowasa to every second night with canasa between?Tell me the schedule exactly.

q
Posted 10/4/2017 10:58 AM (GMT 0)
Hi Quincy-
First, I skipped one day of the rowasa per week and used the canasa instead just to see how I was.

Then I started using rowasa 2 days in a row and canasa the third day. I alternated like this for probably a month or so. I was nervous about this being too much of a taper, but knock wood, my butt didn't mind.

Currently, I'm using the rowasa on Sundays, Tuesdays, and Thursdays with Canasa in between. I've done this two weeks so far. I'm still doing well even on that second night (Saturday) without rowasa.
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