Remission

Remission is when you're not flaring, there's no pain, no blood, and decently formed BMs.


Asacol is needed to stay in remission when you get there. It's not something you take for a few weeks and then you're fixed. Sorry, but she'll be on it for life (or until something better is developed.)

Prednisone is an amazing drug. If you have experience with it, and as you will certainly see in the UC postings, it has brought relief in flares when nothing else works at the time. However, it is also nasty, and not meant for long term use for remission. The goal for remission is no flare, bleeding, D, urgencies, constant BM, etc. with the least overwhelming meds. For some it is Asacol, for others it could be the immuno suppressant class, up to remicade. Prednisone for me has been to calm down bad flares and give the other maintenance drugs a chance to do their jobs, or just to give the doc a chance to see what works and does not work. Sometimes that means that the prednisone taper does not go well, and steroids have to be reintroduced while the MD tries something new. The remission can be a process of ups and downs until the right treatment is found. For me, Lialda (Asacol) just did not do it. I needed prednisone to stop the suffering, and am now trying a combination of Imuran and Remicade.  I have had trouble weaning from the prednisone and the goal is to maintain a symptom free life without the steroids. From reading these posts I see how so many people get to the remission point, and that gives me a lot of hope. The prednisone seems to have certainly helped your daughter with her symptoms, and I hope that as the prednisone is further reduced she continues to have good results. Just remember, if there is any set backs, she still has a lot of options available. Stay in touch with your MD and good luck!

Hey Glenn -- how is it decided if the Asacol should be stopped and use Lialda instead? We go to the Mayo Clinic October 1st and I have so many questions prepared to ask. Hubby is definitely improving and looks like he is headed towards remission. I just wonder if it might be better to switch from the 12 asacol each day to the Lialda. Less pills (they are larger I think?) but better results with that class of drug.

However with the introduction of the imuran for the past 3 1/2 months that seems to be making the difference towards remission so maybe the asacol is ok but just wasn't ok by itself with the prednisone which we are tapering.

For Sam definitely listen to the Drs. It seems like a pain to have to continue to take the asacol if it looks like she is getting better but from what everyone says it is necessary to maintain with this. In all likelihood they may reduce the number of asacol to what seems to be the right dose to keep it at bay from what I have read here.

I left out replies to some of your questions. Yes, the pills are a bit bigger, but no so much more than a multi vitamin. It is easy to get used to. I am also on Imuran and Lialda together (as well as Remicade and prednisone). My doctor is slow to remove meds once I start because his feeling is that if he goes too fast he may not be able to tell which of the drugs is responsible for my improvement. This is especially true if you are also on prednisone. Because prednisone can be so effective you have to be careful when weaning (other than the body needing to learn to produce natural cortiosteroids again) so that you can tell if the remission is still in effect even as prednisone is being cut. My doctor uses this same philosophy for the other meds. While I am pretty sure that the Lialda has minimal effect on me (although it may help to minimize some symptoms if not create a remission) it is still unclear if it will be the Imuran or Remicade (or both) that will hopefully get me off prednisone and into a longer term remisssion. Have your family members keep taking all meds until the doctor changes them, and then as others have said, do not let them stop taking the maintenacne drugs just because they feel better. That is a sure invitation to relapse.