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asacol, lialda and proctitis

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Ulcerative Colitis
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Posted 10/17/2007 5:04 PM (GMT 0)
So i had tapered off my asacol a few weeks ago since I didn't think it was doing jack to help me. My doctor subscribed it when I complained about severe abdominal cramps and bloody diarrhea but I still felt like I had symptoms while I was on it and that the canasa suppositories were really the only thing helping me at all.

Well, turns out that the cramps came back after stopping and I started up on the asacol again. I instantly feel better after a day. This has left me with a few questions I was hoping people may have answers to:

1.) My doctor has always been pretty insistent that I only have proctitis and the likelihood of me getting anything further is very slim, considering I've had proctitis for about 4 years now. However, I wonder if my positive reaction to asacol means that it has developed further? Is this the probability or is it possible that the proctitis itself is getting treated well with asacol?

2.) Can proctitis cause abdominal cramping? I would think that means a further developed UC would cause that since your large colon is in your abdomen if i'm not mistaken. No?

3.) I'm surprised my doctor never mentioned lialda. That sounds like a once a day pill that has the same affect as asacol. Is this true? I'd much prefer taking that rather than 4 pills three times a day.

Thanks for your input.
Posted 10/17/2007 5:12 PM (GMT 0)
Hi Tiesto,

Last colonoscopy I was up to .30 cm in 2005 (was .25 in 2000) and am flaring badly now, and I have cramping, d & blood, don't even see the mucous anymore. GI says this is typical and I am starting to get somewhat better but every bm starts w/a cramp, cramping through it and cramping out of it while my colon stops spazzing. Then I get some relief.

Also, I was on Asacol and my UC responded very well to it, then got switched to Lialda, I think it's a newer drug and the GI wanted me to go on it b/c I was not good at remembering to take all my pills.


HTH! and hope you are better soon!
Posted 10/17/2007 5:25 PM (GMT 0)
Hi Beth,

Thanks for the kind words! You mention that you were up to .30 cm. That would be less than an inch no? Or did you mean 30 centimeters (11 inches). I wasn't sure if you had proctitis or further.

Can proctitis alone cause the cramping, d and blood?

How have you found lialda to be working for you? Does it have the same effectiveness as the Asacol just in one pill? Thanks!
Posted 10/17/2007 5:57 PM (GMT 0)

Hi,

Just to reassure you - proctitis can definitely cause right sided abdominal pains and abdo cramping - I have experienced this and a recent scope only showed proctitis this time.  The cause of the pain isn't inflammation as aside from rectal burning,  inflammation itself doesn't usually cause pain - it's bowel dysmotility and spasm which can occur proximal to the inflammation.

Hope this helps.  Also although with proctitis the inflammation is limited you can get all sorts of symptoms which can fluctuate markedly ranging from severe diarrhoea with urgency to normal stools with a hint of mucus.

Posted 10/17/2007 6:35 PM (GMT 0)
I have been on Asacol for 11 years.  Right now I am in a flare - some days better than others.  Earlier this summer, I was put on Lialda in place of Asacol for 6 weeks.  I found my symptoms got worse.  The active ingredients are the same in both medicines.  I was bummed that the medicine didn't work for me but someone else on this forum said that their GI said Lialda isn't as effective for those with proctitis - not enough of the meds reach the end of the colon.  My UC involves 35 cm.  HOpe this helps. 

Posted 10/17/2007 6:39 PM (GMT 0)
That's a bummer :( I am sorry to hear that. I spoke with the nurse at the doctor's office and they offered to let me try Lialda. I will give that a shot to see if it has the same affect as the Asacol. I think the bigger issue for me mentally is acknowleding that the Asacol is helping. If it is, I figured that means my proctitis has advanced since my understanding is the oral medications don't do much at all for proctitis. That combined with the abdominal pains and lack of them while on the pills doesn't bode well.
Posted 10/17/2007 7:10 PM (GMT 0)
yes, I have proctitis 30 centimeters, doc seems to think it will stay that way. I wasn't able to stay on the Lialda for more than a few weeks b/c of other issues, so unfortunately I can't add to that helping or not, GI did say that I could flare on the Lialda b/c it was a changing of meds. I'm on pred (not helping) and imuran now, looking into remicade. unfortunatley I can't take the 5ASA's anymore (sulfa, asacol & lialda) b/c of my kidney's but I wish I could go back to them, the other drugs are so much harsher, if they work for you give it a try but always let your doc know if you think they are making you worse or not better.

When I am going through a really bad cramp on the toilet, I have ice water with me and suck on an ice cube, it helps to ease my nausea, I don't know why but I think if I did not have it I would get sick.

Last night I just left the ice water and magazines all over the bathroom (I also need reading material).
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