If Lialda (mesalamine) has side effects that mimic UC...

... how can you tell if you're having side effects or if your flare isn't under control?

I had myself convinced that Lialda wouldn't cause bleeding, but I just checked their website and they say:

Mesalamine has been associated with a syndrome that may be difficult to distinguish from an ulcerative colitis flare-up. If you experience cramping, abdominal pain, bloody diarrhea, fever, headache or rash, talk to your doctor immediately.

and

In Lialda clinical trials, the most common adverse events were headache and flatulence. As with other medications, some serious side effects may occur. Less than 1% of patients experienced inflammation of the pancreas, which led to discontinuation of therapy with Lialda.

Right now, my symptoms are: bloody diarrhea, flatulence, and occasional urgency.  I keep thinking the flare has ended, and then the bleeding starts again.  I don't know if I have more gas than usual (it seems like it) or if I just notice it more because I HAVE TO be on a toilet to release gas, since it usually is accompanied by blood.

Plus I can't decide whether my mood swings are related to the disease or are side effects of prednisone (I'm on such a low dose now that it seems unlikely) or if this is related to menopause.  I'm far enough into menopause that my periods are slightly irregular, but not far enough into it to actually have the darn things STOP.  I'm so tired of having to deal with periods, and my dear bf is baffled because his ex wife had (according to him) a voluntary hysterectomy, so she never had periods, so he doesn't really know what to expect, and I actually find myself feeling guilty when I get my period.  We're going to an out of town wedding this weekend, and I'm already stressed enough over the idea of a hotel room (the walls between bedroom & bathroom are notoriously thin) and now I have my period to deal with as well, which in itself isn't such a big deal for me, but it does cut down on the sexual romp we were sort of planning.  So that makes me feel even guiltier.  I know it's stupid, but I think I kind of needed to air it out someplace.

Thanks, and thanks for any insight on the side effect issues.

I'm allergic to asacol and lialda, when I was on lialda for about a week my joints (wrists and neck) started to hurt really bad, than I got severe stomach cramps, and than I would go to the bathroom all the time(like 20 times in 5 hours) it was horrible. I knew I was allergic because while these can be symptoms of UC they go worse when I started the med. I really though i was going to die my stomach hurt so bad. The same thing happened with asacol(I was on this first)

So my history is:

when I first was diagnosed in March 2009, I started out on 2 Lialda daily (2.4 g) and then increased to 4 daily (4.8 g). After a few weeks (and immediately after starting acupuncture), I went into remission.

Then I was off the Lialda for almost a year. It somehow didn't sink in that I was supposed to be taking it as a maintenance med.

In May of this year, I started flaring again. I went onto the Lialda and crossed my fingers, and in July I called my doc, who put me on 40 mg prednisone, which stopped the bleeding immediately, but then when I began to taper off of it, every time I would lower the dose, the bleeding would start again. Through trial and error, I found that it seemed like the bleeding would start again but ease up & go away within a few days. So I held to the tapering regimen.

Also in this time frame, I asked for and was prescribed steroid enemas. (Quincy, my request to my doctor was due in large part to your sig, and I feel like those enemas made a difference, so really I owe you a lot.) I took those nightly for about 2 weeks, and then it really seemed like I was in remission. So with my doctor's advice, I tapered off of both prednisone & the steroid enemas.

I've been off them for about 2 weeks, technically, but I took 2.5 mg prednisone on Sunday and on Wednesday of this week (my last dosage was 2.5 mg every other day), and I used an enema on Tuesday night. It seems like it's just getting worse, and I don't know how much of this is me overreacting because of this trip coming up and my hormones all stirred up from getting my period. I never had PMS when I was younger. :-(

My UC is classified as "mild to moderate" & my doctor has said that it reaches the midtransverse colon, which when he said it I thought he meant the middle of the transverse colon but now I see that "midtransverse" is one word so I don't know if he means it reaches it and stops or reaches it and includes part or all of it. I should ask but I don't know if it would do all that much good to know.

So I have had a really good experience with Lialda, but I wasn't on it this long before, and this time I feel like it's either having no effect or only a negative effect. :-(

Thanks, Quincy. I'll ask my doc for the Rowasa. I did increase the prednisone this morning and am more or less expecting to stay on 10 mg for the weekend, at least, just to reduce the issues during this little trip.

I may be more disturbed by prednisone than I should be on this dosage. I'm probably just really overreacting. I just want to be off the steroids asap :-( and that's probably more emotional than anything. Which I blame on the prednisone. It's a vicious circle :-(