My GI doc wants me to take Asacol (and I don't want to)

Hello,

I am just getting off prednisone and so far it's successful.  But sometimes I flare-up after about a month of being off of prednisone.  My GI doc wants me to take Asacol, along with the Imuran, but I personally don't think Asacol helps me.  But my doctor is really pushing hard for me to take it.

I sometimes see a great GI doc in Beverly Hills and he says sometimes Asacol can make things worse (side effects include bloody diarrhea).  He also says "one-drug therapy" is best. 

So, does anyone have experience with Asacol making the UC worse...or better?  Should I go against my instinct and listen to my doctor?  I really don't want to take it but he is pressuring me to and he says it's the best thing for me.  Am I just being stubborn?  I don't know what to do!  I hate taking so many pills.  Any advice?  Thank you!! 

I don't think you are being stubborn. I started Imuran in October and stayed on Apriso too. After about 6 weeks I noticed quite a bit of improvement but when I stopped the Apriso I noticed even greater improvement. It made me wonder if the Apriso was actually causing some of the symptoms which were mimicing UC symptoms. I tested my theory and started taking Apriso again and began to see an increase in bloody diarrhea so I am stopping Apriso and just sticking with Imuran. So far so good. I still have a few days here and there that I see some blood but when I do I just use procto-foam for a while and it clears up... I do agree that you should try to get off the pred and stay off it. Are you really taking both Humira and Imuran? That would concern me more than the Asacol...

Yes. Asacol made my condition worse. It does that for some people.

I don't think 1 month off prednisone is long enough - I can relate to what your doctor is saying. You need something that helps keep you in a long-term remission. If you've been on Imuran for long enough and you're in the theraputic range and you're still flaring after a month, it sounds like these treatments aren't working for you. I personally would prefer to give Asacol a try over some of the alternatives but if you've tried it and feel it's a waste of time, that's your decision to make.

I was on Asacol for about 8 years and it didn't do anything to control my uc and infact I felt it made things worse.  I am only on Imuran and my GI doc said it's pointless to put me back on Asacol since I am doing so well on the Imuran.  He did add Canasa because I have a very small patch of inflammation in my rectum.  It seems to be working.

MyUC

My UC got MUCH MUCH worse- superflares - when I took any of the mesalamine based drugs such as Asacol, Lialda, etc.. Most people however seem to benefit, and you will generally know right away if you tolerate them or not.

 

I started taking Asacol in May 2009 and it has helped. Initially I had some complications and I was forced to come off of it and then go back on it at a lower dose. I still have occasional abdominal pain and soft stools but I almost never have diarrhea. Honestly there is no perfect medication I think stress and eating habits play the most important role. If I have greasy or deep fried foods then I will have abdominal pain. And Asacol can only work if you take your medication religiously. When I first started it was hard to remember to take it three times a day especially because it must be taken with food. I'm a believer in Asacol but I hope to come off of it one day.

I could not imagine life right now without Asacol, it is the foundation that keeps me alive. I consider my 100mg/day of azathioprine to be just covering the patches that Asacol doesn't always get. If I ever miss Asacol for more than a few days I quickly go into a flare.

I briefly (a week or two) had an itchy rectum from the Asacol, but that was the only side effect I ever had in 5 years of taking it. It is 99% upside and almost zero downside.