In flare, doctor on vacation, need help

Hi, all,

I just found this forum, and saw that people were having a lot of good advices here.
Maybe i can get help from you guys too. Thanks in advance.

I was on asacol (10 x 400mg) a day for a while and had minimal symptoms, however, my doctor saw intact pills in my colon during my last colonoscopy along with inflammations (although i was not feeling any before the procedure). She was worried that i am not absorbing the asacol, so she recommended that i switch to apriso.

I was not feeling well immediately after the procedure, pain in lower abdominal. My doctor assure me that it has nothing to do with the procedure and that i must have inflammation even before the procedure. Though a couple years back, i did had a adverse reaction to one of the prep med for the procedure and had to be taken to the hospital by an ambulance.

I started taking apriso 4 tablet a day since the colonoscopy and it has been getting worse. I am having bloody diarrhea for more than a week now and its getting harder and harder to maintain a normal life.

I asked my doctor a couple days ago about taking more apriso since 4 tablet is only shown to work in maintaining remission and i am having a flare up now, but she said it is the usual dose and we should stick with it.

Now she is on vacation, and i am just getting worse. What should i do?

Thanks for all the help!

Windgirl, your doctor was completely wrong in telling you colonoscopy doesn't cause pain. The air they put into your colon so they can see the colon walls better distends the colon and can cause sharp cramping until you expel it. And as sherbear said, if biopsies are taken (with a competent GI they almost always are) it's entirely normal to have crampy pain and even some bleeding for a few days. Your doctor should know this, so she either doesn't know as much as she should or she didn't give you the whole truth.

I agree totally with Sherbear's recommendations. Many of us keep rectal meds - suppositories or enemas - on hand all the time to deal with minor flare ups. In my case, I keep both and my doctor refills them for me as needed.

I'm also surprised at your doctor's reaction to finding undissolved Asacol in the colon. First of all, depending on where in the colon she found it, it could be completely normal. Asacol is a topical drug and is supposed to begin dissolving only after it enters the colon. In the proximal (beginning) colon, whole pills would be normal. Secondly, Asacol is encased in a thick waxy shell to prevent it from dissolving before it reaches the colon. It's not uncommon to see these even in the stool, and they can look just like undissolved tablets. When people check them, though, they're empty: only the waxy coating is left, the medication has dissolved.

All in all, I'd probably be thinking about getting a second opinion from another doctor, or maybe even changing doctors if that's an option for you.

Thank you all for the replies. Its so nice to feel that i'm not alone. :D

I contact my doctor's secretary today and she told me to go to my primary care. Unfortunately, being on student health insurance, I don't get any doctor as my primary care but only a nurse practitioner. For most of the questions i have, she turns to a thick book on her desk and start flipping through it for answers @@

I have had CANASA as rectal med before, should i ask my primary care for the same thing? Or is Rowasa or Entocort enemas better options. I hope i can convince my primary care to give me some.

My GI doctor said that the prep or the colonoscopy exam could induce inflammation in the very terminal of my colon, but she said i had inflammation both in the ascending and descending segment (nothing in the transverse segment), so she argued that this is definitely not caused by the prep or the colonoscopy. Is this true?

I didn't know that it is possible to have just the waxy coating of asacol left, Judy2: is the true even for the 400mg tablet?

Thanks for all the feedback, i can't believe i didn't knew about this forum earlier.

If it's possible, maybe you should switch GIs. Your GI's office should be able to help you and prescribe meds even if your GI isn't there.

Enemas will go further up the colon, so I think that's a better option. But you could take Canasa AND an enema. If Asacol was working for you before, you could ask to switch back.