Asacol and Remission

A little background : Before my diagnosis, scope, medication, I would flare at most once a year and sometimes a year and half (I had no idea what was wrong and my pcp diagnosed ibs). Now that I've been diagnosed and have begun taking Asacol regularly (2x400, 3 times daily - going on a year), I'm flaring every three/four months - four months of remission after diagnosis, three after second remission and I'm flaring again. Nothing else has changed. My diet remains the same (while in remission), plenty of water and exercise(while in remission), low stress. The only thing that changed is that I was scoped and I started the Asacol. While in remission I eat a very balanced diet with very little to no junk, plenty of fruits and veggies, etc.

I don't know if the increase in flaring is due to the medication or the psychological aspect of accepting/worrying about this disease. I'm considering stopping the medication since other than being scoped, it is the only thing that has changed. I'd rather be well for a year a time without medication than sick every three months with. It appears to me that the Asacol is either not working, or making things worse.

Atm, I don't have a GI because I am uninsured and am having a hard time finding a doctor who will take self pay. I'm looking for advice at to possible courses I should take. The GI who scoped me was a bad doctor (I've posted about him here before).

Before the diagnosis I would just "wait it out". Reduce diet to very little, tolerable food and levsin every four hours. Since the diagnosis, I follow about the same routine, plus the Asacol and fiber supplements. I tolerate the pain as best I can and eat and drink what I can tolerate. Which sometimes is nothing at all.

I'm usually sick for about a month at a time and then remission. This has been the case for about 5 years. Only now the flares are occurring much more frequently. My diet since the diagnosis is also much better, but I'm flaring more frequently.

My first guess and only guess is the medication, since it is the only new factor in all this.

I would want confirmation of the UC diagnosis.

Also, while blaming 5-asa is a reasonable first guess, because it can (in rare cases) produce symptoms very much like UC. But it should not be you "only guess" because it is also plausible that things have slowly gotten worse, and you will continue to have more frequent and more serious flares. The line-up with scoping and 5-asa could have been coincidental, ro could have really been whatever made you decide it was time to fork out money for a scoping. (Were you already concerned about getting worse?).

The remission you are describing is only for sure symptom remission. It is possibly that visually you colon is still ulcerated, friable, and inflamed, just a a lower level that spares you the symptoms. Looked at this way, you have been in a multi-year flare, and it is only the symptom hot spots coming more frequently.

I would seek out more anti-inflammatory foods, and maybe take a break form harder to digest items.

I hope you feel better soon.

I would say that oral meds are not sufficient to keep you in remission. Rectal meds in combination with oral 5-ASA is a much more effective way to manage UC long term. And yes, I think your disease could be getting worse. And what DB said - every time you're feeling like your in remission, you might be missing some subtle problems indicating that inflammation is still present.