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Asacol buried in formed stool

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Ulcerative Colitis
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Posted 1/16/2013 7:51 PM (GMT 0)
I have posted before that SOMETIMES (very rarely) one of my Asacols would pass through without being used and I have seen others post similar things as well BUT this is a little different ---------

about once per week (that I know of) I find an Asacol literally buried inside a totally formed stool. I have formed stools almost all of the time, but, unfortunately, several times per day. Like many here I check for blood or blood streaks almost every time. I don't normally have much blood ever either. Every once in a while I see a reddish maroon color inside my stool and examine to see if it's blood and find that it is actually an unused Asacol, completely buried inside. Now I know different forms of 5 ASA meds are made to release at different ph levels but would any of this apply to me? It's like my bile just binds around the pill as it goes through my system and buries it, causing it to not reach the proper ph to ever release - so  a few questions:

1. Would any other 5 ASA be of benefit in this particular situation, especially considering probably about at least 90% of my Asacols must be doing what they are supposed to or would this happen to any 5ASA med anway?

2. I can't help but think that maybe I'm missing some or many that are so "buried" that I wouldn't even see them. Since doing Asacol and VSL I have formed stools almost all of the time so if there actually are more buried than I realize is it possible that since they are actually not even functional that I have improved to the point where the Asacols aren't really needed? I used to take 8 pills per day and about a month ago I cut that down to 6 per day and feel like I am actually doing better and am seriously considering cutting down even further.

Posted 1/16/2013 7:58 PM (GMT 0)
Part of the reason I switched from Asacol to Apriso was because I found whole Asacol pills in my poop on a fairly regular basis. And yes, I confirmed there was still medication inside them and that I wasn't just seeing the empty shell (because that can happen).

Apriso starts dissolving at a lower gut pH than Asacol and I've heard that UCers tend to have lower gut pH than the normal population.

However, I mostly wanted to use Apriso for the convenience of once-daily dosing. Apriso is also a much lower dose of mesalamine. It supposedly is more effective at delievering the mesalamine to the colon, and is therefore why it's lower (yet equally effective), but who knows if that's really true or not. I personally don't think it's been studied enough to say for sure.

Lialda, I believe, is a time-release capsule, not a pH-based release capsule.
Posted 1/16/2013 8:31 PM (GMT 0)
Gv, you only take asacol and vsl#3, you believe this put you into remission. Sweet! How long have you had UC? Did you see improvement right away with asacol? How many sachets of VSL#3 do you take a day?

 I wish I was like that! I have seen asacol in my bathroom some formed and some just barely cracked open. 5asa make me feel nervous, like I'm on caffine.

Posted 1/16/2013 9:02 PM (GMT 0)
I don't claim to be in remission since I still have frequency and urgency but yes I believe only the Asacol and VSL got me to the point where I have formed stools and no blood. I have had UC a little over 2 years. I try other things to attempt complete remission but still working on it.

Fruitgirl: I just don't know what to think. If the Asacol has got me to this good of a level then I would be very nervous about switching to another med instead, expecially if the majority of my Asacols appear to be working. But then I wonder if some go through without working, and maybe I am having others I don't know about, since I'm not getting any benefit out of the ones which slip through and I'm still doing ok, then maybe I don't even need them at all or can get by on less? Come to think of it, I just started up on Slippery Elm at bedtime again and now today I find an Asacol in my stools. Maybe there is a connection there?
Posted 1/16/2013 11:59 PM (GMT 0)
Are you on ASACOL or generic?

q
Posted 1/17/2013 12:09 AM (GMT 0)
It is real asacol.
Posted 1/17/2013 12:14 AM (GMT 0)
first time you noticed it? full pill colour or orangey?

There are other options, for sure....but if your stools have been increased or you're taking something to change the ph of your colon, that could be in part the reason they're not completely dissolving.

Maybe take 3- 2x a day instead of 2- 3xa day. See if that makes a difference first before switching.

q
Posted 1/17/2013 12:45 AM (GMT 0)
Never orangey. Since Asacol got me to where I am, which is much better than many, I really don't see myself changing up. I'm pretty sure over 90% of the pills do what they are supposed to and if I switched it could very well be 90% for a different med. I also worry that the Asacol is actually getting to where it is supposed to most of the time and if I switched my results might actually be worse.

Since today was the first time I noticed it in a while, and I just recently started taking Slippery Elm again at bedtime, maybe that is a factor. When this happens I wish I knew which time of the day these Asacols are coming from. It has also confused me that I only find one pill when I always take two pills at a time. Why have I never once found 2pills which made it through? Doc had me once go from 2 pills 3 times per day to 3 pills 3 times per day and I got worse so I prefer not to take more than 2 at any one time. I think the main wondermont of my post was if some pills are getting through unused and I'm still having formed stools with no blood, then maybe I could get by taking less pills than I am now since on these days I get less anyway.
Posted 1/17/2013 5:53 AM (GMT 0)
i say just keep doing what you are doing - just stop looking at your turds !

you know, that whole ignorance is bliss thing -

:-)

Posted 1/17/2013 4:43 PM (GMT 0)
Gary have you ever tried Colazol? I beleive that would be the next med my doc told me he would have me on if I ever flared again. I guess thats the order of progression he would have the meds for me go. I also beleive OM said there is a generic version of which I would think is less expensive than asacol. I took asacol for months and never felt it helped and then stopped and found that canasa did the trick so my doc said to only take the canasa now. If the canasa gets more expensive I may go ask the doc about the generic colazol if its cheaper and as effective.

OMG ignorance is soo bliss..I see it everyday all around me that is the statement of the day soy!


hahaha

Post Edited (twiggs) : 1/17/2013 9:46:22 AM (GMT-7)

Posted 1/17/2013 5:39 PM (GMT 0)
Is Colozal available in the US? I may have to give some thought to this one. You may be onto something. Read up on it and it seems to be a clone of Asacol. How is it different?
Posted 1/17/2013 6:03 PM (GMT 0)
Old Mike would be best to find out the difference. I guess he has been on colazol and I beleive still is. I am not really sure of the difference but I mentioned it and my doc agreed that he would prescribe if I ever flared again. He also was aware I stopped asacol because I felt it didnt do anything for me which he was ok with. Let me know if you go that route. I am curious how it would work for you. Yes it is available in the US. I live here myself. The great news is that there is a generic and have to imagine it is cheaper than asacol..That was another concern of mine and why we spoke about it of which he agreed.

Post Edited (twiggs) : 1/17/2013 11:07:16 AM (GMT-7)

Posted 1/17/2013 8:25 PM (GMT 0)
Gary, you went from 6 to 9 pills...2 x 3 to 3 x 3 .

I still suggest you do 3 x 2.

Not all asacol pills travel at the same speed. My last c-scope there was one pill that was hanging around in the transverse colon...and the last time I took Asacol was the day before in the morning.

q
Posted 1/17/2013 10:00 PM (GMT 0)
I have been taking Asacol for 19 years. I thought I was the only one who passed the whole pill. I take 3, 3x's a day, when I can afford it. I have asked for generic asacol several times and have never been given generic. I wasn't aware there was a generic. I don't think the asacol does anything for me. I have flare ups 3 or 4 times a year now. Last summer was the worst. I started with ulcerative colitis, then medication, then c-diff, then back to ulcerative colitis. I spent my whole summer vacation druged up and in the bathroom. I have quite a bit of blood in my stools right now, cramping and lots of painful gas. I'm trying to get a refil for the cort enema. It helped me the most/fastest.
Posted 1/17/2013 11:35 PM (GMT 0)
Heather, when I went from 2 pills 3 times per day to 3 pills 3 times per day I got worse so I immediately on my own changed it to 2 pills 4 times per day and I did much better. Doc said that was actually a good idea and gave me a new prescription to take it that way. about a month ago I decided to drop back down to 2 pills 3 times per day. Since I didn't do well before on taking 3 pills at once I'm afraid to go that route. I'm actually considering dropping my dose down a little bit more. I have always suspected that even though Asacol is apparently giving me formed stools with no blood it is also giving me more frequency and urgency. It may be a double edged sword.
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