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Lialda seemed to be working but...

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Ulcerative Colitis
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Posted 8/1/2015 5:37 AM (GMT 0)
Hey all -
I recently posted about how I was diagnosed with UC and all that jazz around a month ago, instantly I got put on Lialda (2x a day, 1 pill each dose)
A week into taking it, I felt great! No belly pain after eating whatever I wanted, my bowel movements were pretty much regular again (a little D and C but no blood and no urgency really), I was able to eat many meals a day, everything seemed almost normal again.. But
Today after I had dinner it seemed to go downhill. I instantly felt nauseous, severe tummy pain, no diarrhea, but the urgency to go and nothing would come out at all.
It COULD be just what I ate because they just popped up again, but I've been eating everything without any consequences. I'm just scared that if the medicine isn't working because I'm afraid of the next step in medicine :(
I plan on waiting until Monday to see if the pain and symptoms subside as I'll continue taking my Lialda but if this doesn't work - just so I may have an idea - what would be the next step?

Thanks all
Posted 8/1/2015 11:41 AM (GMT 0)
If you are only taking 2 lialda a day, you should go up to before before switching meds. Also, rectal meds are very helpful, albeit intimidating the first couple of times you use them. 2 lialda is theming enhance dose, 4 is for flare.
Posted 8/1/2015 12:28 PM (GMT 0)
Momto2boys is right. Ask your gastroenterologist for a prescription for 4 lialda a day, plus a meslamine-based enema (rowasa). If that doesn't work, then move up to the next class of uc medications (immunosuppressive medications Imuran, 6mp, aza).
Posted 8/1/2015 1:22 PM (GMT 0)
you may want to use more Lialda and eat a little more plain and steady so you can notice any food issues. maybe get some rectal mesalamine too.

if you are scared of the next step on the med ladder, it is advisable to act like you are scared.
Posted 8/1/2015 1:37 PM (GMT 0)
Ditto everyone else. I wouldn't move up the med ladder until you've done four Asacol first. You could add rectals if you need to. Don't eat whatever you want. That's probably what is responsible. You say you are scared what's next. Are you scared enough to not get cocky with your food choices?
Posted 8/1/2015 4:25 PM (GMT 0)
To me this experience says that you might actually have some food intolerance too, seems kinda strange that with a small dosage amount you started feeling great then increased a variety of foods then started to feel gross again so yes, although your meds probably need to be increased that will help with your UC but it's not going to help some underlying food intolerance that you may very likely have on top of UC.

I suggest the low FODMAP no fructose diet and then the reintroduction of the food groups that you avoid on the low FODMAP no fructose after doing it for at least 5 weeks, and monitoring what you eat and how your bowels behave during those 5 weeks as well as the reintroduction phase (another 5 weeks) to more easily help you figure out if you also have any food intolerance issues.
Posted 8/1/2015 5:47 PM (GMT 0)
You're not on enough medication....especially rectal.

Where exactly is the location of your UC...throughout or limited?

Call the doc for sure and get on rectal retention mesalamine enemas. That would be Rowasa or the generic.

You're new into the treatment...hang tough and reassess with your doc for additional meds.

q
Posted 8/2/2015 4:02 AM (GMT 0)
Well, to see if it was the food, you'll just have to give it a couple days and see if you get better.

Regarding the lialda, your story sounds just like mine. After my colonoscopy and diagnosis, the doctor prescribed 3 lialda per day. That's all. It initially helped but then lost its effectiveness. After trying uceris (which made me worse), the doctor pretty much said "well, start thinking about biologics." I switched doctors.

I was pretty stunned to hear the doctor suggest biologics so quickly. Why? Because there are many oral mesalamines out there, AND there is the rectal approach to medication. I'll put it this way: I'm not against biologics and immunosuppressants, but I'm not touching those until I've tried multiple brands of mesalamine pills, exhausted my medication options using enemas, and sufficiently explored reasonable alternative remedies.
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