Delzicol stopped working. 2nd flare and scared!

your sig says 6 delzicol/day but you said 9/ day - when did that change ?

you should be on an enema also, every day until your symptoms are negligible -

Generally, you should max out the anti-inflammatory medications before going to immunomodulators. The max is 4,800 milligrams oral (400 mg delzicol x 12 = 4,800) and 4,000 milligrams rectal-route (4,000 milligrams rowasa). I'd ask your gastroenterologist about increasing your dose and adding the enema.

Understanding risk versus benefit is an important part of living with and treating chronic illness. Actually, the delzicol you're on now has statistically small odds of scary side effects (inflammation of heart, kidneys, liver, and blood abnormalities). Similarly, immunomodulators (Imuran, 6mp, aza) have very statically small odds of scary side effects. Few get them, but they are serious when they occur. The odds of the worst side effects are usually less than one percent, while the benefits of reduced uc symptoms are around 70 percent. Your doctor monitors you, and medication dosages are adjusted if you were to experience them.

Our uc can spread and get more severe over time, it's important that we keep pace with those symptoms with an appropriate treatment that gives us the best possible quality of life. For some, that means immunomodulators or biologics. We have some nurses, teachers and med students who are regular posters and are on immunosuppressive medications. I agree it's a little scary at first, I've been on both medications, but I wasn't sick any more than usual and I experienced no side effects. Immunomodulators and biologic medications just slightly reduce your immune system's abilities, you still have a functional immune system. Colds, the flu, cuts and bruises are no concern on these medications. What you have to be concerned with is the types of infections that normally require antibiotics (such as uti, sinus infection, bronchitis) as on immunosuppressive medications you need to seek out treatment earlier as they are more aggressive in symptoms.

Here's some good info on risks versus benefits of immunomodulators and biologics from the Crohn's and Colitis Foundation of America
Webcast: programs.rmei.com/CCFA139VL/presentation/player.html
Transcript: www.ccfa.org/assets/pdfs/risk-and-benefits-transcript.pdf

Well, I went to my appointment. She said 2 flares since my dx in December is not what she likes or what she thinks is okay. She prescribed Uceris for 28 days and she also told me to take 12 delzicol per day...the full 4.8gram dose. However, she didn't give me the rowasa. She told me to continue Canasa nightly. She said her goal is to maintain remission for ATLEAST 8-12 months (which I am a fan of that idea!!!).

Sounds like a good plan. How far does your uc extend? If it's limited to the rectum then saying no to rowasa is fine.

Enemas...it will deal with rectum and sigmoid....where the oral 5asa won't fully.
Enemas are designed to deal with which they are designed. Your doc's statement makes no sense.

Use the suppositories during the day, the enemas at night. Start with 4g enemas.

If the mesalamine enemas don't give enough improvement, consider to add a steroid foam enema during the day.