Relentless Diarrhea

Hello all. This is my first post, but I've been on this website a lot in the last few months looking for help and guidance. I was just diagnosed with Ulcerative proctosigmoiditis colitis on December 1st 2016. My GI intially prescribed me enema's and lialda (two pills, once a day. I have insurance through my work (post office) and even after that, the enema's were still right around 400 a month, which I could not afford. So my GI switched me to Canasa suppositories. So for the last month / month and a half I've been taking both canasa and lialda daily, as well 2000 MG of fish oil and phillips colon health. I don't have stomach pain or cramping, no blood in the stool or other symptoms EXCEPT for, you guessed it, constant and persistent diarrhea. I feel like it's getting worse since I've been diagnosed. I have roughly 15 - 20 bm's a day. Sometimes I don't even have to go to, but the urge comes and I have to sit on the toilet just to pass gas, and make the urge go away. I've missed work the past couple of weeks due to the onset of anxiety I get while I'm the car. I have pop up panic attacks and even the thought of driving somewhere literally terrifies me. After talking to both my GI doctor and regular doctor, they decided to up my dosage today (2/20/17) of lialda to 4 pills a day. I was just curious if anyone else has had these issues, or if anyone has any helpful insight. Thank you for reading this long ass post and I will try to respond as quickly as I can.



27 y/o male
Diagnosed with mild to moderate UC December 2016
Lialda 4 pills a day
Canasa nightly suppositories

Ditto a stool test, and getting off of the fish oil (it gives some problems). When things aren't working it is often a good idea to get an assessment of your current inflammation, either a flexible-sigmoidoscopy with biopsies, a CRP blood test, or a fecal calprotectin stool test. It's possible that your UC has gotten much, much worse, since your initial colonoscopy.

A mesalamine-intolerance is an interesting thought. Did your UC get worse once you increased the dose from 2 lialda to 4 a day? You could always skip the Lialda and Canasa for two consecutive days and see if your condition dramatically improves. If it does not, then you do not have an intolerance and should resume your mesalamine.

The anti-inflammatory mesalamine isn't strong enough for everyone's case of UC. Sometimes we need much stronger medications to control our UC symptoms. There's always immunomodulators (azathioprine/Imuran or 6MP) or biologics (remicade, humira, or entyvio) which are better for more severe cases that don't respond to the mesalamine.

Slightly off topic but if you have Mail Handlers insurance, check on the copay if you order a three month supply of your meds. I have Mail Handlers (I work for another agency but can get it) and my copay for one month of lialda and Canasa is $157 and $200, respectively. If I order a three month supply, the copay is $80 each total for all three months. That's using CVS or the Caremark mail order program. It may be the same at other pharmacies ( the one month copay is the same at Walgreens). I bet the price of the rowassa enemas are much cheaper in three month orders as well but I haven't checked.

Post Edited (NiceGuyEddie) : 2/21/2017 8:43:12 AM (GMT-7)

Hey everyone thank you for your replies. I appreciate all of the feedback. I have discontinued the fish oil and probiotic until further notice because as some of you mentioned it may be hurting more than helping. My GI said that it sounds like it could be c-diff but he's going to up my prescription of lialda first to see if that helps at all. On day 3 of the upper dosage and the only difference I can tell is that there's some blood in the stool. No mucus or stomach pain, just blood and D still.

Jane974: I agree that I need more testing. I've done the blood work and that all came back good and raised no alarm with my GI doctor. He told me that if the upped prescription doesn't make a difference than he wants to do a stool test and others. No mucus, but constant urgency every half and hour. Sometimes it's nothing but gas but I have to run to the bathroom just to be sure. And thank you for link I'm looking into it immediately.


IPoop: Im going to ask you my GI about more extensive testing and if I need another colonoscopy then so be it because something has got to give. I have only had 3 days of the 4 pills dosage and the only change is blood in the stool which is weird because I haven't seen that since I started taking the lialda. And I think I'm going to give that 2 day trial a try and report back what I find. What are your opinions on a steroid like prednisone or hrdyro.?


NiceGuyEddie: I have never even looked at that possibility. I have insurance through the p.o. but the actual provider is Aetna. I don't know if that makes a difference or not and can't change anything in it until December when open enrollment comes around. But Im going to look into it.


Deltaforce: I have tried pepto, and imodium, but they don't seem to do a thing for me. I will give Bentyl a try because I need something for a piece of mind. And yeah I'm done with the fish oil for now and where exactly can I get the steroid enema's? Are those prescribed? And yes the Canasa was cheaper so that's what I went with.

Mail Handlers is under Aetnas network. I believe
Aetna bought them. Check on a three month supply of the suppository that worked for you. You can just call and they will tell you how much 3 months will cost you.