Mesalmine Question

Hello everyone,

Things have been going well; my last dose of Prednisone was Saturday morning, and I still do not have any symptoms, as far as I can tell. I am currently taking 3200mg (1600 twice daily) of Delzicol and a Rowasa enema (4ml, I think) at night.

Considering that I have Proctosigmoiditis/Left-Sided UC (My GI doesn't seem to distinguish between the two), is Delzicol the right form of Mesalamine? I have read that Lialda and similar pills are designed to travel further down the colon. Some of you may have read that I cannot swallow large pills, hence the Delzicol.

Eventually, I will get my esophageal stricture stretched, and that should eliminate my problem swallowing pills. Until then, though, is the Delzicol doing any good?

Not true that the enema is good enough...! Absolutely not unless you can predict your UC will never travel beyond? Why risk good enough?

Delzicol is fine.

They ALL will treat the colon and into the sigmoid. If you see them whole in the stool, then you could consider another option.

Kevin....Try not to micromanage when you have so few options at this point.....oral / rectal...you want your whole colon and rectum covered.

q

Of course, because I said yesterday that I wasn't seeing any signs of symptoms, I saw two ultra-small spots of blood in my stool this morning.

Everything else is going well: 1-2 well-formed BMs a day, no cramping or urgency, good energy, gained back the weight I lost. I know that, more than likely, I've had some tiny bits of blood in my stool all along, but just haven't seen them. It's frustrating because I feel like I'm SO close to remission.

I'm twenty-four days out from my diagnosis. Should I still feel like the Delzicol and Rawasa are doing their jobs?

Well hold on thar......the specks could be the casings of the delzicol since they're tiny once empty.

q

Often it is a false alarm. You're likely seeing food residue that's undigested or flecks from the red/orange shells on the tiny delzicol pills inside the clear case. Our digestive system pours acids and enzymes on foods and they change color. Seeds and skins off of fruit can look red when pooped out. Normal people without IBD would see those too if they ever cared to look. We inspect them like tea leaves and try to read the future.

Unless you're seeing blood on tp when you wipe you bumm then do not worry. It seems like you have some health anxiety. Uc is a long and bumpy road more like a rollercoaster ride. That journey is going to be much more difficult if you worry and try to analyze every bm. Best to flush before standing and before looking. Good for mental health.

If you're flaring then you will have multiple symptoms at a time like increased urgency and blood when you wipe your bumm.

You are on the right track....no feeling or overthinking about it. And yes it could be tomato skin or the casings (coating) of the delzicol. My asacol casings are pulverised orangey- red and I have to do a double take.

Love your analogy John....how true!

q

There's slight differences in the formulation of the various mesalamine/5ASAs that result in different release points and release rates. We're not talking huge differences but rather very slight. However, there's no clinical or prescribing guide on which of those 5ASA meds is best for specific types of UC to the best of my knowledge. Rather we findout through trial and error. Some see improvement by switching but others do not, so there's no guarantees that switching would make a difference.

And don't worry about seeing the occassional whole pill in your stool (happens to us all). However, do worry if it is all of the time.

quincy said...
Again.....don't micromanage. Once the casing is cracked, it slowly releases the medication as it moves though the colon. Its the same concept as asacol, Lialda, salofalk. Not time released.

Do you take it with food or not?

q

I typically take it either before a meal or after. Should I take it during?