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Mesalamine suppository alternatives

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Ulcerative Colitis
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Posted 3/14/2017 8:56 PM (GMT 0)
Hi there, so I am heading back to the GI Thursday for a followup since being in remission for over a year with no meds. I have had very bad luck with oral mesalamine so wondering if anyone has had success with suppositories if they haven't been able to tolerate oral ones? Mucus and blood BM...no stool, on and off for past month.
THX!
Posted 3/14/2017 9:17 PM (GMT 0)
lazz4, I've had the reverse experience - bad luck with mesalamine enemas, but good response (so far, fingers crossed!) to balsalazide, which is converted to a mesalamine in the colon. I have heard that some who can't tolerate oral can tolerate rectal and vice versa, though the more experienced members of this forum can speak better to that. So I think based on my own reading and experience the answer may be yes.
Posted 3/14/2017 9:23 PM (GMT 0)
I actually did great on balsalazide (I was on Giazo) but awful scary reactions from Asacol and Lialda. Not sure if my new GI dr will prescribe them but my old one wanted me to give them a go in the past but I was so afraid of side effects. Have to go to new dr this week because of insurance so I guess a 3rd opinion is good. I posted here in the past when my dr took me off giazo and everyone warned me about a flare being worse without maintenance meds. Many were concerned why he would take me off of them when doing well. Back to square one but the SCD diet (and recently no dairy) was life saving when first diagnosed. Might have to go strict again, I have let grains back in. Such a frustrating disease!!
Posted 3/14/2017 9:37 PM (GMT 0)
Fleth10 what were your reactions? Just to prepare myself if I have to try them.
Posted 3/14/2017 9:53 PM (GMT 0)
"Might have to go strict again, I have let grains back in. Such a frustrating disease!!"


ya, just let em go - kick em to the curb - adios - etc etc !

imo, they really are a piss poor excuse for food -

and ya, if you haven't tried mesalamine enemas, give them a shot -
Posted 3/14/2017 10:09 PM (GMT 0)
The strangest thing that I have added the past few weeks of feeling bad have been Dale's Raw Protein bars and Vega Plant Based protein shake...until then I have been good. Do contain a few SCD "illegal" items. Kicking those to the curb too because I have lasted SO long without meds!! Last colonoscopy had no signs of inflammation where as year before active colitis.
Posted 3/18/2017 7:01 PM (GMT 0)
I have done much better on the rectal mesalamines than the oral ones, but I've only tried Lialda. Can you tell me what reaction you had to Lialda? It makes me gassy, bloated and tired. My doc is open to trying a different brand but I am not sure which one to ask for yet.
Posted 3/18/2017 7:41 PM (GMT 0)
lazz4, my reactions to the Rowasa were stomach pain, nausea, abdominal discomfort, bloating and gas. I also had an increase in bleeding and on one occasion (we tried Rowasa for a week, two different times) diarrhea, which was not a normal symptom for me.

Unfortunately, it looks like balsalazide may be giving me a similar reaction - I've had gradually more gas, bloating and discomfort but then this week started having a major and sudden increase of UC symptoms, with tenesmus, urgency, pain, and intolerable bloating, discomfort and nausea. They told me today to stop the balsalazide for two days and see if symptoms improve.
Posted 3/18/2017 7:58 PM (GMT 0)
Fletch 10 That is what is going on with me. Canasa works good for me but everytime I try a pill version I get flare ups. I am balsalazide right now and I started having a lot of gas and about a 2 weeks into it I have the tenesmus, and mucus. dr told me to stop it today and go back to canasa.
Posted 3/18/2017 8:34 PM (GMT 0)
Slindsay1015, thanks for sharing that! I was wondering if it was hormonal, but I don't think it is - the symptoms have gotten worse and worse since starting the balsalazide. I am hopeful that stopping it will bring some relief and then we will look at other med options next week.
Posted 3/18/2017 9:49 PM (GMT 0)
keep me posted with what you go on next. I have been having all kinds of issues with mesalamines except the rectal suppositories. I noticed you are contemplating starting vsl#3 I just started them last week. I am hoping these will help.
Posted 3/18/2017 11:27 PM (GMT 0)
So sorry everyone is having issues. I have a colonoscopy scheduled for this Friday. He wants me to take a Medrol steroid pack for 7 days too. I have never had to do that. He said the constant changing of UC is what makes it a beast. Did have my worst flare Tuesday than I ever have had so I was very relieved to get in the colonoscopy asap. We shall see what it says!

F, 43, dx June 2014
Lialda failed, Apriso failed, Uceris did nothing. Did well with Giazo and strict SCD diet
Clear colonscopy August 2015
Stopped taking Giazo February 2016 and have been clear until now
Currently paleo diet..no gluten, dairy incl eggs, soy, preservatives, processed food etc. Gluten free treat every once in a blue moon
Posted 3/21/2017 8:04 PM (GMT 0)
Surprised to hear that you were put on Giazo, which was originally tauted to be better for male UCers. If you have trouble with balsalazide, it could be from an inert ingredient rather than mesalamine; generic meds can be problematic for that reason and because the big pharmas can get away with marketing compounds that only contain 80% of the mesalamine in the brandname drug. (Colazal, in this case.) Another unfortunate & frustrating situation in the U.S. is that we cannot get mesalamine FOAM, an alternative to suppositories that has been available for a decade in the UK, Europe, Australia, & New Zealand!!!!!!! (Probably because the pharmas make higher profits from suppositories.) / Old Hat (36 yrs with left-sided UC; presently in remission taking brandname Colazal)
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