First flare - things aren't getting better

Two weeks ago I started to experience blood in my stool and more urgency than normal. I called my dr. who prescribed me 10 days of Canasa suppositories. I started them that evening and throughout the 10 days I felt a little better each day. Now that I'm done with all 10 days the symptoms have returned. I'm still taking Lialda 3x per day. However, there is more blood, lots of urgency, abdominal pain, etc. I called my dr. back and explained the situation. She said there isn't much we can do other than prednisone. I refuse to believe that. She suggested coming in on 5/1. I haven't been thrilled with this dr. since I started going there.

I have a 2nd opinion at Hershey Medical Center's IBD Clinic on 5/2 so I told her I would hold off on making the apt. there. But I wanted to go into the dr. at Hershey Medical Center armed with suggestions that state prednisone is not the only option. My UC is considered severe and hurts my entire large intestine.

Advice?

You can take up to 4 lialda a day (ask for an increase). A 4.0 gram rowasa enema (same ingredient as canasa and lialda) is recommended. Although you do have pancolitis so the enema and canasa will never reach the entire large intestine.

With pancolitis it's likely prednisone or at least uceris-delayed-release steeoid (much less side effects with delayed-release steroid).

You'likely need an immunosuppressive med like 6MP or imuran. Or a biologic medication like remicade or humira.

A 4.0 gram rowasa enema (same ingredient as canasa and lialda) is recommended.

I agree, enemas are very effective with few side effects. And because most inflammation begins near the rectum some people find that enemas help with the entire intestine.

Thank you for all your suggestions. The issue with staying on Canasa is for 10 pills I paid $300 and I can't afford to stay on them. I wonder if there is a generic I could try. I can ask the dr. that when I go on 5/2. I'm approx. $400 away from hitting my insurance deductible but was told my insurance doesn't cover them at all.

I've never used an enema before - I'm kind of intimidated as I wasn't able to do the Canasa myself (my boyfriend had to help and will be away for the next 30 days for work).

In the meantime I will up my Lialda they are 1.2GM and hope that I can at least hold off until my apt.

@soynomore - I haven't made many dietary changes. There are a lot of things that I stay away from as I am allergic to all nuts, shellfish (shrimp specifically), some raw fruits and veggies (oral allergy syndrome), wheat, and soy. I can eat bananas, pineapple, and mixed berries so I have them in a morning protein smoothie with organic plant based wheat free protein powder. I typically stay away from spicy foods as they've always irritated my stomach even before I was diagnosed. I eat mostly organic veggies and fruits provided to me by a local farm through a CSA. I don't eat a lot organic meat because it's expensive but when I find it on sale I do purchase it. Typically my meat consumption consists of chicken and sausage. I thought of going back to a clear liquid diet because that helped a lot before I was diagnosed but it doesn't leave me with a lot of energy and I work a full time job with a lot of travel.

Thank you FlowersGal! I'll check this out now.

My DR. prescribes me canasa in 30-day supplies so im not sure why yours only did 10? Seems like not enough time for the meds to work effectively. I take Canasa ongoing now every 3-4 nights. I think I would try this option first.

Smart on you for getting a second opinion first. I was also skeptical of taking prednisone as I have a minor condition as of now so I never took it.

*As for the cost of Canasa, I know insurance companies do different things but after insurance mine comes out to about $90 for a 30 day supply. I signed up for the patient assistance program while at Costco pharmacy and now I pay $35-40 for a 30 day supply, which I take every 3 nights ongoing so a 30 day supply is really a 3-month supply for me at the moment. Definitely ask about the assistance program.

Post Edited (RaleighUC01) : 4/26/2017 11:52:40 AM (GMT-6)