Left-sided colitis

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

mjw82704
Regular Member


Date Joined Dec 2006
Total Posts : 251
   Posted 12/29/2007 3:04 AM (GMT -6)   
Hi I just went to see a new GI Specialist who told me that Left-sided colitis can be harder to treat with regard to flare-ups. Anyone know anything about this? Anyone with Left-sided colitis have success with remission? Please post any information that you can. I am now taking 4 asocal 3x per day and an enema steroid and rowasa every other day rotating.



Thanks,
Melissa
Left-sided colitis diagnosed at age 28 in 2001
Asacol 3 pills 3 times per day
Hydrocortisone Enema as needed
Probotic taken Daily


barnsbury
Regular Member


Date Joined Jan 2006
Total Posts : 443
   Posted 12/29/2007 5:09 AM (GMT -6)   

Hi Melissa

I have also been told this.  I think there is an element of truth to it.  The main reason behind it is probably due to the standard 5ASA drugs, like asacol, not reaching the left (descending) colon.  Enemas can be a god send here but many people, including me, have a real problem retaining them.  And so left sided colitis can be notoriously difficult to treat.

My first flare was pan-UC, and I managed to get into a 2 year remission. But, the last 4 years  I have had left-sided UC flare and I cannot get into remission.

I actually read somewhere the majority of people who have their colons removed due to refractory UC, have left-sided disease.


Back on Pred - 6mg - Steroid Dependent :-(
Azathioprine 125mg
Actonel 35mg
Predfoam Enema
EPA Fish Oils
Various Homeopathic meds
Asacol x 9
Remicade every 8 weeks  (Stopped working)
Aloe Vera Lily of the Desert Juice  Gave me the worst D !
Primadophilus Reuteri Probiotic
 


Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 21976
   Posted 12/29/2007 8:13 AM (GMT -6)   
I have left sided and yes, it can be extremely difficult to treat. My GI told me that mainly it's because oral only goes down to a certain area and then the enemas only go so high up - it's that in between area that can be the most hardest to treat because it doesn't get the proper amount of medication. I originally started with UP, then it spread to Sigmoiditis then to Left Sided and it was when it hit the left side that I started having a real hard time achieving remission or even feeling normal :(
 @--->--SHERRY--<---@
Moderator for Allergies/Asthma and Co-moderator for UC
~Left sided Uc -'92 - Colazal (9 daily), 6mp (50-100mgs), Prilosec, Biotin, Forvia, Pro-Bio**Unable to tolerate Asacol, Rowasa or Canasa** ~Allergies - Allegra & Singulair
~Secondary Reynauds Syndrome - '04 - Norvasc~Fibromyalgia - '06~
To help Healingwell - click here: DONATE
http://www.myspace.com/82595818
"The quality of my life depends on the quality of my thoughts."
 
 
 
 

 
 


mjw82704
Regular Member


Date Joined Dec 2006
Total Posts : 251
   Posted 12/29/2007 11:28 AM (GMT -6)   
Wow your posts were hard to read (emotionally) but I am glad that I heard what you had to say. I had no idea about this. but it explains why I have been having so many problems in the last couple years. Mine progressed from Ulcerative Proctitis to Left sided colitis. Does anyone know how that happens? Does it just happen or is it a lack of proper meds or both. Well if anyone out there has found out what has helped their left sided colitis get into remisssion please post as well. The colon removal that you posted about KSU really scares me. If that happened I could most likely get a J pouch right?




Thanks,
Melissa
Left-sided colitis diagnosed at age 28 in 2001
Asacol 4 pills 3 times per day
Hydrocortisone Enema and Rowasa Enema rotating days for the next thirty days
Prenatal vitamins


gaff
Regular Member


Date Joined Jul 2006
Total Posts : 442
   Posted 12/29/2007 11:42 AM (GMT -6)   
I have left-sided colitis and have been in remission for almost 1 year. I currently take 2x2 Colazal daily and 1/2 Rowasa every other day. I exercise and try to keep stress to a minimum.

Try not to skip meds. Once you're in remission for a while you might try to lower the dosage of your meds.
gaff
left-sided UC since 11/05
 Rowasa, Colazal, Calcium, Centrum
Natren Healthy Trinity Probiotics


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 4530
   Posted 12/29/2007 1:13 PM (GMT -6)   
See my earlier post, "New Online IBD Article Summarizes Current Medical Treatment Options". Part 1 discusses UC & has a chart differentiating 5-ASA meds. The docs who say meds "do not reach the left-side colon", etc. are kind of stupid. Everything that enters the colon has to exit by the same route! The truth is that different oral 5-ASAs begin to dissolve in different areas of the GI tract-- that can make a difference in their effect on the patient's particular inflammation site. I have done better taking Colazal than on any of the earlier oral 5-ASAs, or on Rowasa alone. My inflammation is usually in the sigmoid, but I have occasional inflammation in the descending colon, too. If Asacol doesn't do enough for you, Colazal or Lialda may be better-- worth a try, I think. Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily for maintenance of remission)

Judy2
Forum Moderator


Date Joined Mar 2003
Total Posts : 9338
   Posted 12/29/2007 3:09 PM (GMT -6)   
My GI also told me left sided is more difficult to control. And he uses Colazal for the same reason - it's released the lowest in the colon.

Don't despair, though. There are a lot of people with left-sided UC who have good remissions. My doctor also told me I was one of the most difficult to get into remission, so my experience will totally not be typical. However, I have now been in remission for more than 18 months. I feel good, I go to work every day, I eat what I want within moderation, I have no pain and no bleeding.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Intolerant to Asacol and rectal mesalamine preparations.
On Prednisone then Entocort 2001-2006 with only short periods off. 
Current meds are Colazal, Azathioprine and Remicade.
In remission since April, 2006. Remicade has been my wonder drug.
 


UCinNC
Veteran Member


Date Joined May 2007
Total Posts : 526
   Posted 12/29/2007 3:17 PM (GMT -6)   
so, I have pancolitis and this conversation makes me wonder..... is pan colitis like having left-sided and then some? I always thought that pan colitis was the hardest to treat due to how extensive it is. are you guys saying left-sided is actually more difficult than pan?

Melissa - as for your original question, I wouldn't worry about surgery right now, as it appears, from your signature, that you haven;t even tried Imuran or 6-Mp yet, much less remicade. If you were to stay sick, you could always bump up to imuran. I was VERY scared of that drug after reading about it, but I have actually had no problems on it so far (knock wood) and would recommend it if you need to try something else. But I also echo the earlier post about maybe trying a different ASA. my GI has said that too, that different people have more/less success with different ASAs.
29/Female/NC
Pancolitis dx 3/07
12 Asacol/day
150mg Imuran/day (steroid dependent)
Various vitamins, a probiotic and fish oil.


barnsbury
Regular Member


Date Joined Jan 2006
Total Posts : 443
   Posted 12/29/2007 3:26 PM (GMT -6)   
Melissa - I agree, you shouldnt be worrying about surgery at this stage.  I have been battling UC for almost 8 years (most of that time spent flaring) and I do not want surgery. But, in answer to your question, yes - j-pouch is usually an option.

Back on Pred - 5mg - Steroid Dependent :-(
Azathioprine 150mg
Actonel 35mg
Predfoam Enema
EPA Fish Oils
Various Homeopathic meds
Asacol x 9
Remicade every 8 weeks  (Stopped working)
Aloe Vera Lily of the Desert Juice  Gave me the worst D !
Primadophilus Reuteri Probiotic
 


Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 21976
   Posted 12/29/2007 4:11 PM (GMT -6)   
Old Hat, I happen to think that my GI is highly intelligent, kind and compassionate which is why I've been with him for over 10 years. To call any GI stupid that is just trying to simplify an explanation is uncalled for. I agree that there are some GI's that shouldn't be in practice but you shouldn't "assume" that a GI is stupid for trying to make their patient (who doesn't understand medicalnese) more aware of why certain meds treat certain areas.
 @--->--SHERRY--<---@
Moderator for Allergies/Asthma and Co-moderator for UC
~Left sided Uc -'92 - Colazal (9 daily), 6mp (50-100mgs), Prilosec, Biotin, Forvia, Pro-Bio**Unable to tolerate Asacol, Rowasa or Canasa** ~Allergies - Allegra & Singulair
~Secondary Reynauds Syndrome - '04 - Norvasc~Fibromyalgia - '06~
To help Healingwell - click here: DONATE
http://www.myspace.com/82595818
"The quality of my life depends on the quality of my thoughts."
 
 
 
 

 
 


Judy2
Forum Moderator


Date Joined Mar 2003
Total Posts : 9338
   Posted 12/29/2007 4:20 PM (GMT -6)   
UCinNC, the way my GI explained it, pancolitis can make you much sicker. More weight loss, etc. But he says it's usually easier to achieve and maintain a remission than with left-sided. That's statistically, of course. Each individual is different.

And yes, medicines that enter the colon have to exit through the left colon. But the absorption is done in the right and (a bit) in the transverse colon, so not nearly as much of the drug will be absorbed in the left colon regardless of how it's delivered. And oral meds that work topically will be more likely to expend themselves in the first sections of the colon, with less left at the end. So even though the drug gets there, it may not be used as well by the body.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Intolerant to Asacol and rectal mesalamine preparations.
On Prednisone then Entocort 2001-2006 with only short periods off. 
Current meds are Colazal, Azathioprine and Remicade.
In remission since April, 2006. Remicade has been my wonder drug.
 


damo123
Veteran Member


Date Joined Jul 2007
Total Posts : 677
   Posted 12/29/2007 4:34 PM (GMT -6)   
Old Hat,

I diasagree with your assertion that "The docs who say meds "do not reach the left-side colon", etc. are kind of stupid". Even if you dont agree with that statement thats a terrible way of expressing your opinion. If i read that line as a complete newcomer to this site and to UC it would make me kinda nervous and anxious about the whole GI / Med process.

From what I've read Asacol doesnt start the dissolving process until the first few cms of the colon. At that point it has 100% efficiency. As it moves along the colon its efficiency drops. Sure it reaches all of the colon but it does not do so at 100% efficiency. According to my GI by the time it starts descending the left side of the colon its efficency is between 25%-40% depending on the metabolism of the person. By the time it gets to the rectum its efficency can be 0%. And that is the main reason why rectal medication is prescribed.

I agree with Red_34. I have lots of issues with my GI and at times I question a lot of what he says and the same with modern medicine. But I've yet to meet a GI or a GP that isn't a sharp intelleuct and well read in their area. I believe every GP and GI trys to helps us as best  as they can.

D


800 mg Asacol + 250mg suppositories daily...
 
...but more importantly a Healthy Diet, low levels of Stress and a steadfast belief that "I am a healthy person".
 
 
 
 
 
 
 


damo123
Veteran Member


Date Joined Jul 2007
Total Posts : 677
   Posted 12/29/2007 4:42 PM (GMT -6)   
The rates of remission are smallest for pancolitis so yes pancolitis is the harest to get into full remission.

The rates of rectivation of the disease are the same whether you suffered pancolitis, left sided or whatever. I find this strange but surveys have shown it to be true. So if uve just come out of a pancolitis flare u have the same chance as a person with just left sided UC of having a subsequent flare at a given time.

I don't understand the argument that pancolitis should be easier to get into remission than just leftsided. If you have pancolitis then technically you also have left sided colitis i.e. leftsided UC is just a subset of pancolitis since UC begins in the rectum and spreads upwards. Therefore pancolitis should be at least as hard to get into remission as left sided (and probably harder). If my logic is wrong here I'm sure I will be corrected!!...:-)

D
800 mg Asacol + 250mg suppositories daily...
 
...but more importantly a Healthy Diet, low levels of Stress and a steadfast belief that "I am a healthy person".
 
 
 
 
 
 
 


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 4530
   Posted 12/29/2007 4:57 PM (GMT -6)   
Damo, recommend that you have a look at online article with chart I cited. It states that Asacol begins dissolving in the terminal ileum. As for calling some doctors "kind of stupid", some of them are, and their staffs, too. Read some posts by Sara14 and other members who discuss this. These docs may be jolly good fellows with positive intentions, but they end up harming patients or retarding their progress toward better control of UC. I am interested in helping other UCers get the most up-to-date, medically accurate info. This is a continual learning process. I assume that everyone posting here has completed at least a secondary school education. Why the fright and recriminations when members occasionally vent at doctors? No one is naming names! This site is supposed to allow venting! "Stupid" is a common adjective, not a curse word. Peace, brothers and sisters. We are trying to share good solid info. / Old Hat

damo123
Veteran Member


Date Joined Jul 2007
Total Posts : 677
   Posted 12/29/2007 5:10 PM (GMT -6)   
Old Hat,

No I won't be checkin it. I've read about the efficiency of Asacol enough and thats good enough for me. Its easy to just quote online article after online articele. U can always find a document that contradicts another, That doesnt get us anywhere.

As for calling docs stupid and using that term...hey maybe we come from different cultures. Not something I'd do. I've no problem with venting at docs and GIs...just not my method, friend. But as u say peace brother.

Sure the site allows venting. I think it also calls for a little respect to all. I seem to remember a moderator reminding of us of that point recently.

D
800 mg Asacol + 250mg suppositories daily...
 
...but more importantly a Healthy Diet, low levels of Stress and a steadfast belief that "I am a healthy person".
 
 
 
 
 
 
 


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 4530
   Posted 12/29/2007 5:35 PM (GMT -6)   
"Respect" is a fine principle, but this is a forum, not a place of worship. And, yes, we may come from different cultures. What's wrong with that? Not everyone has the patience to suffer fools gladly, and they may express their frustration in different terms. I do not go around yelling "This sucks!", etc., but if a younger person expresses him or herself that way, I still try to hear them out or read/reply to their post. If everybody looked, spoke, wrote, and behaved the same way, it would be a very boring world-- and a very boring Healingwell Forum. / Old Hat

damo123
Veteran Member


Date Joined Jul 2007
Total Posts : 677
   Posted 12/29/2007 5:41 PM (GMT -6)   
Old Hat,

I actually havent read much of your reply this time nor do I intend to read any further replies. I'm not here to have a tit for tat argument with you on this and I'm sure the residents and moderators dont appreciate it either. So this is my last comment on the matter.

I don't agree with what you say. Does that mean that both me and my GI are "stupid" by your reasoning. No it doesnt.

I don't believe its right to label anyone nor any profession as "stupid" becasue the hold different points of view. But thats just my opinion on the matter. and if others feel it is then I apologise and go for it. Just not something i was brought up to say. And that's my final word on the matter.
800 mg Asacol + 250mg suppositories daily...
 
...but more importantly a Healthy Diet, low levels of Stress and a steadfast belief that "I am a healthy person".
 
 
 
 
 
 
 


Judy2
Forum Moderator


Date Joined Mar 2003
Total Posts : 9338
   Posted 12/29/2007 6:29 PM (GMT -6)   
The logic may say otherwise, but my GI says he and the 8 others in his practice experience more difficulty with getting left-sided UC-ers into remission, on the whole. He's not stupid and he's not a liar, so maybe their experience is atypical. I'm just telling you what he told me.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Intolerant to Asacol and rectal mesalamine preparations.
On Prednisone then Entocort 2001-2006 with only short periods off. 
Current meds are Colazal, Azathioprine and Remicade.
In remission since April, 2006. Remicade has been my wonder drug.
 


Mitzo
Veteran Member


Date Joined Dec 2007
Total Posts : 536
   Posted 12/29/2007 6:33 PM (GMT -6)   
I wonder if taking asacol or pentasa together with psyllium, meaning, washing one down with the other, can help the med reach the left side? The active ingredient might stick to the fibre and release more slowly all the way through the colon? Just something I am imagining.
21 years of UC which started after quitting smoking. In and out of flares which are usually triggered by antibiotics.


Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 3766
   Posted 12/29/2007 7:47 PM (GMT -6)   
Mitzo - Interesting theory. I have no idea what the answer is, but interesting thought.

And, yes, I can attest that some (not all) GI docs are kind of stupid (and very frustrating!).
23 years old
Diagnosed with UC March 2007
Current inflamation in the rectum
Asacol 4 tablets 3x/day
Rowasa (generic) - as needed for flares
Nature's Way Primadophilus Reuteri 1/day; Chewable multivitamin; Metamucil; Viactiv (Calcium and Vit. D) for Osteopenia; flaxseed


barnsbury
Regular Member


Date Joined Jan 2006
Total Posts : 443
   Posted 12/30/2007 4:43 PM (GMT -6)   
I don't think it is worth arguing whether some GI's are stupid or not.  There are some great GI's around and there are some who are the worst medical "experts" I have ever come across. So, all of us as UC patients can make our own judgements. It's a free country. 
 
If people want to nominate an outstanding GI for a coveted award, then thats great.  Conversely, if people want to label a particular GI as stupid, then that is equally fine.
 
Back to the topic in hand - I was told by a GI that left-sided UC does not respond as well to medications as pan-colitis.  He cited Imuran as a particular example. 
 
This can sound hard to believe as pan-UC is much more serious than left-sided, but I think when UC does respond to meds, pan-UC is more likely to than left-sided.  This is the case for me.  My pan-UC flare which was my first flare went into remission with azathioprine. 
I have had numerous flares since - all left-sided - and none responded to azathioprine.
Back on Pred - 5mg - Steroid Dependent :-(
Azathioprine 150mg
Actonel 35mg
Predfoam Enema
EPA Fish Oils
Various Homeopathic meds
Asacol x 9
Remicade every 8 weeks  (Stopped working)
Aloe Vera Lily of the Desert Juice  Gave me the worst D !
Primadophilus Reuteri Probiotic
 


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 4530
   Posted 12/30/2007 6:23 PM (GMT -6)   
Ulcerative proctitis can be very stubborn. I know a UCer who spent 1 month in hospital being bombarded with IV steroids to subdue a severe flare there. This patient is now doing well on Colazal. / Old Hat (nearly 30 yrs with left-sided UC ... [etc.])

kelina
Regular Member


Date Joined Aug 2005
Total Posts : 307
   Posted 1/1/2008 8:56 PM (GMT -6)   
i have left-sided colitis, as you can see from my signature, i take a few meds, but it wasnt until i was on remicade that i fulled reached remission, i still have a few days when i feel "crappy" but nothing like what i use to go through, i only worry when i get pain and blood, haven't seen either since being on remicade, it was a year this past june, so i'm working on almost 2 years of remission.

but i explore new things all the time, i love researching new meds cause i know that some meds may not work forever, and i know if i flare its cause of the food i eat and i suffer for it.

27 yr old, female lower left moderate to severe UC since 2002

Colazol 3 pills 2x per day, 6 MP 50 mgs per day

Flax Seed Oil 2 per day, VSL#3 4 pills per day, Food enzymes 2 b4 meals when needed

canasa when needed, can't do rowasa!

Next Remicade Treatment Jan 31st

 


Knitty_Cat
Regular Member


Date Joined Jun 2006
Total Posts : 105
   Posted 1/2/2008 3:36 AM (GMT -6)   
I have left sided UC but tend to get fairly lengthy periods of remission. For me, the trick was getting the right amount and right mix of oral and rectal 5ASA meds - I seem to need both for maintenance but can bring myself out of most flares with extra 5ASA enemas so things are pretty good.

I have heard that left sided is the hardest to treat but I've been going pretty well with just the 5ASAs. For what it's worth, my Dr was really happy when we found out it was just left sided and not through the whole colon. He said then I could use rectal meds. I didn't quiz him any further on this but he did seem more worried when it thought it was pan-colitis.

Mitzo - I actually take my last dose of oral 5ASA just after a big glass of metamuscil (just before I go to bed). However, I've been doing this for years so can't really say if it helps. The Metamuscil really forms a gel that goes through your system so it does seem possible that it would sweep the Asacol further along than just a glass of water would. I could do some testing of this by moving the metamuscil so it is 2 hours away from any of my Asacol doses but things are going well at the moment so I don't want to risk that! Interesting idea though.
Left Sided UC
Maintenance Meds: Salofalk tablets (Asacol) 2 tablets 4 times daily (4gm total) plus 2 Salofalk foam enemas per week.
Flare Meds: Salofalk enemas and/or Colifoam
Oat bran 60grams daily, Metamuscil and multivitamins

New Topic Post Reply Printable Version
Forum Information
Currently it is Thursday, August 28, 2014 10:03 AM (GMT -6)
There are a total of 2,203,119 posts in 245,228 threads.
View Active Threads


Who's Online
This forum has 155170 registered members. Please welcome our newest member, dee1961.
461 Guest(s), 24 Registered Member(s) are currently online.  Details
naturalcurl, sarahm620, notsosicklygirl, BnotAfraid, Agent9er, hateuc, mikeb2308, Sickandtired68, PFB214, Stroud5393, SuperBlanks, lovif, Debicat, ks1905, Traveler, Ex Paratrooper, Red_34, MariaMaria, jacket fan, Nosila, straydog, Teletubby, windypetunia, iPoop


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest  Follow HealingWell.com on YouTube
Advertisement
Advertisement

©1996-2014 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer