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Regular Member

Date Joined Aug 2007
Total Posts : 255
   Posted 6/24/2008 7:54 AM (GMT -6)   
ugh! My awesome new GI changed my meds to Asacol 4 pills 3 times/day and Rowasa at night. I've been on this regimen for 1 week today and notice the bleeding is diminished. However, I'm pooping liquid. I called the doc and am waiting to hear back, but just wonder if this could be because my dose is too high. Could it be the dosage, the med or more flaring? I've never pooped liquid when I flare.
Tressa 35 (F)
probably pancolitis
Colazal 3X3/day, Lialda upped to 4/day,Phosphatidylcholine 4 (420 mg capsules) once/day
Colazal 3X3/day (not generic)
Rowasa & Canasa as needed
Asacol 12/day

Regular Member

Date Joined Jul 2007
Total Posts : 402
   Posted 6/24/2008 7:59 AM (GMT -6)   
Tressa - This is the exact dose of both medications that I take when I am flaring. I remain on 12 Asacol per day when in remission but eliminate the Rowasa. So, I don't think your dosage is too high. 12 Asacol per day is the maintenance dose.

Is your stool liquid at every BM? Or is it just in the morning? The enema liquid does need to be expelled in the morning (or at some time overnight). So, it could just be the enema liquid, not necessarily stool that you are expelling if it is only happening in the morning.

Of course, there is always the possibility that the mesalamine is bothering you (both Asacol and Rowasa are mesalamine medications). It doesn't seem that would be possible, though, as you were previously on Lialda. Did you have any runny stool while on the Lialda or Colazal?
Wearing many hats: Mother, Wife, Daughter, Professional, Sister, Friend
Current Medications:
- Asacol (4 pills, 3x per day)
- Rowasa (1 enema daily, as needed)
- Folic Acid (1 mg, 1x per day)
- Calcium (600 mg, 2x per day)
- Multi-Vitamin (1x per day)

Regular Member

Date Joined Aug 2007
Total Posts : 255
   Posted 6/24/2008 8:04 AM (GMT -6)   
Hi, thanks for your reply.

I couldn't retain the Rowasa last night and expelled it after about 10-20 minutes. Some nights, I can retain it all night and then have white stool in the am.
The quantity and color of the current situation would suggest that it's not the Rowasa.

I never seemed to have trouble with mesalamine in the past. I lost control of my bowels the first time I was on Colazal; that's when I switched to Lialda.

I'm so glad to have a place to talk about poop! Thank you HW!
Tressa 35 (F)
probably pancolitis
Colazal 3X3/day, Lialda upped to 4/day,Phosphatidylcholine 4 (420 mg capsules) once/day
Colazal 3X3/day (not generic)
Rowasa & Canasa as needed
Asacol 12/day

Veteran Member

Date Joined Jun 2008
Total Posts : 610
   Posted 6/24/2008 8:12 AM (GMT -6)   
With all due respect to Expecting, I would suggest that 12 may be too high.
There are studies that show 12 Asacol may induce remission more effectively, but I haven't read anything to suggest that 12 is the standard maintenance dose.

Regular Member

Date Joined Aug 2007
Total Posts : 255
   Posted 6/24/2008 8:26 AM (GMT -6)   
That makes sense. My doc said that this is the highest prescribable dose of Asacol. This is the highest dose of mesalamine I've ever been on (with the rowasa). I wonder if it's too much for my system. I don't want to make any changes without the docs ok, though. I don't want to jinx my chances of getting better. I really want this to work, because I'm running out of options. (pred or remicade is next. I'd like to avoid that, if possible.)

Still waiting for the GI to call back...
Tressa 35 (F)
probably pancolitis
Colazal 3X3/day, Lialda upped to 4/day,Phosphatidylcholine 4 (420 mg capsules) once/day
Colazal 3X3/day (not generic)
Rowasa & Canasa as needed
Asacol 12/day

Regular Member

Date Joined Jul 2006
Total Posts : 442
   Posted 6/24/2008 9:18 AM (GMT -6)   
The same happened to me.  It was because I was on way too much medication.  Lower the dose.

left-sided UC since 11/05
 Rowasa, Colazal, Calcium, Centrum
Natren Healthy Trinity Probiotics

Regular Member

Date Joined Jun 2008
Total Posts : 73
   Posted 6/24/2008 10:26 AM (GMT -6)   
I take 12 asacol a day and don't think I have any problems from it (but its hard to say where the various problems I do have come from - are they from the UC? the prednisone? the 6-MP? the asacol? something else?). Just wanted to comment that my GI doctor also said that 12 per day is the maximum dose (but not necessarily standard for maintenance).
- diagnosed ulcerative colitis Feb 2005
- currently 25mg prednisone (tapering down), 75 mg 6-MP/mercaptopurine/purinethol (just started), asacol/mesalamine 4800mg (4 pills x 3 times day), 1 Canasa 1000 nightly, VSL#3, multivitamin, calcium, fish oil, sometimes digestive enzymes

Veteran Member

Date Joined Apr 2007
Total Posts : 1366
   Posted 6/24/2008 10:28 AM (GMT -6)   
Every time I've been put on Asacol, by a few different doctors, I've ALWAYS started at 12 a day. Four pills, three times a day typically. I've never been started on anything lower than that and when I have lowered the dosage I just started to bleed and flare more. But Asacol hurts me more than it helps me, it doesn't work for everyone.

Forum Moderator

Date Joined Mar 2003
Total Posts : 10407
   Posted 6/24/2008 12:23 PM (GMT -6)   
Everyone's tolerance is different. Even on a low dose of Asacol, I developed severe liquid diarrhea and cramping within three days. I can't take it at all. Perhaps your system tolerates it, but not at such a high dosage. Hope you reach your GI soon.
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from steroid therapy.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.

Elite Member

Date Joined May 2003
Total Posts : 30380
   Posted 6/24/2008 12:51 PM (GMT -6)   
Continue with the Rowasa should try to lower the dosage of Asacol. Usually it's one pill a week, but maybe for you you could lower it it over 3 one pill a day.

See if it helps.

I think pooping liquid is easier on an inflamed least for me it is.

How many bms a day are you having?

You could add a fibre supplement to bulk up the liquid a'll kind of slow things down a teeny bit..

it's really better to start at a lower dosage of Asacol and increase rather than a higher dosage....

12 is not a maintenance dosage...

*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!

potty girl
Veteran Member

Date Joined Dec 2006
Total Posts : 835
   Posted 6/24/2008 1:10 PM (GMT -6)   
6 a day is my maintenance dose. if I take over 9 I get runny poo most the time. when I am flarring I ussually take 9 a a day.

synthroid .088 mg, lowpressor 50 mg x 2, cozaar 25mg x2, imdur 30 mg
nitroquick, proventol, plavix 75 mg, protonix 40 mg x 2, asacal 400mg x 9
carafate 1 gm x 4, zyrtec 10 mg, rhinocort aqua nose spray, fish oil,

at wit's end
Veteran Member

Date Joined Jun 2007
Total Posts : 565
   Posted 6/24/2008 1:17 PM (GMT -6)   
I'm on Asacol, a maintenance dosage of 4 pills per day. And I protonix a day, plus I Canasa 1000mg suppository every other day.
Diagnosed with left sided UC in sigmoid colon and rectum 1986.
Put on Azulfidine 2 X 3 a day and Rowasa enemas 60mg.
Have been pretty much in remission overall other than a few flares over the past 21 years.
Medicine changed to Asacol 400mg 2 pills X3 times a day. Taken off all meds in 2004.
Diagnosed with acid reflux 2005. Put on Protonix 40mg.
Have been using Canasa 1000mg suppositories nightly since January 2007.
Was put back on Asacol 400mg 2 pills 2X a day in July 2007 maintenance. 

Regular Member

Date Joined Aug 2007
Total Posts : 255
   Posted 6/24/2008 2:22 PM (GMT -6)   
Thank you all for your responses. I got a call back from my GI. She said if it's helping (to stop the incessant bleeding), then continue until my colonoscopy on 7/9 when she can figure out what's going on.

I'm sure that it's too high a dose for me, especially after some of the replies I read. But, I really trust this doc and may stick with it as directed. I'm not sure. I might tough it out for 2 weeks.

Quincy,thanks for the encouragement to continue the rowasa. I was gonna cut that out first.
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