First Time Forum Submission --- TOLERANCE TO MESALAMINE

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Happy Cat
New Member

Date Joined Aug 2008
Total Posts : 13
   Posted 8/5/2008 1:55 AM (GMT -6)   
Hi Everyone:
I am new to the forum and excited to see there is an actual online support group for UC.  I accidentally discovered you while online looing for some info mesalamine. I am a 62 year old, married female living in Los Angeles who was initially diagnosed with UC in August 2001. Since diagnosis I have had periodic flare ups with periods of glorious remission including a fabulous 2 year period of remission from 2002-2004. During flare ups I have had been prescribed all the usual treatments with varying degrees of success (i.e., prednisone, short course of budesonide until I developed a rash, Canasa, Rowasa, Asacol, Lialda, Imuran (discontinued due to elevated liver readings -- actually passed out at the market thanks to that drug!!).  I am currently facing a strange flare up unlike prior ones.  I have the urgency to get to the bathroom fast in the morning, about an hour after awakening, but only pass a small, semi solid stool without blood or mucous.  However, the downside on this current flare up is I then have 8-10 return visits to the bathroom during the remainder of the day (up until bedtime) with very tiny amounts of diarrhea that is granular in appearance. Fortunately I am retired because I could never have faced this while working.  With those repeat visits, I have cramping, gas throughout the day and always a sense of urgency but only pass the very small amount of diarrhea.  I am currently taking four 1.2 g. of Lialda (2 in AM and 2 in PM) plus 4g. Mesalamine generic enema at bedtime.  In the past, I had some success with the enemas and was actually on an "every-other-night" maintenance enema for several months before this current "flare up." However, prior to this current "flare up," I never really felt in complete remission as before --- just sort of keeping things under control and always wondering what the next day would bring.  Does anyone know if one can develop a tolerance to the Mesaline enema?  I have been back on the nightly enemas for 7 nights now, and I am not getting any significant improvement. In fact, tonight I even saw a small amount of stringy blood in my diarrhea. My gastroenterologist is out of town for 2 weeks sad and I am hoping someone has some insight into success or failures with the Mesalimine enemas. Do you think there is a qualatative difference between a generic Mesalamine (which I am on ) and the brand - Rowasa? I am willing to stay on these enemas for 2 weeks before giving up.  Before leaving town, my doctor gave me a prescription for 4mg MEDROL (PAK) in case my condition worsened during his absence.  I assume the MEDROL is like the regular prednisone I have taken in the past, but I am not 100% sure on that. I am would prefer to hold that until I really am desperate.  Bottom line, any good, bad or  ugly observations on Mesaline enemas?  I will start the metamuscil tonight that everyone is raving aboutSo sorry this was so long, but as a first-time forum writer, I think I got carried away.  Next time I will keep it short and snappy.  Any ideas will be dearly appreciated.  Thanks so very much in advance,

Elite Member

Date Joined Apr 2004
Total Posts : 23551
   Posted 8/5/2008 7:59 AM (GMT -6)   
Hi, welcome to Healingwell :) I was on and off Rowasa for many years. And I didn't actually build up a tolerance but rather an intolerance. I can no longer do mesalamines because it increase my D severely and it also gives me severe abdominal pain with a flu like feeling. Before the bad intolerance issue, Rowasa or Canasa would just increase my D. So yes, some people can begin to have an intolerance to this med. As for the generic and brand name; I found that the generic made me worse then the brand. So you can try switching to the brand name if you think this is the problem.
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**~Year-round allergies-Singulair, Allegra~Secondary Reynauds Syndrome-'04-Norvasc~Spinal Stenosis(?)~Sacroiliitis-epidural injections~bulging and herniated discs C5/C6 & C6/C7~2nd epidural injection 8/14, Neurontin and Skelaxin
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Regular Member

Date Joined May 2008
Total Posts : 388
   Posted 8/5/2008 4:40 PM (GMT -6)   

You symptoms are similar to my own right now. I am having unusual symptoms as well. As it happens I just discussed the mesalamine intolerance that red34 wrote about with my GI today. He said some people can't handle all that mesalamine in their body. Too much of the drug causes diarrhea, in some people and you are taking a lot right now between the four lialda and the rowasa so it is certainly something to consider. He said that lialda breaks down low in the colon and then with the 4Grams of rowasa on top of it (also low in the colon) that it can actually cause colitis type symptoms.

Anyway, I am just repeating what I heard. I hardly EVER know what I am talking about!

To answer your question re: observations on mesalamine enema. I hate using them, but they have helped my abdominal pain so much that I can almost forgive them for being so awful to use.
UC diagnosed 10/05, first symptoms 1983
asacol daily and rowasa as needed 
Trying out Digestive Fitness Probiotic
past rx: colozal, lialda, canasa

Veteran Member

Date Joined Feb 2006
Total Posts : 5698
   Posted 8/5/2008 4:47 PM (GMT -6)   
I have never heard of anyone building up a tolerance to meslamine before but there are many cases where some UC drugs just stop working for the patient. Have you tried the steroid enemas? That might be your next line of defense.

dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free

Happy Cat
New Member

Date Joined Aug 2008
Total Posts : 13
   Posted 8/5/2008 10:11 PM (GMT -6)   

Thanks so much for the quick and interesting replies.  This forum is wonderful.  Ironically,  I felt better today even after another mesalamine enema last night.  I will continue for 2 weeks straight until my GI returns from vacation.  After reading all the positives about metamuscil, I took 1 large glass of water and metamuscil before bed.  Maybe that helps because I felt quite well today and didn't have 6-7 return visits to the bathroom.  Again, I really appreciate getting input from other people. It is so helpful especially since one starts thinking, "Am I the only one?"

diagnosed with UC (proctitis) to 15cm August 2001 year remission 2002-2004
Currently on 4 tablets of Lialda 1.2 g and 1 rowasa enema nightly
62, married female

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