How do you know if you're sensitive to mesalamine?

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potato
Regular Member


Date Joined Jun 2008
Total Posts : 281
   Posted 8/17/2008 7:36 PM (GMT -6)   
This might sound like a dumb question but I'm not sure if I'm flaring (more) again or if I might be sensitive to mesalamine. 
 
I was doing ok, not great, but ok when I tried to switch to 6 asacol from 9 and rowasa nightly a few weeks ago.  One night of that, plus Quincy feedback, and I went back up to the 9 asacol and rowasa.  Did that for a couple of weeks and got D, fever, and blood.  Blood work showed my white cell count up slightly.   
 
I called my GI's office about 10 days ago and we went with a cortisone enema pm and am and lomotil along with the 9 asacol.  That worked well about 5 days, to no blood and about 5 D per day, but the past three days I'm back to seeing blood once a day and up to 9 - 10 D a day, no firm stools at all, even with increased fiber tabs and an extra daily dose of culturelle. 
 
Can anyone tell me how they figured out whether it was mesalamine or their UC causing the D? 
 
I'm tired of this pain in the butt disease!  pun intended! 
Potato...  Female, 58, dx mild left sided ulcerative colitis 11/07
asacol 3 3x a day 
cortenema am & pm 
culturelle, benefiber wafers 
children's vitamin, Vitamin E 400 mg
omeprazole 2x a day
oxazepam (anti anxiety) when needed, lomotil if needed (trying this out)
 
 
 
 
 
 


kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 8/17/2008 8:00 PM (GMT -6)   

I wish I could answer your question as I am having similiar.  I was doing so-so with 6 Colozal a day and proctofoam enema but not getting rid of blood or cramping.  Stool was forming somewhat and less times a day.

So, gastro doc put me on 9 Colazal a day and changed to Rowasa enema.  After three days - blood was much less if non-existent BUT nausea is so bad and sweating early morning and more cramping.  How do we know what is worse?

ElaineNY


68 yr. old granny
New diagnosed with proctosigmoiditis
Colazal 3X3
Probiotic Align
Prilosec for GERD
Inderol for hypertension
Xanax,Lipitor, multivitamin, calcium w/D, Tylenol
Starting Rowasa
 
 
 
 
 
 


jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10407
   Posted 8/17/2008 9:42 PM (GMT -6)   
When I started taking Asacol at the time of my diagnosis, I got much worse within a week. Increased D. and cramping were my main issues. My GI had me stop the Asacol, start Pred, then re-start the Asacol after five days. When I once again got much worse, we decided it was the mesalamine. I had the same problem with Rowasa, so had to stop using it after just a few days.
Judy - Southern US 
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from Entocort.
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.


potato
Regular Member


Date Joined Jun 2008
Total Posts : 281
   Posted 8/17/2008 10:10 PM (GMT -6)   

I hear you about which is worse, Elaine.  Plus there are so many other possibilities of what could be going on.  This really is a day to day disease (and sometimes morning to afternoon!)

Judy, thanks for your input.  Since I'm only on the cort enema, if I'm in a real flare, I may not be getting enough prednisone, but I prefer not to go on the tablets unless I have to.  Fortunately, the nurse practioner agreed and just suggested I get as informed about meds and treatment as I can.

I think I'll just keep asking lots of questions and learning from everyone here.   


Potato...  Female, 58, dx mild left sided ulcerative colitis 11/07
asacol 3 3x a day 
cortenema (generic) am & pm 
culturelle, benefiber wafers 
children's vitamin, Vitamin E 400 mg
omeprazole 2x a day
oxazepam when needed, lomotil or ImodiumAD (but not in the same day)
 
 
 
 
 
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30596
   Posted 8/18/2008 12:09 AM (GMT -6)   
I think the only way you'll know is if you taper down on them and see if you improve.

Were you always on pred for flares? When did you start the Asacol?

When did you start taking the Benefiber?
By wafers...do you mean chewables tablets? They do contain artificial sweeteners....do you also have artificial sweeteners in other products?


The higher white blood count..did the doc take stool samples?

q


*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
~vitamins/minerals/supplements 
~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 !!!


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 8/18/2008 12:12 AM (GMT -6)   
The experiance I had with asacol was after taking just one dose of 4 pills, a few hours later I broke out into a full body rash along with nausea, fever and chills, that was strong enough evidence that I was severely allergic.

:)
My bum is broken....there's a big crack down the middle of it!  LOL  :)


Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 23551
   Posted 8/18/2008 4:50 AM (GMT -6)   
I started by not responding to Asacol - now I am wondering if I was becoming intolerant of it. Then I was switched to Colazal and when I would flare, the doc would put me on Rowasa. After a while, it started increasing my D, blood and urgency. The more I tried it the more the symptoms became pronounced and then I started getting severe abdominal pains as well as feeling like I had the flu. The doc said ok, maybe you can't use that and would put me on a steroid enema. So then a few years ago, I was in a mild rectal only flare so the doc wanted me to try Canasa. I was on vacation at the time and the only symptom I had was minor bleeding. Every morning after I used a Canasa, I had severe urgency with D and increased bleeding. I decided to go every other day with them and the days that I wasn't on them, everything was almost perfect. It was the mornings after I used them that was hard so that is when I knew for a fact that I just can't tolerate any meslamines.
 @--->--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**~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
To help Healingwell - click here: DONATE
 
 
 
 

 
 


puffed rice
Regular Member


Date Joined Feb 2008
Total Posts : 495
   Posted 8/18/2008 6:33 AM (GMT -6)   

I am having the same problems right now, I started flaring 4 weeks ago after being in remission for almost 2 years.  I started with urgency, blood and diahrea so I began cortifoam during the day and hycort enema at night along with my usual dose of salofalk pills 6 daily.  Well since then there was still a little blood after the first week so I increase my salofalk pills to 9 daily because the doc advised me to, well the cramping became severe, I had major diahrea with tons of blood and now I'm up many times through the night with just liquid coming out.  So about 4 days ago I totally cut out the salofalk pills because I tought I'm getting worse not better and the cramping stopped, the blood has decreased but I am still waiting for stool formation patiently.  I will stick with just rectal meds for a while to see if things improve.  The same thing happened during my last flare years ago the doc increased my pills to 12 daily, well my hair fell out in clumps, I was in my bed for four months with the worst flare since 1995, but I never made the connection then it was my meds.  I have been on these since 95 but I guess I can't increase my dose without side effects..

 

 

 


Diagnosed with Ulcerative Colitis 1995
Salofalk Tablets , salofalk suppositories or cortifoam nightly
Bio-K Probiotic daily
multivitamin
metamucil nightly


kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 8/18/2008 7:44 AM (GMT -6)   
That is what I am thinking.  I was going in the right direction with 6 Colazal a day but got more nausea and cramping when NP added 3 more a day.  I went back to 6 a day two days ago and no enema for two nights because of my son visiting.  I took Imodium twice yesterday and was fine.  Today so far one BM which was nicely formed and trace of blood (can you believe I used a flashlight in the toilet LOL).  I always have a good day after using Imodium (so two good days) and then back to more problems.  Calling my NP tomorrow.  ElaineNY

68 yr. old granny
New diagnosed with proctosigmoiditis
Colazal 3X3
Probiotic Align
Prilosec for GERD
Inderol for hypertension
Xanax,Lipitor, multivitamin, calcium w/D, Tylenol
Starting Rowasa
 
 
 
 
 
 


potato
Regular Member


Date Joined Jun 2008
Total Posts : 281
   Posted 8/18/2008 1:33 PM (GMT -6)   

Wow, thank you all for your feedback.  We really have to be detectives here, don't we?  Add Red's, rice's, and Elaine's experiences (and maybe mine, too) I suspect reactions to mesalamine might be dosage related. 

It figures, last night I went to the pm and am cort enema and have had much less D today.  I also have not taken any lomotil or imodium today and even did some work and errands for a couple of hours without cramps or D, which hasn't happened in a LONNGGG time.  Like I said, day to day.

Quincy, I only had the one real flare in Jan. when I was off everything, in my denial phase.  When I had my colonoscopy in Nov last year, the GI put me on asacol 2 3xday, which I did for about 3 weeks and then decided heck, I really didn't have much of a disease (hahahahahahahahahaha) and quit the meds.  I did fine off of them until Jan., right before we went on a cruise.  After we got back, things went downhill and that's when the GI put me back on the asacol and on about a 6 week prednisone regime.  I have to say I didn't have many problems on it, and it's the only time I've ever been on it.  I was pretty moody on it and at the end of the taper downright hostile sometimes.  So, I'd rather keep it as a last choice if possible.

The benefiber, a GOOD question.  Yes, I've been using the artificially flavored orange tablets AND I've been wondering if some of what I thought was blood colored might be the orange in them!  I did do the max dose a couple of days ago, which probably added to the D problem.  I don't do any other artificial sweeteners.  But have you looked at the fiber choices lately?  Almost all are artificially sweetened!   

Yep, I began wondering about the higher blood count and stool samples last night.  I'll request them if the D continues. 

So many factors that can contribute to this disease!  (and thanks for all the good input and questions)    

 
Potato...  Female, 58, dx mild left sided ulcerative colitis 11/07
asacol 3 3x a day 
cortenema (generic) am & pm 
culturelle, benefiber wafers 
children's vitamin, Vitamin E 400 mg
omeprazole 2x a day
oxazepam when needed, lomotil or ImodiumAD (but not in the same day)
 
 
 
 
 
 

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