Asacol and Inflammation

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notsosicklygirl
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Date Joined Dec 2008
Total Posts : 16744
   Posted 5/7/2009 7:05 PM (GMT -6)   
If I am on Asacol and I still have slight inflammation, should I be on something else to get rid of the inflammation? What are my options?
Diagnosed with proctitis in March 2007 - Treated with Canasa 2x Daily
December 08 - Began treating with Asacol 400mg (9 a day)


Shadam
Regular Member


Date Joined Jan 2009
Total Posts : 307
   Posted 5/7/2009 7:54 PM (GMT -6)   
I guess it depends on how bad your inflamation is.  When I first got on Asacol my GI put me on Pred to reduce the inflamation throughout my colon which was very bad (my doctor said my colon looked like a beef patty).  From my understanding I dont think Asacol reduces inflamation, I think it maintains the current state but I could be wrong...

Age: 25 / Male / Florida
Diagnosed: 11/08 / Pancolitis
Asacol - 2 x 3 day (waiting for results)
6MP - 50mg - started 5/04/09
Prednisone / ended 1/09 (started at 30mgs and tapered down)
Mens Multi Vitamin - 1 a day
Calcium & Vitamin D3 - 1200mc of Calcium and 800iu of Vitamin D3  
Jaro - Dophilus Probiotic (3.4 Billion) - 1 a day
Diagnosed with PSC: 3/9 --now taking Urso
Sunflower Seed & Spinach Diet - Started 4/26/09


notsosicklygirl
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Date Joined Dec 2008
Total Posts : 16744
   Posted 5/7/2009 7:59 PM (GMT -6)   
The doctor said it is "slight".

Diagnosed with mild proctitis in March 2007: Treated with Canasa 2x Daily
December 08: Began treating with Asacol 400mg (9/day) + Canasa 2x/day
May 09: Off Canasa, taking Asacol (9/day)


Zippy123
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Date Joined Feb 2009
Total Posts : 735
   Posted 5/7/2009 8:03 PM (GMT -6)   
notsosicklygirl said...
If I am on Asacol and I still have slight inflammation, should I be on something else to get rid of the inflammation? What are my options?


Only thing I could tell you to help would be anti inflammation foods and or try Boswellia at a high dosage, it may help, but can take a while to have an effect.

notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 16744
   Posted 5/7/2009 8:46 PM (GMT -6)   
Thank you. Ill check it out. I have been adding turmeric to everything hoping it would help but i've never tried Boswellia.
Diagnosed with mild proctitis in March 2007: Treated with Canasa 2x Daily
December 08: Began treating with Asacol 400mg (9/day) + Canasa 2x/day
May 09: Off Canasa, taking Asacol (9/day)


Peety
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Date Joined Mar 2008
Total Posts : 2855
   Posted 5/7/2009 8:56 PM (GMT -6)   
The Asacol can only reach so far into your colon. Do you know where the inflammation is? If it's near the end, you need rectal med to treat it.

The supplement called Curamin has both Boswellia and the active ingredient in turmeric (curcumin).
49 year old female attorney, diagnosed UC/pancolitis 1985, no surgery but much suffering. Asacol/5ASA 6x400 mg maintenance for 20+ years; used prednisone & Rowasa for flares. 
August 2008 sought care of naturopathic doctor. Food sensitivity test showed wheat/gluten, other intolerances; eliminated wheat/gluten from my diet. Probiotics (Ultimate Flora, 50 billion). 
Bad flare in March, used prednisone. Humira denied, started Remicade 4/12 and doing great~ 


notsosicklygirl
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Date Joined Dec 2008
Total Posts : 16744
   Posted 5/7/2009 9:02 PM (GMT -6)   

It is near the rectum. I recently stopped taking my rectal meds. I was kind of hoping I would be okay without them. Do you think I would get better if I use them again? I don't have any symptoms but the dr saw inflammation in my colonoscopy.

I definitely need to try this Curamin stuff.


Diagnosed with mild proctitis in March 2007: Treated with Canasa 2x Daily
December 08: Began treating with Asacol 400mg (9/day) + Canasa 2x/day
May 09: Off Canasa, taking Asacol (9/day)


Peety
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Date Joined Mar 2008
Total Posts : 2855
   Posted 5/7/2009 9:07 PM (GMT -6)   
Doc didn't tell you where it was inflamed? Ask for the pictures (they are fascinating anyway). My doc gives me color copies.
49 year old female attorney, diagnosed UC/pancolitis 1985, no surgery but much suffering. Asacol/5ASA 6x400 mg maintenance for 20+ years; used prednisone & Rowasa for flares. 
August 2008 sought care of naturopathic doctor. Food sensitivity test showed wheat/gluten, other intolerances; eliminated wheat/gluten from my diet. Probiotics (Ultimate Flora, 50 billion). 
Bad flare in March, used prednisone. Humira denied, started Remicade 4/12 and doing great~ 


Christine1946
Veteran Member


Date Joined Aug 2008
Total Posts : 5975
   Posted 5/7/2009 9:13 PM (GMT -6)   
     If you don't think the Asacol is helping, ask your doctor about Colazal.  I have ulcerative proctitis and the doctor switched me from Asacol to Colazal several years ago.
62 yr old granny. South Jersey
Diagnosed with ulcerative proctitis in 1998 in hospital
Hospitalized (2nd time) in May 2008
Update 11/03/08...finally in remission!!  Hope I don't jinx myself.  Off the prednisone since 11/01/08...now see if I can stay off for longer than two weeks.  Other meds: 6MP (75 mgm), colazal (6 per day), Benicar and Toprol (high blood pressure meds), Probiotic (2 per day), fish oil capsule and multi-vitamin and calcium with vitamin D.


lovemyboys09
Regular Member


Date Joined Apr 2009
Total Posts : 249
   Posted 5/7/2009 9:43 PM (GMT -6)   
Christine.....did colazal work better for you than the asacol did?? I have ulcerative proctitis also and he said that its going to go up the left side probably if we can't get the inflammation control.... (in my opinion) it is doing nothing for me. I have been on prednisone for 3 weeks....started at 20 mg because I have a hard time tolerating it and that gave me high blood pressure and racing heart so they moved it down to 10 mg a day. I also started taking 50 mg of azathioprine about a week ago. Im just wondering if colazal works better for what I have...My inflammation is severe he says with ulcers and friability so trying to figure out something better.


Diagnosed with Crohns in October 07
Diagnosed by new dr with Ulcerative Colitis 03/09
Colonoscopy on 4/23-diagnosed with severe ulcerative proctitus
 
Meds:
12 Asacol/day
proctofoam at night
prednisone (10 mg)
Azathioprine (50 mg)
pentasa
canasa
 
Waiting to feel healthy again....
 
 
 

Post Edited (lovemyboys09) : 5/7/2009 8:59:11 PM (GMT-6)


quincy
Elite Member


Date Joined May 2003
Total Posts : 31006
   Posted 5/8/2009 12:26 AM (GMT -6)   
Absolutely go back on the rectal meds in conjunction with the oral. Why did you stop the Canasa?

If the inflammation is slight, then I would think that one nightly would be good to start for a few weeks, then taper to every second night, etc.

Did your doctor not say to treat the slight inflammation?

q
*Heather* Status: mild flare enemas tapered to every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 x2 daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(Natural Factors Protec, Primadophilus Reuteri Pearls). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 16744
   Posted 5/8/2009 8:41 AM (GMT -6)   
I have to speak with her. Maybe she will change the plan after the biopsy results but there was no mention of changing anything. I don't have a lot of symptoms right now but I don't like the idea of inflammation, even if it is slight. I stopped canasa because I was supposed to go into a study and it was not allowed. She did mention that she doesn't like patients using Canasa for long periods of time. Why would this be the case? I was using it for a long time without any problems... I need to speak with her and see what I should do next. I was really sick a few months ago and I don't think she wants to "rock the boat" while my symptoms are so manageable.
Diagnosed with mild proctitis in March 2007: Treated with Canasa 2x Daily
December 08: Began treating with Asacol 400mg (9/day) + Canasa 2x/day
May 09: Off Canasa, taking Asacol (9/day)


quincy
Elite Member


Date Joined May 2003
Total Posts : 31006
   Posted 5/8/2009 2:11 PM (GMT -6)   
I don't get it...and canasa long-term isn't a problem at all. Does she mean not to tapered to be used as maintenance? Not clear on what she says NO about.

Don't rocking the boat....well, here's one thing that you can be sure of...one may not recognise symptoms until they're obvious. Obvious...that's subjective, because one may not deem some symptoms to be symptoms of inflammation or a flare.

You should be on the Canasa to treat the inflammation you have now or at least on every second or third night as a maintenance until your symptoms warrant to be treated as a flare. Then one or two daily to get inflammation down and then once "normal"...taper to every second night for a while then every third night....I would think twice a week for the suppositories would be a good maintenance dosage.

I prefer using the enemas, but my inflammation is higher. As well, there's a higher dosage of 5ASA in the enemas...and I don't like suppositories. So, that's personal.

But, since the supps are such a LOW dosage, you should use it to the fullest advantage. The plan should be for you to keep inflammation down for the longest period possible. Some doctors may not think that patients can do so....but my 20 years experience of using oral 5ASA and rectal 5ASA state that it can be done...and my flares the first 2 years were truly the worst until I figured out how to use the enemas as treatment and taper them to maintenance.

You should ask her if your UC did get worse.....what would be the next step. REALLY...ask her that. Because if she says pred or immuno meds...you should get real smart real fast about how to use the 5ASA in your favour for a long time so that you can control the inflammation to "help" prevent the inflammation from spreading upward or the inflammation from getting to the point where meds don't work any longer.

Yeah, I know I'm ragging on about that....but it could totally be worth it in your future.

quincy
*Heather* Status: mild flare enemas tapered to every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 x2 daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(Natural Factors Protec, Primadophilus Reuteri Pearls). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 16744
   Posted 5/8/2009 3:00 PM (GMT -6)   
No, I totally understand what you're saying and I am thankful you pont out these issues. I do need to know what the course of action will be "if" and what I can do to make sure I am not dealing with constant inflammation forever. I will start the Canasa again and see if the urgency in the mornings gets better. I need to get a more detailed report of the location and severity of the inflammation so I can make sure that I can keep things at bay for as long as possible.
 
Have you ever had to use pred or 6mp to manage a flare? I don't think I could take an immunosuppresent, my bloodwork was pretty weak with the anemia and all.
Diagnosed with mild proctitis in March 2007: Treated with Canasa 2x Daily
December 08: Began treating with Asacol 400mg (9/day) + Canasa 2x/day
May 09: Off Canasa, taking Asacol (9/day)


notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 16744
   Posted 5/8/2009 3:02 PM (GMT -6)   
Oh, I also think the inflammation is slightly higher now and it's probably not 100% reached by the canasa. I will inquire about using enemas or find out what the options are for that area. I really want to to have normal movements but the only symptoms I have are morning urgency and sometimes loose stools in the AM. I only go once a day and no blood or mucus.

Diagnosed with mild proctitis in March 2007: Treated with Canasa 2x Daily
December 08: Began treating with Asacol 400mg (9/day) + Canasa 2x/day
May 09: Off Canasa, taking Asacol (9/day)


Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4538
   Posted 5/8/2009 9:42 PM (GMT -6)   
Shadam said...
From my understanding I dont think Asacol reduces inflamation, I think it maintains the current state but I could be wrong...


Asacol does reduce inflammation. It doesn't work for everyone and it works better for many (including me) in conjunction with rectal meds to get to the rectum. With UC, the inflammation starts at the rectum and then extends upwards. That's probably why your doctor said it will spread up the left side if your flare continues to get worse or if you stop your meds.

Definitely ask about the Rowasa enemas. They have helped me a lot! Canasa doesn't do much for me, but the enemas do. Good luck! I'm glad your symptoms aren't too bad.


25 years old; diagnosed March 2007;
Currently: persistant rectal inflammation
Asacol, 4 tabs, 3xday; Rowasa nightly; Viactiv; Metamucil wafers; multivitamin; Primadophilus Reuteri; sublingual allergy drops; Ortho Tri-Cyclen


quincy
Elite Member


Date Joined May 2003
Total Posts : 31006
   Posted 5/9/2009 3:16 PM (GMT -6)   
I would do the 5ASA enema..if you're in the US, it's Rowasa (or maybe there's a Pentasa as well?), and the Asacol.

I do NOT think you've utilised any where near the base-line meds to their fullest potential. Also, remember, it's more like the tortoise and the hare process....slowwwww for results, but good for longevity in the long-run to find the lowest dosage possible for maintaining a remission/keeping inflammation at bay.

You don't want it spreading. however, for some....no meds control that, but there are always variables as to the reasons.

Many people don't want the commitment of using meds...I didn't know any better 20 years ago, just that my doc had a plan and it was better than the "other" doctor who wanted me on prednisone first thing. What's the big deal to use the meds anyway if they work? I still grumble when I use the enemas because it's just nice to go to bed without having to do so....but what's a whole 10 seconds out of my life? LOTS....of positive return as I look back and what my c-scope 2 years ago revealed....that it was all unremarkable. That's a good thing....

Keep us posted as to what's happening.

quincy
*Heather* Status: mild flare enemas tapered to every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 x2 daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(Natural Factors Protec, Primadophilus Reuteri Pearls). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 

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