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Date Joined Mar 2009
Total Posts : 21
   Posted 5/26/2009 4:59 PM (GMT -6)   
Just had some questions about the asa's. I originally was on salofalk with no effect, then on asacol and achieved remission but I think it was mostly the prednisone. For those of you that have been on several different asa's, did you seem to notice differences in the effectivness? My other question is with the asa enemas. How far up into your colon do they go? I only ask this because I have pan colitis. Sorry for asking so many questions in here but the more I learn the more ammo I have when I go see my narrow minded doctors:S


Diagnosed with moderate UC left side 2005
Salofalk 3pills x 3 times daily - No effect
2006 moderate to severe UC
Prednisone 25mg daily cycled down 5mg per week
Asacol 3pills x 2 times daily
Remission achieved
2009 severe pancolitis
60mg prednisone cycled down 5mg per week
2grams fish oil, multivitamin
Currently at 10mg prednisone, starting to flareup again.

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Date Joined Apr 2004
Total Posts : 23551
   Posted 5/26/2009 8:35 PM (GMT -6)   
Certain medications are designed to target specific areas of your colon. I can't comment on the Salofalk but Asacol, depending on the PH level in your colon, can release all the way thru or half way. I am not sure what the PH level has to be but sometime if someone has left sided on down they don't do well on Asacol because the medication doesn't reach all the way. Colazal, which is a basalazide not a mesalamine, is more ideal for left sided - down. Asacol is usually the better choice for Pancolitis.

Mesalamine enemas only reach to the sigmoid colon, maybe a bit higher. But even if it only reaches so high, it can still be beneficial for someone with Pancolitis. Asacol can heal from the top on down and the enema can treat the end section.
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Old Hat
Veteran Member

Date Joined Feb 2007
Total Posts : 5154
   Posted 5/29/2009 9:57 PM (GMT -6)   
If you have severe left-sided UC, you likely need steroid enemas as minimum treatment. The liquid only reaches as far as the sigmoid colon (same as 5-ASA liquid enema), but with 3+ weeks of use the steroid enemas have a systemic effect that helps the descending colon, too. Mesalamine enemas only have a topical effect-- so oral med is needed to treat inflammation in the descending colon or higher up. ASAs vary in their effect among patients and in the same patient at different stages of treatment. For example, ten yrs ago I achieved remission after 8-10 weeks on mesalamine enemas, but a couple months ago they aggravated a flare so I had to stop them & depend on Colazal capsules, which, thankfully, worked to subdue moderate ulceration in the sigmoid. I agree that if your doctor is "narrow-minded" about meds it could add to your problems. There's a huge range of response to meds among UC patients so it's best to hook up with an IBD-experienced gastro who listens to your complaints and RXes/adjusts meds accordingly and monitors your condition carefully via appropriate scopes/lab tests. / Old Hat (30 yrs with left-sided UC; original Colazal has been my best med to-date, the generic (balzalazide) made me sick)
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