help with request from doctor.

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Regular Member

Date Joined Apr 2009
Total Posts : 178
   Posted 6/26/2009 6:59 PM (GMT -6)   
well ya'll please help if you can.....been in a flare for most of the year.  been on pred for 4 months or so, supposed to be tapering, but still struggling some.  I take 2 lialda a day, which pass right through me undissolved.  I don't think the doc believes me, but i see them all the time still hole in the stool, so they are really not doing anything for me.  I use rowasa nightly, which sometimes i hold all night, sometimes not too long at all.  I am supposed to be at 15 mg of pred, but cheated yesterday, took an extra 10 cuz not feeling very good.  I have friends coming down late next week for a few days and i wanna feel good while they are here if possible.  Doc is pushing 6mp, which i have resisted thus far.  Are there any other meds i can request either to replace the lialda which i am passing whole or should i request steroid enemas as i taper the pills.  Is there something else that i am unaware of that i can take in conjunction with the rowasa.  I don't know if he will fulfill my requests, i don't see him enough to have a super repoir with him, but I would like to at least have a plan of action to talk to him about monday.

Veteran Member

Date Joined Oct 2008
Total Posts : 938
   Posted 6/26/2009 9:37 PM (GMT -6)   
I don't have any advice on different ways to take the meds, etc. (Probably best discussed with the doc anyway) but I was wondering if it's possible that you aren't passing the Lialda whole but just the outter shell?  I think I read on the pamphlet from my pharmacy that this can happen sometimes.  Are you able to tell if it's actually the whole pill rather than just the shell?  You may still be getting the meds if it's just the shell. 

UC dx 2/08
Former treatment:
Asacol (2 pills 3xday)
Rowasa nightly x 6 weeks
Current treatment:
Lialda (4 pills 1xday)
Rowasa nightly
Specific Carb Diet

Veteran Member

Date Joined Jun 2008
Total Posts : 610
   Posted 6/27/2009 8:18 AM (GMT -6)   
I made a huge improvement when I went from Asacol to sulfasalazine, and Lialda is a different variation of Asacol, if I'm not mistaken.  Asacol/ Lialda use an acrylic covering that dissolves at a certain ph.  Sulfasalzine breaks apart by bacterial action.
The first few weeks on sulfasalzine, I had some headaches, but they went away.  One can also start with a low dose and build up to prevent thise side effect.

New Member

Date Joined Jun 2009
Total Posts : 10
   Posted 6/27/2009 8:30 AM (GMT -6)   
There is also Pentasa and Colozal, they're like Lialda.

Female, age 34
Diagnoses: UC, Depression, Acoustic Neuroma
Meds: Humira 2 pens every 2 weeks, Lialda, Imuran 150mg, Cymbalta, Prednisone

Elite Member

Date Joined May 2003
Total Posts : 31006
   Posted 6/27/2009 12:04 PM (GMT -6)   
Hi lucas..are you taking the Lialda on an empty stomach or with food?

It's possible the pred changes the ph or however the Lialda needs to help dissolve the outer capsule in order to dispurse.

Are you taking it with the pred? You might want to consider taking it at night instead of in the's digestive system tends to be a bit less active at might have time to do its thing then.

I think the fact that you're on pred....maybe while tapering, you could switch to the steroid enema and start adding the Rowasa when you're closer to a much lower dosage of pred.

Is this the first time you've been on pred or was that the initial choice by the doc since you've been diagnosed?

Hang tough...hopefully you'll get the right combo of options to try.

*Heather* Status: maintenance Asacol 6 daily + Salofalk enemas every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x 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....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ 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 !!!

Regular Member

Date Joined Apr 2009
Total Posts : 178
   Posted 6/28/2009 5:18 PM (GMT -6)   
Yeah, i am sure the medicine is not dissolving. I sometimes have to use the bathroom on the ground. I work railroad, so i am in the woods a lot so i go on the ground. Sometimes the covering is partly gone, but medicine is still formed. I take it with food in the morning. I used to see it even when i was in remission sticking out of formed stools too, when i was not on pred. I don't know. Is Sulfasalzine the same as mesalamine(sp).

Veteran Member

Date Joined Aug 2007
Total Posts : 2204
   Posted 6/28/2009 5:24 PM (GMT -6)   
Yes, Azulfadine (Sulfasalazine) is another ASA. It's an older drug that has a sulfa component the other ASAs don't have. I also did better on sulfasalazine than Asacol. And Elaine Gotshcall recommended sulfasalzine as her drug of choice. (You're on the SCD, right?) There is some school of thought that the sulfa component is actually very helpful.

I also agree that the steroid enemas might be a way to help you taper off oral steroids with less systemic side effects.
You may also consider looking for another gastro doc: one who listens when you tell him the meds are not dissolving and one who respects or supports your wishes for treatment.

Diagnosed with ulcerative colitis spring 1999. Have been in remission for years with only a few minor blips. Scope on 6/22 showed no inflammation at all.
Maintenance dose sulfasalazine. Probiotics, vitamin D, fiber supplement and fish oil caps. George's aloe vera juice and l-glutamine for gut healing. Mostly grain-free and dairy-free low carb diet.

Regular Member

Date Joined Apr 2009
Total Posts : 178
   Posted 6/28/2009 5:33 PM (GMT -6)   
thank you princessa for the info. I actaully like my doc a lot. He has pretty much put up with me. He has not pushed the 6mp hard knowing i am trying to avoid it. He simply thought maybe my digestion was moving to quickly and that is why. I am gonna mention the sulfasalzine to him. Maybe i will absorb that better.
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