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decision to not take medication?

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jerkygirl
New Member
Joined : Jun 2009
Posts : 17
Posted 8/6/2009 5:14 AM (GMT -7)
hi all

I am thankful Im not in as bad a condition as many on this forum. I have UP, but I don't have any urgency issues, I go to the bathroom once, maybe twice a day, which is mostly fine, except for quite a bit of blood and mucous.
After reading many horrible stories about the meds and such, and given that my symptoms are not impacting me (aside from being a little disturbing with the blood), am I doing further damage to my ulceration / inflammation by not taking any meds? I would like to just try fixing myself with diet, supplements and probiotics (so far no luck, but Im only a week or 2 into the spinach/sunflower diet).
My GI did give me a script for colifoam, but I don't want to take it if it means Im starting on a journey of ever more and more and stronger drugs.
Would appreciate your thoughts and knowledge.

Thanks, and I really hope we can all get better. It really does suck to read how tough some of you are doing it.

jerkygirl
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suebear
Veteran Member
Joined : Feb 2006
Posts : 5698
Posted 8/6/2009 6:18 AM (GMT -7)
Research shows that it is better to take the maintenance meds than to not take them. While you think you might be avoiding stronger drugs in the future, by not taking them you are actually increaseing your risk of having to take stronger meds in the future. Inflammation is the root of evil with UC/UP and keeping it in check should be your #1 priority. I'm not of the belief that diet and supplements can accomplish this but there are many who believe it can.

Sue
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Rio in Maryland
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Joined : Nov 2007
Posts : 891
Posted 8/6/2009 6:22 AM (GMT -7)
It's great that your symptoms are only mild. But if you're seeing a lot of blood and mucus then it's important to get that under control soon before things get worse -- as they did with me when I didn't take my meds initially.

I agree that watching your diet and taking the right supplements is the best way to go, but maybe you could do that once you have things under control.

Just wondering, have you tried other rectal meds such as canasa or rowasa enemas? I think that it's better to try those first before even thinking of using anything with steroids.
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love4cats
Regular Member
Joined : May 2007
Posts : 458
Posted 8/6/2009 6:23 AM (GMT -7)
My GI has stated that as long as I don't have symptoms, then there is no need to take meds.  The meds just control inflammation, they are curing, so to me, it would be like staying on cold meds all the time to control getting a cold.
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thatfield
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Joined : Jul 2008
Posts : 823
Posted 8/6/2009 6:32 AM (GMT -7)
Hi - I would not stop taking the meds at this time. The rectal meds and 5ASA are really not bad and most people have no side-effects at all. It is the more powerful stuff (especially oral Pred) that can be worrisome. The colifoam is a rectal steroid I believe. If so those are very mild and not a systematic type drug. It will only affect the rectal area where you need it to work. It will not cause side-effects or be absorbed through your whole body like oral pred. So...I agree with the others - your symptoms could get much worse if you do not get them under control now. You most likely will not have to stay on the colifoam once this is controlled...
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Dr-A
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Joined : Jul 2006
Posts : 2105
Posted 8/6/2009 7:47 AM (GMT -7)

love4cats said...
My GI has stated that as long as I don't have symptoms, then there is no need to take meds. The meds just control inflammation, they are curing, so to me, it would be like staying on cold meds all the time to control getting a cold.


I suppose he would wait until someone had a heart attack before he addressed cardiovascular disease too? Same concept. Symptoms are a horrible way to go about determining health.
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AmyWaffle
Regular Member
Joined : Jun 2009
Posts : 173
Posted 8/6/2009 8:03 AM (GMT -7)

love4cats said...
My GI has stated that as long as I don't have symptoms, then there is no need to take meds. The meds just control inflammation, they are curing, so to me, it would be like staying on cold meds all the time to control getting a cold.

It's like using sunscreen all the time to control getting skin cancer. Pure quackery.
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kops2da
Veteran Member
Joined : Jun 2008
Posts : 2865
Posted 8/6/2009 8:12 AM (GMT -7)

You are all confusing me.  Does the doctor believe no meds if there are no symptoms?  Right now I am doing ok like jerkygirl - no urgency - 2 or 3 BMs each morning - formed but with blood and mucous.  I have a little left sided discomfort from time to time but also have IBS.  Both my doctors took me off all medication because I cannot tolerate them.  WE ALL seem to believe now that it is mostly the additives in the medications (propellants in foam, etc.) that I cannot tolerate.  I used Cortifoam 2 to 3 times a day for a couple weeks and just got worse - more pain than anything in pelvic area which went away as soon as I stopped the foam.  5 ASA's give me flu  like symptoms - continually getting worse.  I took prednisone for nearly 6 months and have tapered off and feeling better but not good.  I know if I flare badly I am back on prednisone - the choices are too limited for me.

BUT - having said all that for me - I think those of you who can stay on Asacol or LIalda for maintenance should do so. I think Colazal and proctofoam helped my UC but side effects I could not live with.

ElaineNY 

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fruitgirl
Veteran Member
Joined : Feb 2009
Posts : 7150
Posted 8/6/2009 8:16 AM (GMT -7)
Elaine, that's what I think love4cats doctor is saying...that there's no need for meds if there are no symptoms. I know you wish you could use the meds...it really sucks that you can't! You seem to be a pretty rare case, though! :)

This isn't a a good thing to believe, IMO. The meds help keep the inflammation from coming back, too. So, if you stop them, there's a much higher chance that it will come back. I've heard WAY too many stories about people who quit taking the 5ASA meds b/c they felt so good, only to have the symptoms come back worse than they ever were before, and then the 5ASAs didn't work any more and they had to move on to a stronger drug. So, that's why I'll always take my 5ASAs. If I can avoid 6MP, Remicade, etc, all the better!
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quincy
Elite Member
Joined : May 2003
Posts : 32474
Posted 8/6/2009 8:27 AM (GMT -7)
jerkygirl..you're flaring and its best to treat it. I would suggest you start with the 5ASA meds...so the research and make an informed decision.

As well...understand what they really do and why maintenance meds are helpful.

Yes, they treat the symptoms because it's an autoimmune reaction. if you want to remain in an inflamed state, that's definitely your decision, but you do risk it spreading upward.

A bit of prevention helps if in fact yours might spread...not all do.

In saying all this, some low in the rectum IBDs are very difficult to treat and patients become pretty immune to any treatments...

sucks for sure...no one wants to use meds.

q
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thatfield
Veteran Member
Joined : Jul 2008
Posts : 823
Posted 8/6/2009 9:08 AM (GMT -7)
Agree with all - get out of this flare - the cort foam may help then get on maintenance meds.  It likely will get worse if you do not. 
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subdued
Veteran Member
Joined : Dec 2008
Posts : 3231
Posted 8/6/2009 9:35 AM (GMT -7)

love4cats said...
My GI has stated that as long as I don't have symptoms, then there is no need to take meds. The meds just control inflammation, they are curing, so to me, it would be like staying on cold meds all the time to control getting a cold.

I agree.

The kidneys only last so long. My son-in-law's grandfather just died of kidney failure a couple days ago. He was in perfect health until a couple of months ago when he fell. He started retaining water; so his family took him to the hospital. The doctors found out that he was retaining water in his lungs. They checked for heart failure. His heart was fine. They checked for lung cancer. No evidence of cancer. They then said it probably was his kidneys. However, he was 96. Too old for surgery. So they didn't do much to help him.

I agree. If the colon isn't inflamed, then why take maintenance medicines that reduce inflammation? If you have no symptoms of flaring and are still worried that you could be flaring and not know it, then you can be on an anti-inflammatory diet. Some ingredients, such as turmeric, reduce inflammation without hurting the body. Why not add turmeric to some of your foods?
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ickypoo
Regular Member
Joined : Dec 2008
Posts : 224
Posted 8/6/2009 10:37 AM (GMT -7)

Dr-A said...
I suppose he would wait until someone had a heart attack before he addressed cardiovascular disease too? Same concept. Symptoms are a horrible way to go about determining health.

That seems a tad unfair Dr-A. After all, medications are not the only way to address many diseases. Don't other variables like lifestyle changes have a role to play too? Even for cardiovascular disease?

The working assumption for many on this list seems to be that UC can only be effectively treated (symptomatically) via prescription medications. I have my doubts. That is not to say that you should do nothing, especially if you are experiencing bleeding/mucous. Even if your bleeding is relatively minor, how can that be a good thing?

As others have suggested, I think it best to treat your condition. I don't agree that this necessarily involves the use of prescription medications - maybe, maybe not. I wouldn't rule them out entirely (use them myself - for now), but I certainly don't blame you for seeking an alternative path.
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Dr-A
Veteran Member
Joined : Jul 2006
Posts : 2105
Posted 8/6/2009 1:31 PM (GMT -7)

subdued said...
I agree. If the colon isn't inflamed, then why take maintenance medicines that reduce inflammation? If you have no symptoms of flaring and are still worried that you could be flaring and not know it, then you can be on an anti-inflammatory diet. Some ingredients, such as turmeric, reduce inflammation without hurting the body. Why not add turmeric to some of your foods?

You can have inflammation and no symptoms. If you are ruling out the inflammation with colonoscopy I agree with ya.

ickypoo, that wasn't unfair at all. I never said meds were the only way to treat this, but you can't sit back and wait for a flare before you worry about your disease. I mean, I guess you can, but you would suffer on down the road for it. I didn't read that love4cats doc was giving her alternative recommendations? Since most GI's (at least everyone I have ever seen) don't think diet affects the disease, or that anything alternative helps, I am assuming the doc just turned her loose until she gets a symptom.

To the OP, there are alot of different things to try to naturally keep things quiet. I think the vitamin E enemas are pretty effective, especially with UP. Sorta wish I had known about those back when I first got started in this whole thing and I just had UP. It's trial and error, just don't trial yourself too much and get worse.
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jerkygirl
New Member
Joined : Jun 2009
Posts : 17
Posted 8/6/2009 2:29 PM (GMT -7)
thank you all for your replies. it does suck to have to take meds, but perhaps you are right, just take it and get rid of this flare then come off it. It sounds like a simple plan huh. So I guess I shall give the colifoam a go, and see what happens after this course....I neglected to mention i have had the bleeding since March this year, so I guess the diet control isnt working...will keep up the spinach diet though,dont mind it at all :)


cheers
jerkygirl
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kops2da
Veteran Member
Joined : Jun 2008
Posts : 2865
Posted 8/6/2009 3:23 PM (GMT -7)
I would be extremely happy if anything I try puts me in remission.  Except for the two weeks on prednisone 40 mg. (bleeding stopped after 5 days) I have been flaring since diagnosed and before - May, 2008.  Almost every day blood and mucous - some worse, some better. My blood work is always normal. 

I thought 6 MP might help so I could go off prednisone but it was found to be not working at 50 mg. and I could not tolerate 75 mg. even though I tried 10 days twice! 

So, if you can take medications, use enemas, suppositories, whatever works for you - do it - get into remission and then decide about maintenance.  Maybe you won't need it if you choose that route.  Right now I am not on any meds and having mostly bad days - not diarrhea, not lots of BM's but nausea every morning with cramping, blood and mucous - exactly what sent me to the doctor over a year ago.  Like I never tried anything - had three scopes in that time - all showed inflammation - mostly proctites and 30 cm. up left side.  IBS is not helping.  I will contact my new specialist as he is the one who took me off the rectal meds.  I was in so much pain from them all around me in pelvic area. 

ElaineNY

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fruitgirl
Veteran Member
Joined : Feb 2009
Posts : 7150
Posted 8/6/2009 3:31 PM (GMT -7)
I think most of us actually meant to keep on taking the meds (the 5ASAs and other maintenance meds, not steroids) once you were in remission...I know that was the intent of my post!
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notsosicklygirl
Forum Moderator
Joined : Dec 2008
Posts : 17743
Posted 8/6/2009 3:45 PM (GMT -7)
I was exactly like you a few years ago and stopped my meds. A few months went by where I was ok, not great but not terrible. After some stress in my life, things went downhill extremely quickly. Before you know it, my one trip to the bathroom a day turned into 2, then 3, then 5, next thing you know I was running to the toilet 15x a day with severe cramping and anemia. Mild cases can and do get worse. Not always but mine did. I wish I had been able to afford the medication I needed instead of ending up in the situation where I allowed much more of my intenstines to flare up and now it feels like I am fighting off a massive flare all the time.
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Hopeful4uc
Regular Member
Joined : Jun 2009
Posts : 90
Posted 8/6/2009 6:12 PM (GMT -7)
I was just like "Notsosicklygirl" and then whamo my colon got the disease all the way through.  I now have pancolitis and i also was just having 2 bm's in the am with blood and mucous.  So, you really don't want to let this go.  it sucks to realize that this does not go away on it's own.  I also have tried the probiotics, diets, and it worked ok, but then when i took calcium with vit D that did it for me.  My colon could not digest a vitamin so with the colonoscopy that determined that my UC got worse, and probably have been working on it with minimum systems until I started taking vitamins.  So, from my experience please do not let this go especially if you are loosing blood, check your hemoglobin/differential and get a current base line.  i did and my UC got worse without me even really knowing it (just little blood, mucous).  Try rectal meds and that may just do it for you, etc.  I too didn't want any more meds, but keeped with the Lialda, but that wasn't even enough, so now I'm on Remicade (3rd) infusion and doing pretty well.  No bleeding, I actually had a few formed (normal) stools, yes!! I haven't had that since i was dx with proctitis 5 years ago.  Yes, Remicade is very, very serious, but with minimal side effects for me so far, I'd say the benefits outway the risks.  Wish you luck in what you decide.

Hopeful4UC

 

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Supa
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Posts : 748
Posted 8/6/2009 7:03 PM (GMT -7)

fruitgirl said...
Elaine, that's what I think love4cats doctor is saying...that there's no need for meds if there are no symptoms. I know you wish you could use the meds...it really sucks that you can't! You seem to be a pretty rare case, though! :)

This isn't a a good thing to believe, IMO. The meds help keep the inflammation from coming back, too. So, if you stop them, there's a much higher chance that it will come back. I've heard WAY too many stories about people who quit taking the 5ASA meds b/c they felt so good, only to have the symptoms come back worse than they ever were before, and then the 5ASAs didn't work any more and they had to move on to a stronger drug. So, that's why I'll always take my 5ASAs. If I can avoid 6MP, Remicade, etc, all the better!

Fruitgirl-this is exactly what happened to me.  I had a pretty crappy GI doc initially, and she didn't explain any of this kind of thing to me.  I was diagnosed with a mild case, symptoms were almost gone even before diagnosis actually, was put on Colazol, ended up in remission extremely quickly, so I quit the meds.  Before too long, stress came into our lives, I started having problems again, but this time the meds didn't do it.  I tried at that point to manage things "naturally" and wound up in the hospital and now have been told I have a severe case (while my first GI doc told me UC didn't get worse-that it was limited to your initial diagnosis, and could get better but not worse-nitwit) and am on much stronger meds, most likely for life.  Had I known, i would have stayed on the colazol, and maybe that would be the only thing I ended up having to take!  Who knows...

At any rate, I wouldn't go off of the maintenance meds.  I know people who can start and stop, but it didn't work that way for me, and I wouldn't wish what happened to me on anyone!

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elt27
Regular Member
Joined : Jan 2009
Posts : 35
Posted 8/6/2009 11:34 PM (GMT -7)
When I saw my doctor last week, he said that within the first year, if you don't take maintanence meds you've got a 50% chance of getting another flare. In the second year that drops to 25%. I don't know if the figures are the same in the States, but I'd agree with everyone else - don't come off your maintanence meds just because you feel ok.
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ickypoo
Regular Member
Joined : Dec 2008
Posts : 224
Posted 8/7/2009 7:36 AM (GMT -7)

Dr-A said...
ickypoo, that wasn't unfair at all. I never said meds were the only way to treat this, but you can't sit back and wait for a flare before you worry about your disease. I mean, I guess you can, but you would suffer on down the road for it. I didn't read that love4cats doc was giving her alternative recommendations? Since most GI's (at least everyone I have ever seen) don't think diet affects the disease, or that anything alternative helps, I am assuming the doc just turned her loose until she gets a symptom.

I didn't mean to put words in your mouth - I agree that waiting for a flare is not the best way to proceed.

But that may not have been the rationale of the GI in question. The key word in your reply is 'assuming'. Neither of us knows what he or she was thinking. There may have been a perfectly good reason for not insisting on meds while being asymptomatic - especially if no inflammation is present.
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love4cats
Regular Member
Joined : May 2007
Posts : 458
Posted 8/7/2009 9:37 AM (GMT -7)
Dr A:

Heart disease can't be compared to UC, it is permanent unlike UC which normally shows itself in way of flares. If the immune system is not attacking the colon, then to take meds to stop inflammation is useless. Like a coldsore, do you put meds on your lips while you are in remission, no. How about cancer, do you take chemo while you are in remission?

Even while on meds, your UC can spread, it just depends on your immune system and where it wants to attack.

As some people know, you can take meds until you are blue in the face but it doesn't control their symptoms and the only cure is to have their colon removed.
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Dr-A
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Posts : 2105
Posted 8/7/2009 10:11 AM (GMT -7)

love4cats said...
Dr A:

Heart disease can't be compared to UC, it is permanent unlike UC which normally shows itself in way of flares. If the immune system is not attacking the colon, then to take meds to stop inflammation is useless. Like a coldsore, do you put meds on your lips while you are in remission, no. How about cancer, do you take chemo while you are in remission?

Even while on meds, your UC can spread, it just depends on your immune system and where it wants to attack.

As some people know, you can take meds until you are blue in the face but it doesn't control their symptoms and the only cure is to have their colon removed.

Heart disease isn't permanent. Cold sores, well some people do take meds to help before they get a problem (Valtrex). I'll give you the cancer one though, you don't take chemo if its in remission, probably why I didn't use that example. My point, you can have no symptoms going on and still have inflammation, or any other bad health condition. In general, waiting for a symptom before making a decision to address the problem is a bad way to take care of your health no matter what comparison you are using. We could start another thread on that if anyone wanted to, lol.

I assumed (we all know what that does) you didn't have a colonoscopy to base your inflammation on. Was your GI was basing your inflammation on symptoms? Thats how your post reads anyway. I won't post anymore on this in this thread anyway. Not beneficial to the OP.
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princesa
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Joined : Aug 2007
Posts : 2204
Posted 8/7/2009 10:25 AM (GMT -7)
If it's UP, why not take rectal meds only? They may totally do the job for you and have little to no side effects compared to the systemic effects of oral meds. Surprised Q's respose didn't really mention rectals.

In addition to meds, high doses of omega-3s will help reduce inflammation - and are good for you in many other ways.

Taking the milder meds - rectals, ASAs - won't necessarily start you down a path of no return to higher powered drugs. In my experience, limited meds can help get the situation under control while you figure out what combination of diet, natural supplements and lifestyle changes works for you to ensure long-term healing.

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