perach...you are on the highest dosage of lialda....it would be best to use the rectal meds at a maintenance dosage and then lower the Lialda.
you can up it if needed, but in truth, the first part to flare would be the rectum and many times it's not noticable until more apparent. If you are to lower the Lialda, lower it by one pill every few weeks.
It's easier to maintain above the sigmoid with a lower dosage of meds and deal with the lower part with a higher dosage.
You could also try the 2g dosage of rectal meds instead of 4.
*Heather* Status: ...Asacol 3 twice 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/supplements; Probiotics....(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 !!!