My doc put me on 4 Mesalamine daily, with no improvement, he then added 40mg Prednisone 3 weeks later (I had been on Sulfasalazine for 4 weeks prior to colonoscopy on Oct 3rd, after a CT Scan). I was having 5 - 7 clumpy non formed BMs a day (most were urgent, and little to no warning) at this time. After reading many people talking of reactions to Mesalamine I cut dosage to 2 a day to see what would happen, and it got better as in 2-3 clumpy non formed BMs a day and urgency went away. I tried a few days of not taking Mesalamine at all, and symptoms returned to 10+ urgent BMs a day. So I am currently back at 2 a day.
Sounds like you might have a mesalamine allergy/intolerance. Although some here can tolerate mesalamine at a lower dosage, as you are describing 2 pills a day.
if symptoms and inflammatory markers do not improve, he wants to move to Biologics. I read some on Biologics, and I am not sure the benefits out weight the risks ( I have always been the odd one that gets the rare side effects to medication).
I've been on biologics, remicade specifically, for 4 years now and I have yet to experience a side effect from it. I did find a remission though. We're all initially nervous about
the prospect of side effects from a new class of UC medications. For me that was all worrying for nothing.
The odds of biologics helping improve your UC symptoms are about
65%. Few experience side effects from biologics. The benefits far outweigh the risks. The Crohn's and Colitis Foundation of America has a great risks versus benefits read and video that delves deeper into it, and looks at the odds of specific side effects occurring:
Moderator Ulcerative Colitis
John, 39, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, 4.8g generic-Lialda, and rowasaI believe that my anus is a portal from Hades as only evil comes out of it.