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What are the symptoms of mesalamine allergy?

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Ulcerative Colitis
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svetla
Regular Member
Joined : Jan 2009
Posts : 45
Posted 5/31/2019 10:15 PM (GMT -6)
My son was recently diagnosed with UC. At first it was presenting as pancreatitis. After he was diagnosed with whole colon UC the doctors started him on prednisone and two weeks after the prednisone he started taking Mezavant. Two weeks after discontinuing the steroids he started flaring up or that is what we thought. He got tested for bacterial infection and it turned out it was an infection. He was really sick for a few weeks until we got the results back. In the meantime the doctors switched him to Pentasa. Now after the 7-day course of Sulfa-trim he had two really bad episodes of pooping and throwing up at the same time. Both episodes happened after he had had a meal and taken 4 pills of Pentasa. Could it be allergy to mesalamine? Now he is much worse than before the diagnosis and before he took all these meds.
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16368
Posted 6/1/2019 6:16 AM (GMT -6)
A mesalamine-allergy/intolerance is described as a dramatic worsening of uc symptoms. Like going from 2 formed, non urgent bms a day, to suddenly 6-8 very urgent diarrheas a day; very dramatic change. Usually happens when 1st trying the med. As it's medication-induced, stopping the med for 48-hours makes symptoms dramatically better. about 5% of us have said intolerance. Easy to skip meds for a day and see.
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quincy
Elite Member
Joined : May 2003
Posts : 33231
Posted 6/1/2019 10:26 AM (GMT -6)
Sulfa-trim...possibly?

What is the time-line exactly since symptoms started, diagnosis, meds on and off, etc?

Has he had an upper scope done?

You can definitely stop the Pentasa for a few days, but he does have a lot going on in such a short time. What Pentasa exactly is he on?

q
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svetla
Regular Member
Joined : Jan 2009
Posts : 45
Posted 6/1/2019 11:22 AM (GMT -6)
Thank you for your replies. He is 17 y.o. I have had UC for 18 years.

June'18 - hospitalized with abdiminal pain and very high levels of lipase. First BM with blood on the day of admission; nobody paid attention; nobody paid attention to the fact that I had UC and there might be a connection; everybody was focused on the lipase.Diagnosis: pancreatitis.

A few more stays in hospital due to abdominal pain, diarrhea, no blood in stool, lipase off the charts. MRI and ultrasound of pancreas did not show anything.

He was referred to and seen in the Provincial Children's Hospital. Diagnosis: Chronic Pancreatitis.

December'18 blood in stool, diarrhea, exhaustion (3-4 bm/day). Doctors finally decided to check his faecal calprotectin and it was elevated.

Jan'19 colonoscopy and endoscopy, UC of the whole colon diagnosed. MRI of small intestine. A tiny red dot of inflammation of the stomach; nothing significant, they said.

Feb'19 started prednisone (starting at 40mg for two weeks and then tapering off for 8 wks); 2-3 weeks after he started the prednisone they included Mezavant as maintenace medication. He had diffculty swallowing the tablets and was not very consistent. They switched him to Asacol.

April'19 about a week after prednisone was finished and he had established a good regime of taking tbe Asacol, he had a very bad episode of diarrhea, abdominal pain, and so on.

A very bad flare-up had started, we thought (10+ bm/day, blood 35% of the time, abdominal pain, bathroom visits at night).

Stool culture test was done and initially it was negative (30 April-7 May). He was switched to Pentasa oral and suppositories. There was slight improvement but temporary. The idea behind Pentasa was that he can dissolve the tablets in water or food and be more consistent (his doctors at theChildren's Hospital are 1350km away, there is not paeediatric GI here and they were still concerned about the initial reports of his inability to swallow the huge pills; I communica via phone/e-mail with the nurses, they talk to the doctor and send me the info).

22 May. I got a call from the local Health Unit that his stool was tested 10 days later and it was positive for Yersenia. Sulfa-trim was prestibed and started on 24 May for 7 days.

In the meantime he had got worse. Watery diarrhea, throwing up, complete exhaustion, nausea, bathroom visits at night, 10+ bm/day. Missed school. 3 days after he started the antibiotics he got better. But the two episodes of him throwing up and pooping simultaneously happened after he had started (1) and after he had finished (1) the antibiotics.

Yesterday he took only half a dose of Pentasa. The prescription is 8x500 mg tablets (dissolvable) a day. Manufacturer Ferring.

If it turns out he is allergic to it, what other medications are available for maintenance?
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 1499
Posted 6/1/2019 11:59 AM (GMT -6)
Maybe his symptoms are from the yersinia? He sounds very sick sad I'm so sorry he has to go through this. Wishing him a speedy recovery.
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16368
Posted 6/1/2019 12:26 PM (GMT -6)
If he cannot tolerate mesalamine then it's some form of immunosuppressive meds. Either thiopurines (azathiopurine/mercacaptopurine/imuran) or biologics (humira/remicade).
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Rusty Barr
Regular Member
Joined : Feb 2016
Posts : 275
Posted 2/12/2021 7:59 AM (GMT -6)
I too am wondering if I am allergic. I went to GI because of a mild flair. One semi formed first thing in morning, then 2 or 3 watery BMs throughout the morning. But then things would calm down until the next morning.
This went on for about three weeks so I went to my GI.

Three days ago I started taking 40 mg of prednisone in the morning and a half dose of Apriso morning and night. A full dose of Apriso is 2 tables morning and 2 at night. He said let’s start you out slow on this and see how it goes. Work yourself up to the 4x a day.

Well, day three now of this new combo, and my flair has become way worse. No blood, but I’m having water BM now continually. Last night I had to get up 3 times in the night and get to the bathroom.

Today, I’ll start a very strict diet.

I have had excellent success with prednisone alone before. Normally within a few days I am on the road out of the mild flair.

I’m wondering if this Apriso is something I am allergic to?

I know I am allergic to sulfa drugs like Bactrum. Five years ago I took Lialda and that made things a lot worse then. So, I assumed I am allergic to Lialda. But, now I’m thinking maybe it’s the metheslamine I’m allergic to.

Argh.
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