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Mezavant XL undigested in stool

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Posted 1/16/2020 5:05 AM (GMT -7)
Hi all I was wondering if any one could help. I keep seeing my mezavant tablets in my stool. Somethings they come out whole sometimes they appear broken up. A simple google search told me it’s quite common but my question is, does it mean they aren’t working? Surely if they are coming straight out they can’t be doing much.

Thanks in advance
Posted 1/16/2020 8:07 AM (GMT -7)
Mezavant/lialda tablets are supposed to disintegrate and all you normally see are orange/red flakes in your stool. I would occasionally see a dud-pill in my stool, maybe once a month and that's no worries at all. If you are regularly seeing mezavant pills in your stool then the medication is not releasing, and it is not healing you. I would call your gasteroenteroligist and tell him/her of this problem. Usually the fix is to switch us to another mesalamine/5-ASA, perhaps Pentasa, Asacol, Apriso, etc.

The pills all have a PH-delayed-release coating, and a whole pill in your stool means that coating never dissolved and never released its med. Different brand mesalamines have different coatings, another brand might have a coating that does dissolve correctly for you. Each brand has a different target PH, different dissolve time on the coating, etc etc.
Posted 1/16/2020 8:10 AM (GMT -7)
This is very useful information thank you. I will bring this up with my team.
Posted 1/16/2020 8:57 AM (GMT -7)
I see this quite a bit in my stool, moreso when I'm flaring. I think when I'm not flaring, it's usually just the outer casing of the tablet.
Posted 1/16/2020 11:47 AM (GMT -7)
This would make sense sara14 I am flaring, well at least my recent calpro test says so. 1174 after my third loading dose of vedo. So went back on 40mg Pred. Now down to 15mg and just had my fourth vedolizimab infusion. Really hoping it kicks in soon so I can get back off the pred.
Posted 1/16/2020 2:55 PM (GMT -7)
Are you not having any symptoms even with that high of a calprotectin score? That's quite high. I hope it kicks in for you soon, too!
Posted 1/16/2020 3:27 PM (GMT -7)
Sara14 it’s a long story. I’ve been stuck on pred for 18months+ every time I wean off symptoms return. Started Tofacitinib (Xeljanz) back in June after failing infliximab, had absolutely no response in fact Symptoms got worse. Lots of urgency rectal bleeding etc. Flexi sig in August showed severe inflammation with contact bleeding. So back on the pred until I started vedo in October. I fully weaned off the pred after the 3rd loading dose. A week later the symptoms started grumbling again. Lots of urgency completely liquid stool but no bleeding. (Unusual for me) bleeding usually my first signs things are slipping again. That’s when calpro came back high. It was Down to 206 in June!

So back on the pred and symptoms considerably calmed since. Down to 15mg and grumbling again hence why your theory on mezavant not digesting during flare might make sense.

I just really really want this vedo to work ASAP last option for me before surgery. Doc thinks it can still work but had referred me to a surgeon for a chat just in case as I can’t keep managing it with Pred alone.

Do to answer your question yes and no symptoms are starting to come back again but no where near as bad a before. I can currently trust a fart so generally able to get on with life. But I do know that it’s most likely the pred masking the symptoms 😐
Posted 1/16/2020 4:50 PM (GMT -7)
Ah, I see! Sounds pretty similar to my life the last year and a half. But yeah, I've always seen partially digested mesalamine tablets during flares.
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