Colazal/ Mesalamine Intolerance? Help!

Hello all,

I am a newbie here and having some trouble getting on a med that works. Here’s my backstory…

I was diagnosed via unsedated flexsig 3 months ago while pregnant that Showed mild rectal and sigmoid inflammation. I was started on nightly Rowasa enemas which worked great for 10 weeks and got my FCP levels back into normal range. Suddenly my symptoms increased and after a few weeks I suspected it was the enemas. I went off of them and my symptoms immediately improved. So much so that I was med free for about a month. During that time i got my hands on some sulfite free Rowasa and gave it a shot…again, symptoms returned that night and it made my UC worse so I ruled out a sulfite allergy.

My Dr called in Colazal for me to try 3 pills 3x/day. I have started very slowly over the past couple weeks and yesterday/today got to 6 pills. I have experienced increasing symptoms… stomach cramping (which has never been a UC symptom for me), increased BMs, diarrhea. But I have seen it help with mucus, urgency, and hyperactive bowel sounds.

Whew, that was a lot. My question is… does this sound like a mesalamine intolerance? Or more like a sensitivity to too much and I need to experiment more with a smaller dosage? It’s frustrating that the enemas worked so well for a couple months then suddenly stopped, and then the Colazal seems to improve some of my UC symptoms but causes other side effects/exacerbation of diarrhea.

Any advice or help is appreciated. Thank you all for the support!

A mesalamine intolerance is a dramatic worsening of your bowel symptoms. Like going from before mesalamine 3, formed, not urgent poops to suddenly a very dramatic 6-8 very loose and urgent poops after starting a mesalamine. Ceasing mesalamine results in a very dramatic improvement of your bowel movements in 24-48 hours.

Some cannot take any mesalamine due to an intolerance reaction. Some can only tolerate low doses only, like only 2,400 mgs a day, anything over and they experience intolerance reaction.

Given your reaction to rowasa, sf-rowasa, and colazal, it does sound like it could be an intolerance to mesalamine. I'd discuss with your gasteroenterologist, see if starting you on a medicine that doesn't contain mesalamine would be helpful. That's azathiopurine, imuran, remicade, humira as examples.

I would keep notes. These things aren't always clear cut and a few days is not enough time to make a determination but keeping detailed notes will help you make future decisions.