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Who has had UC for over 25 years and never taken anything stronger than mesalamine?

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Ulcerative Colitis
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ilovefood
Regular Member
Joined : Dec 2010
Posts : 139
Posted 4/27/2022 8:26 AM (GMT -8)
What the title says. I am interested as a perhaps slightly nutty person in this category (dx'd 1995) who has at times taken more mesalamine or stayed on it longer than docs suggested bc it works for me, I tolerate it well, and I don't want to take the other stuff. I often wonder whether my situation is unusual or not.

I recognize this board may not be representative and may include more folks either with more serious illness or more of a determination to heal w/o meds. Still, I am curious, if anyone is game to share.
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Sara14
Veteran Member
Joined : Mar 2007
Posts : 7792
Posted 4/27/2022 8:36 AM (GMT -8)
I wish...
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Old Mike
Veteran Member
Joined : Jan 2007
Posts : 4098
Posted 4/27/2022 11:09 AM (GMT -8)
1980 took azulfadine for 2 years,I would not go to doc anymore so I ran out, it stopped
working anyway. Why I stopped with the doc. Had about 20 rigid sig scopes,that was enough
for me.
But here I am now with a colostomy and Laurie the stoma.
Oldmike
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quincy
Elite Member
Joined : May 2003
Posts : 33571
Posted 4/27/2022 6:19 PM (GMT -8)
Me...for 33 years.

q
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TroubledTurds
Veteran Member
Joined : Jan 2004
Posts : 8717
Posted 4/28/2022 3:20 PM (GMT -8)
i'm close - does that count for anything ?


TT
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Trinxy
New Member
Joined : Jun 2020
Posts : 2
Posted 4/29/2022 5:49 AM (GMT -8)
I was diagnosed 10 years ago approx and have only taken mesalazine so far... I was on 6 g daily at first, orally, + 2 g supps until I reached remission (about 1 month from diagnose). From then, 3 g daily orally. If I am flaring, I increase to 4 or 5 g daily orally + 1 g supp at night which, according to doctor, is waaay to much and I should consult her and she should probably advice me to add other stronger things to the mix instead of increasing dose of good old Pentasa. So, I am not too compliant and I manage my dose a bit according to flaring or remission, and so far so good.

Of course, the extra dose I require sometimes may be working its way to creating something nasty for me in the future, who knows. But if possible, I prefer to remain on mesalazine instead of exploring side effects of other chemicals.
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quincy
Elite Member
Joined : May 2003
Posts : 33571
Posted 4/29/2022 9:07 AM (GMT -8)
Trinxy...it's not waaay too much. You should request the enemas instead of the suppositories. Use them nightly during a flare and TAPER to a maintenance dosage.

Where is the location of your UC?

Welcome to the forum.
q
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 1848
Posted 4/29/2022 9:23 AM (GMT -8)
Trinxy, I used 9g mesalazine for years (4.8g orally and 4g rectally) and no adverse effects.
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garyi
Veteran Member
Joined : Jun 2017
Posts : 2244
Posted 4/29/2022 7:36 PM (GMT -8)
U/C for fifty years.....

I've been taking 4.8gm of Lialda (mesalamine) tabs for about 24 years with no know ill effects.

During a fair I'll add Uceris (budesonide) 9mg. It helps, but don't stay on this potent steroid for more than two months.
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dvoyre
Regular Member
Joined : Jan 2007
Posts : 29
Posted 4/29/2022 10:02 PM (GMT -8)
I've had UC for 27 years... very sadly allergic to all 5-ASAs. Only thing I've taken is budesonide (from both ends). Terrible symptoms currently though and considering surgery.
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3timechamp
Veteran Member
Joined : Oct 2009
Posts : 1794
Posted 4/30/2022 3:43 AM (GMT -8)
Got UC in '85 ,wasn't til 20 plus years later I took something besides mesalamines(6mp). Used Pred here and there when needed. Surgery in 2018 and no more meds needed
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Sassysback
Regular Member
Joined : Dec 2018
Posts : 173
Posted 4/30/2022 3:01 PM (GMT -8)
19 years and counting...nothing but 5 ASA with some suppositories and enemas thrown in the mix. I have never gone down in dose...just upped. In 2003 I was in a blind trial for Asacol...a new drug at the time. It was great...I got free Asacol for almost a year!
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ilovefood
Regular Member
Joined : Dec 2010
Posts : 139
Posted 5/2/2022 8:29 AM (GMT -8)
Hi Sassy, It's interesting that you never went down in dose, just upped. How much do you take now?
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Sassysback
Regular Member
Joined : Dec 2018
Posts : 173
Posted 5/2/2022 11:36 AM (GMT -8)
Hi, I have been taking 6 tablets orally (=2400 MG ) twice a day. That's 400 mg 5 ASA. I may have dipped down 18 years ago, after the 1st year for a while. And as I began getting more and more flares, my dose just went up. The generic drug comes in a smaller pill size, and this has confused both my GI docs. And the pharmacist, not to mention myself! LOL.

I've been able to get prescriptions from my GP most of the time. My fĺares have increased over the past 3 years, and it takes many months or up to a year to just talk to my new GI doc. So I suppose my colitis is still doing ok on this dose. I'll
Find out at the end of May, the results of the last colonoscopy biopsies I had last month. I'm assuming my colon looked ok, as the GI doc never talked to me after the procedure....they are still not seeing patients in office.
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ilovefood
Regular Member
Joined : Dec 2010
Posts : 139
Posted 5/2/2022 11:57 AM (GMT -8)
Sassy, interesting! So when you flare you just add the rectal meds and they go away? How long do you usually need to use them for?

It interests me that a doc never wanted to taper down your Asacol. Mine insisted I do so, but I’m presently still stuck at 8 a day (3200 mg).
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UC prisoner
Regular Member
Joined : Oct 2013
Posts : 138
Posted 5/2/2022 4:12 PM (GMT -8)
Me!
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ilovefood
Regular Member
Joined : Dec 2010
Posts : 139
Posted 5/3/2022 3:47 AM (GMT -8)
So here's the question I have for you all. When you do flare, do you just add rectal meds, increase your oral mesalamine, or both? How long does it take these changes to stop the flare? Do you change your diet? Have your flares changed at all over time?
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quincy
Elite Member
Joined : May 2003
Posts : 33571
Posted 5/3/2022 6:08 AM (GMT -8)
Re diet change, I dont. But I do have nausea with flares, so if something doesn'tappeal to me, I may eat less or nix it.

Re flares...I increase rectal meds from my maintenance. I've always TAPERED, according to symptoms, to a maintenance. I sometimes increase oral to 3200mg daily from 2400mg but usually only for a week.

My flares have changed over time, because I treat at earliest symptoms. Took many many years to get to the point of understanding those symptoms. I do not depend on my doctor to say yea or nay. I've never had calprotectin testing. I never wait for bleeding. My scopes show architectural changes that I had in the past are now in the normal range...so a huge shock to me.

As far as time re meds...depends on symptoms. I'll usually do 3 weeks of nightly to start and go from there. In the first 10 years or so, it wasn't unusual to be 2 or more months on nightly enemas. Tapering depends on symptoms, so at least a month or 2 of every second night. If all is back to my normal, I would go down to my maintenance of every 3rd night. Initially I was tapering to once a week...but it was definitely to much of a span for me. Twice weekly is what's minimally recomended for maintenance. Basically, the butt rules the game. If you taper too fast, you will know and can easily increase back to previous dosage of you drop too quickly. Re oral tapering...slow taper as well, not a quick drop, especially if your flare is past the sigmoid.

q
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ilovefood
Regular Member
Joined : Dec 2010
Posts : 139
Posted 5/3/2022 6:16 AM (GMT -8)
So interesting, Quincy. I really appreciate you taking the time to write this.

What are the signs for you that indicate a flare is coming, before the blood?
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Sara14
Veteran Member
Joined : Mar 2007
Posts : 7792
Posted 5/3/2022 7:13 AM (GMT -8)

poopydoop said...
Trinxy, I used 9g mesalazine for years (4.8g orally and 4g rectally) and no adverse effects.

Same here. For over a decade. I don't know why Trinxy's doctor said it's "waaay" too much. Because it's not.
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Sassysback
Regular Member
Joined : Dec 2018
Posts : 173
Posted 5/3/2022 3:10 PM (GMT -8)
Quincy....if only I knew this 10 years ago!

I have used the rectal enemas for up to 4 weeks 2 years ago, then a couple weeks every other night, a couple months ago. I did not increase the 5 ASA. I have tried to taper several times on my own. But constipation and mucus would start after a week or so. So basically I've remained on whatever dose I was prescribed following a colonoscopy.

I❤ food, my first signs a flare is coming are gas, cramps, constipation, followed with mucus and sometimes blood. Lately I've been nauseous too. I avoid spicy food and eat a white food diet for a few days...rice, mashed potatoes, yogurt etc. Then cook vegetables for another week. I love them raw, but my gut doesn't!
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UC prisoner
Regular Member
Joined : Oct 2013
Posts : 138
Posted 5/3/2022 4:04 PM (GMT -8)

ilovefood said...
So here's the question I have for you all. When you do flare, do you just add rectal meds, increase your oral mesalamine, or both? How long does it take these changes to stop the flare? Do you change your diet? Have your flares changed at all over time?


So don’t really “flare” …maintenance dose of asacol HD and eating things in moderation (avoiding things that aggravate me) seem to keep everything under control.
Moderate dairy intake with very limited yogurt (seem to be intolerant of yogurts) … limited fried foods, gluten in moderation, avoidance of preservatives and I have completely eliminated alcoholic beverages and on those occasions when my gut feels “colitisy” eating white bread seems to be calming
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IamCurious
Veteran Member
Joined : Jan 2010
Posts : 3696
Posted 5/4/2022 5:25 AM (GMT -8)

Quincy said...
Me...for 33 years.
q

Relatively mild mesalamines also have the added value of protecting against cancer over and above the benefit of lowering overall inflammation.

I will remember this thread the next time someone says that sooner or later mesalamines are bound to fail so it is best to attack UC at the outset with Big Gun meds with their possible major side effects.
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 1848
Posted 5/4/2022 8:18 AM (GMT -8)

IamCurious said...

I will remember this thread the next time someone says that sooner or later mesalamines are bound to fail so it is best to attack UC at the outset with Big Gun meds with their possible major side effects.


I don't think anyone has said that. It is better to go on "big gun" meds quickly than spend months or years yoyo-ing around with prednisone. Or live with low level inflammation just because the symptoms are "manageable "
Not sure any doc would go straight to biologics without trying mesalazine first.
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quincy
Elite Member
Joined : May 2003
Posts : 33571
Posted 5/4/2022 9:00 AM (GMT -8)
I have seen it countless times since my time here...and shockingly, how many have refused the mesalamine enemas and consider them an utter waste of time, even ridiculously stating that they don't reach the entire colon 🙄

Mesalamine for its amazing value isn't many times being prescribed or used to its full potential. But remember that it's expensive and requires commitment regarding dosaging. It doesn't work for everyone, but worth a shot initially.

q
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