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At a loss with medication

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Ulcerative Colitis
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TroubledTaurean
New Member
Joined : Aug 2022
Posts : 2
Posted 8/14/2022 2:07 PM (GMT -8)
Hi all,

This is my first post on the forum. I have to say, this forum has helped me greatly over the past year and made me feel less osolated when I last flared.

I experienced bleeding for sometime before finally being diagnosed with proctitis and inflammation at the start of my large intestines in June 2021 following a colonoscopy. Within the report I was told that the proctitis was the reason for the bleeding and was put on Octasa following this. Octasa removed the bleeding and I felt I was able to lead a 'normal' life again, but I started receiving heart palpatations as a side effect so was moved to Pentasa.

I was on Pentasa for approx. 3 months until I experienced a huge flare up in October 2021, that I believe was caused largely by food poisoning. I lost 2 stone (12kg) and was constantly vomiting, dizzy, had nausea and was constantly out of bed going to the bathroom with diarrheoa. I could not eat a thing. I was given Pentasa suppositories, Salofalk suppositories and Prednisolone tablets to no avail. The Pred. did nothing and so the dose was discontinued in agreement with IBD nurses. I decided to stop taking Pentasa as I missed a few doses and felt better. To my surprise, the vomiting etc. began to stop. I began to take Tumeric and sent in samples that confirmed the inflammation had dissipated. I confirmed multiple times to the IBD nurses that I had stopped the medication and they were not concerned.

Since approx. December 2021, my condition has been stablized until the last month or so where I noticed large amounts of blood again, and an urgency to go to the toilet, and occassional diarrheoa. At this point I had stopped taking Tumeric as they appeared to make the bleeding worse and the diarrheoa, but I am unsure as to whether it is just part of the flare. The bleeding got much worse. I contacted the IBD team two days ago to see if anything had come of the previous samples taken approx. 3 weeks ago and was told my inflammation was as 'high as it could be', I was not contacted prior. I was told I needed prednisolone tablets as am aware of negative side effects etc., but declined and was offered an enema option plus balsalazide which I began taking two days ago. My dizziness has returned when taking Balsalazide, I feel dizzy and sick and shaky, my diarrheoa is worse than it has been since last October.

The IBD nurse informed me two days ago that immunosuppressants are the last medication that can be tried. My question is, is there anyone that has experience such negative side effects from the ASAs? If my bleeding is via Proctitis, would I not be offered a non-steroid foam? Can anyone advise?

The worse part of my condition is the bleeding and diarrheoa. When not on medication, I don't feel pain unless when going to the toilet which I understand I am very lucky to have and grateful for as I'm aware of other who are in pain all day every day with UC.

Any response would be greatly appreciated. Thank you.

Post Edited (TroubledTaurean) : 8/14/2022 4:45:03 PM (GMT-7)

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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 2527
Posted 8/14/2022 5:09 PM (GMT -8)
Some people have mesalamine intolerance and get worse when taking it. What you have described sounds like that. You are left with either immune suppressants or alternative treatments. Most people are very hesitant to go on immune suppressants, but they aren't as scary as they sound. Alternative treatments work for some but it's very experimental to find something that works for you. Pharmaceuticals can also be trial and error to find the med that works for you. Fastest acting meds are Xeljanz or Remicade. I have always thought the Entyvio is the safest (my opinion only), but it can take several months to kick in. Some docs prefer to start with azathioprine, but some can't tolerate it and again it can take several months to work. There are several other meds to try so don't feel as though you are at the end of the road.

Do you have a gastro doctor to discuss your options? Prednisone is only a bridge until you can get a medication that works. We all try to avoid it, but if your flare gets so bad that it keeps you from your everyday life it might be necessary. It may not have been able to work for you for your mesalamine intolerance.

Have you been tested for c-diff or any other bacteria or parasites?

So sorry you have to deal with this disease.
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Old Hat
Veteran Member
Joined : Feb 2007
Posts : 5854
Posted 8/14/2022 10:05 PM (GMT -8)
You stated that in June 2021 you were DXed with proctitis and inflammation at the start of large intestine. That sounds like the cecal patch variant of UC. (That's what it's called by gastroenterologists in USA.) Pentasa would likely treat the starting point, but balsalazide is designed to treat left-sided inflammation especially. In either case, you need to keep well-hydrated with a good bit of water throughout your day/evening when taking 5-ASA meds to avoid side effects like dizziness (vertigo). RE foam enemas: yes, you should definitely try the Rx mesalamine foam, as UK is one of the lucky countries with access to it. That or a steroid foam can be very helpful as treatment for proctitis. Right now our forum member Momto2boys is one currently posting who has experience with cecal patch UC-- so hopefully, she can advise you further on successful treatments. / Old Hat (40+ yrs with left-sided UC; in remission taking Colazal)
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TroubledTaurean
New Member
Joined : Aug 2022
Posts : 2
Posted 8/15/2022 9:20 AM (GMT -8)

CCinPA said...
Some people have mesalamine intolerance and get worse when taking it. What you have described sounds like that. You are left with either immune suppressants or alternative treatments. Most people are very hesitant to go on immune suppressants, but they aren't as scary as they sound. Alternative treatments work for some but it's very experimental to find something that works for you. Pharmaceuticals can also be trial and error to find the med that works for you. Fastest acting meds are Xeljanz or Remicade. I have always thought the Entyvio is the safest (my opinion only), but it can take several months to kick in. Some docs prefer to start with azathioprine, but some can't tolerate it and again it can take several months to work. There are several other meds to try so don't feel as though you are at the end of the road.

Do you have a gastro doctor to discuss your options? Prednisone is only a bridge until you can get a medication that works. We all try to avoid it, but if your flare gets so bad that it keeps you from your everyday life it might be necessary. It may not have been able to work for you for your mesalamine intolerance.

Have you been tested for c-diff or any other bacteria or parasites?

So sorry you have to deal with this disease.


Thank you for your reply. There is an IBD team but no designated GI doctors are given in the UK. It can be quite difficult to get a hold of them. I will make note of what you have recommended and will refer myself for immunos. I haven’t been tested for c-diff etc.
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 2527
Posted 8/15/2022 11:25 AM (GMT -8)
They should have tested you for pathogens before you were give prednisone as that can make thinks a lot worse if you do have c diff etc

See if you can get tested before any further meds are started or changed
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