Remission

When is any one considered in remission? I was told my daughter sam would be on Asacol long term. Does that mean we are far off from remission?

Remission is when you're not flaring, there's no pain, no blood, and decently formed BMs.


Asacol is needed to stay in remission when you get there. It's not something you take for a few weeks and then you're fixed. Sorry, but she'll be on it for life (or until something better is developed.)

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12 Asacol
100 mg Imuran
6 or 9 fish oil pills
4 Acidophilus pills
4 Caprylic Acid pills

She is on Asacol and 30/5 Prednisone. We are weaning her off Predison and this may sound strange but we havenot had any blood, flare ups or pain since we started on the the Predisone 2 months ago. Am I being to optimistic to think she may be in remission after only being diagnosed in the end of May?

Or does she have to be completely off the Prednisone and just be on the asacol to be considered in remisssion?

Prednisone is an amazing drug. If you have experience with it, and as you will certainly see in the UC postings, it has brought relief in flares when nothing else works at the time. However, it is also nasty, and not meant for long term use for remission. The goal for remission is no flare, bleeding, D, urgencies, constant BM, etc. with the least overwhelming meds. For some it is Asacol, for others it could be the immuno suppressant class, up to remicade. Prednisone for me has been to calm down bad flares and give the other maintenance drugs a chance to do their jobs, or just to give the doc a chance to see what works and does not work. Sometimes that means that the prednisone taper does not go well, and steroids have to be reintroduced while the MD tries something new. The remission can be a process of ups and downs until the right treatment is found. For me, Lialda (Asacol) just did not do it. I needed prednisone to stop the suffering, and am now trying a combination of Imuran and Remicade.  I have had trouble weaning from the prednisone and the goal is to maintain a symptom free life without the steroids. From reading these posts I see how so many people get to the remission point, and that gives me a lot of hope. The prednisone seems to have certainly helped your daughter with her symptoms, and I hope that as the prednisone is further reduced she continues to have good results. Just remember, if there is any set backs, she still has a lot of options available. Stay in touch with your MD and good luck!

I responded similarly - after a TERRIBLE first flare, going on Pred and Asacol I was feeling 100% better in a few weeks, and stayed in remission for over a year.

Just tell her don't stop taking Asacol just because she's in remission. I know it's expensive and tedious to take so many pills, but the Asacol is needed to keep from flaring back up. Every time you go back on Prednisone, the Prednisone becomes less effective at stopping the flare.

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12 Asacol
100 mg Imuran
6 or 9 fish oil pills
4 Acidophilus pills
4 Caprylic Acid pills

Hey Glenn -- how is it decided if the Asacol should be stopped and use Lialda instead? We go to the Mayo Clinic October 1st and I have so many questions prepared to ask. Hubby is definitely improving and looks like he is headed towards remission. I just wonder if it might be better to switch from the 12 asacol each day to the Lialda. Less pills (they are larger I think?) but better results with that class of drug.

However with the introduction of the imuran for the past 3 1/2 months that seems to be making the difference towards remission so maybe the asacol is ok but just wasn't ok by itself with the prednisone which we are tapering.

For Sam definitely listen to the Drs. It seems like a pain to have to continue to take the asacol if it looks like she is getting better but from what everyone says it is necessary to maintain with this. In all likelihood they may reduce the number of asacol to what seems to be the right dose to keep it at bay from what I have read here.

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60 yr old male~Colitis 1st diagnosed Jan '05-cleared up within a few wks. Flared again in May '06 ... left sided UC now, fully involved and trying to get in remission. Acute inflammation-pancolitis-tenesmus rectal pain-granulation is showing some healing started. Osteopena of spine from prednisone DX 8/07  July 07 good days & bad days 75mg Imuran 40  mg prednisone (tapering 8/07) 12 Asacol, Lidocaine Hydrochloride Jelly 2%,multi vitamin, iron 3X day, DanActive, chewable calcium, Prilosec 20mg, enalapril 10mg, glipizide 5 mg, zocor 20 mg, baby aspirin, (Fentanyl pain patch 50mg 72 hrs  Morphine Sulf 15 mg twice daily)Colocourt enemas at night. Fosamax and mthly B12 shots folic acid 1mg

I am hearing that some doctors are just making the change to Lialda because of the  convenience. Research shows that up to 60% of patients are non compliant to some degree with Asacol because of multi doses during the day. The thinking (correctly so) is that most of those people will be more compliant if they only have to take one dose per day. The meds are the same, it is just the dosage that is different. While I was never non compliant with Asacol, there was the occasional forgetfulness, and then  I had to take the dose of schedule. Lailda is much more convenient, and more likely to be used without missing doses.

I left out replies to some of your questions. Yes, the pills are a bit bigger, but no so much more than a multi vitamin. It is easy to get used to. I am also on Imuran and Lialda together (as well as Remicade and prednisone). My doctor is slow to remove meds once I start because his feeling is that if he goes too fast he may not be able to tell which of the drugs is responsible for my improvement. This is especially true if you are also on prednisone. Because prednisone can be so effective you have to be careful when weaning (other than the body needing to learn to produce natural cortiosteroids again) so that you can tell if the remission is still in effect even as prednisone is being cut. My doctor uses this same philosophy for the other meds. While I am pretty sure that the Lialda has minimal effect on me (although it may help to minimize some symptoms if not create a remission) it is still unclear if it will be the Imuran or Remicade (or both) that will hopefully get me off prednisone and into a longer term remisssion. Have your family members keep taking all meds until the doctor changes them, and then as others have said, do not let them stop taking the maintenacne drugs just because they feel better. That is a sure invitation to relapse.