input on upcoming dr. appointment

icanrace

Regular Member

Joined : Sep 2007

Posts : 224

Posted 10/28/2007 4:35 PM (GMT -7)

I have an appointment this coming Thursday. I've been on Prednisone and Asacol for 1 month after experiencing my first ever flare.
I've gotten better in the fact that I only have to go to the rr 1 to 2 times per day and my stools are now formed for the most part. No D for about a week or so. I do still have a little blood in my formed stool and on the tp. It's not a lot of blood but its enough to notice there is some blood visable.

Here is my situation:
I want off Prednisone for sure and really wouldn't mind to get off the Asacol as well. I just hate taking prescriptions. I've recently added Pro Bio and a really good fish oil to my daily supplement routine. I also have some digestive enzymes on the way in the mail.
I'm going to mention to my doc that I really would like to try to go a more natural route unless I start flaring BAD again like I did at first and then I'd follow his instructions whatever that may be.

Do you think it would be wise to consider this if I'm still noticing blood?
Do you think I can get the blood to completely stop at this point by taking Pro Bio and other supplements or should I still give this other med more time. This past week he started my taper on the pred from 40mg to 35mg per day so I know I still have a little time left on this stuff.

Any opinion you want to share would be appreciated.

Thanks

Prednisone 10mg (1.5) tabs twice per day= 30mg per day

Asacol 400mg (3) tabs twice per day= 2400mg per day

started both meds on Thursday 10-4-2007

10-22-07- coming out of about an 8 week flare (my first one ever)

quincy

Elite Member

Joined : May 2003

Posts : 31373

Posted 10/28/2007 4:45 PM (GMT -7)

Too bad he didn't get you on rectal 5ASA meds before the pred.

I think pred sours many toward seeking a "natural" approach. You don't have to be on pred...ever...if you don't want to.

You're improving..that's good. You'll have symptoms, probably, each time you taper the pred.

Try not to make too many decisions at this time of what you WANT....find out your options. The 5ASA meds are still a good alternative to most others...if you can take salicylates. There's a process and dedication to them.

Know that flares don't heal quickly.

The trick, really, is to treat as early as possible.

You can try a "wholistic" approach with mainstream and alternative. It all can work together.

Where's your UC...limited or throughout?

quincy

*Heather*Status:mini flare June 23* 6asacol daily+ Salofalk (tapered every 4th night)

~diagnosed January 1989 UC (proctosigmoiditis)

~5ASA: Asacol + Salofalk enemas (increase for flares tapered to maintenance)

~Bentylol (dicyclomine) 20mg as needed

~vitamins/minerals

~Probiotic 2 (Natural Factors Protec) + 1 (Primadophilus Reuteri) at bedtime

~Natural Factors Multi Digestive Enzymes with supper

~Ranitidine,Pariet (reflux) Effexor XR 75mg; Pulmicort/Airomir (asthma)

~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)

My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

icanrace

Regular Member

Joined : Sep 2007

Posts : 224

Posted 10/28/2007 4:48 PM (GMT -7)

it's limited if I remember right. I know its a "mild" case so they tell me.

quincy

Elite Member

Joined : May 2003

Posts : 31373

Posted 10/28/2007 5:26 PM (GMT -7)

Even more interesting that you're on pred....

Curious...what were your symptoms before on meds?

q

*Heather*Status:mini flare June 23* 6asacol daily+ Salofalk (tapered every 4th night)

~diagnosed January 1989 UC (proctosigmoiditis)

~5ASA: Asacol + Salofalk enemas (increase for flares tapered to maintenance)

~Bentylol (dicyclomine) 20mg as needed

~vitamins/minerals

~Probiotic 2 (Natural Factors Protec) + 1 (Primadophilus Reuteri) at bedtime

~Natural Factors Multi Digestive Enzymes with supper

~Ranitidine,Pariet (reflux) Effexor XR 75mg; Pulmicort/Airomir (asthma)

~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)

My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

icanrace

Regular Member

Joined : Sep 2007

Posts : 224

Posted 10/28/2007 5:32 PM (GMT -7)

lot's of bm's per day with a bowl full of blood.

quincy

Elite Member

Joined : May 2003

Posts : 31373

Posted 10/28/2007 5:52 PM (GMT -7)

can you be more specific? details...

*Heather*Status:mini flare June 23* 6asacol daily+ Salofalk (tapered every 4th night)

~diagnosed January 1989 UC (proctosigmoiditis)

~5ASA: Asacol + Salofalk enemas (increase for flares tapered to maintenance)

~Bentylol (dicyclomine) 20mg as needed

~vitamins/minerals

~Probiotic 2 (Natural Factors Protec) + 1 (Primadophilus Reuteri) at bedtime

~Natural Factors Multi Digestive Enzymes with supper

~Ranitidine,Pariet (reflux) Effexor XR 75mg; Pulmicort/Airomir (asthma)

~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)

My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

icanrace

Regular Member

Joined : Sep 2007

Posts : 224

Posted 10/28/2007 6:00 PM (GMT -7)

I'd say I was going 15-20 times per day and it was bloody d after about 2 weeks of me noticing blood in my normal stool. I assume this was just before my flare busted out. After a couple weeks of hoping things would get better, I had to get a colonoscopy. That's when they told me I have IBD. To be honest with you, that's about all I know / can remember.

julee70

Regular Member

Joined : Oct 2007

Posts : 486

Posted 10/28/2007 6:17 PM (GMT -7)

Asacol is a pretty an innocuous drug and if you're not having any problems on it, you might want to stay on it in your small maintenance dose. (I think 3 tabs is at the low end of the doses.)

With tapering the Pred from 35mg, you're looking at about 6 weeks more at least. The more gradually you decrease, the better off you are.

I agree with Quincy that it's a shame you didn't start on the rectal meds (Rowasa, Canasa, Cortifoam, etc.) instead of the Pred. Pred is hard to get off of for a lot of us and it has all kinds of side effects that the the rectal meds don't have. It's not too late to try them! Great for stopping all the bleeding. It might also help you taper off the Pred sooner if you used a non-steroidal rectal med like Rowasa.

I think a natural approach is good and can also be combined w/meds too. I've never had any luck myself with all the natural stuff I tried: probiotics, tumeric, fish oil, slippery elm, ginger, etc. BUT I think that meditation, deep breathing, yoga, acupuncture and other things can also help.

Don't worry about taking the Pred. It sounds like you're doing a lot better and that's great!

I would ask your doctor as many questions as you need to really understand why s/he is prescribing this particular treatment. It took me a long time to really understand what was going on. I finally started keeping copies of my colonoscopy reports and actually reading them. (I love when they tell you their findings while the sedation is still keeping your brain fuzzy! I never remember a thing!)

-------
UC for the last ten years
Current Meds: 6MP
Past Meds: You name it; I've tried it.

Old Hat

Veteran Member

Joined : Feb 2007

Posts : 5209

Posted 10/28/2007 9:13 PM (GMT -7)

If you were having 15-20 bms daily before starting meds, I would not call your UC "mild"! That sounds pretty serious to me. You should expect to stay on 5-ASA meds indefinitely for maintenance-- as long as you do not experience salicylate tolerance problems. It may be that your doctor prefers a "top-down" approach to medicating UC, which is why he/she put you on Pred before Rxing steroid enemas. I've just been reading on another Website that the current debate among GIs subspecializing in IBD treatment is btw "top-down" medication 1st vs. "step-up" -- moderate meds 1st to see if they'll be adequate. Whichever approach is used, I think all of us veteran UCers would advise you from experience to NEVER drop UC meds instantly & go cold turkey! / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily; seem to be back in remission)

quincy

Elite Member

Joined : May 2003

Posts : 31373

Posted 10/28/2007 9:18 PM (GMT -7)

I was going 15 - 20 times a day....severe to me, mild according to place of activity.

5ASA did its thing.....and I'm so relieved the doc was one who went that route rather than the "other" who stated he would have put me on pred right away.

Different perspectives...

q

*Heather*Status:mini flare June 23* 6asacol daily+ Salofalk (tapered every 4th night)

~diagnosed January 1989 UC (proctosigmoiditis)

~5ASA: Asacol + Salofalk enemas (increase for flares tapered to maintenance)

~Bentylol (dicyclomine) 20mg as needed

~vitamins/minerals

~Probiotic 2 (Natural Factors Protec) + 1 (Primadophilus Reuteri) at bedtime

~Natural Factors Multi Digestive Enzymes with supper

~Ranitidine,Pariet (reflux) Effexor XR 75mg; Pulmicort/Airomir (asthma)

~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)

My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

icanrace

Regular Member

Joined : Sep 2007

Posts : 224

Posted 10/29/2007 3:54 AM (GMT -7)

interesting.

I will talk to him openly on Thursday and see what he says. I feel comfortable enough with him that I'll listen to what he's thinking. He has a very good reputation around here and has been doing it for years. Who knows............

quincy

Elite Member

Joined : May 2003

Posts : 31373

Posted 10/29/2007 12:26 PM (GMT -7)

Be proactive and prepare your questions. You don't have to go on pred...just know that. Ask what all your options are. Many doctors and patients are not "patient" with treatment. As well....UC is lifelong. One flare isn't the be all and end all of what your future will look like. Setting you up with constant care so that YOU can use your meds according to symptoms will eventually have you more in control.

Of course....this is all based on my treatment and learned process from my doctor and the long use of 5ASA meds.

You're in the learning phase .... experience is the best teacher, and one always revisits strategies.

Let us know how the appointment goes.

quincy

*Heather*Status:mini flare June 23* 6asacol daily+ Salofalk (tapered every 4th night)

~diagnosed January 1989 UC (proctosigmoiditis)

~5ASA: Asacol + Salofalk enemas (increase for flares tapered to maintenance)

~Bentylol (dicyclomine) 20mg as needed

~vitamins/minerals

~Probiotic 2 (Natural Factors Protec) + 1 (Primadophilus Reuteri) at bedtime

~Natural Factors Multi Digestive Enzymes with supper

~Ranitidine,Pariet (reflux) Effexor XR 75mg; Pulmicort/Airomir (asthma)

~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)

My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

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