New online IBD article summarizes current medical treatment options

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Old Hat
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Date Joined Feb 2007
Total Posts : 5182
   Posted 11/10/2007 1:08 PM (GMT -6)   
On Website gastroendonews.com/index -- under column Clinical Review-- there is an article entitled "Crohn's and Colitis: Treatment of 5-ASA Responders and Nonresponders" that I find interesting. It may also be helpful for members here who have Qs about their own present situation with UC, which is discussed 1st in the article. You have to register to use this site, but it's free. Just follow the instructions for a short registration profile in order to login. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily; seem to be back in remission)

AlabamaBabs
Regular Member


Date Joined Jul 2007
Total Posts : 172
   Posted 11/10/2007 4:53 PM (GMT -6)   
Thanks, Old Hat, for the site and the article. It seems to be pretty comprehensive and it was confirmation to read the types of meds used, for how long and why. Thanks!
AlabamaBabs
Pancolitis diagnosed 5/07 
4 Lialda/day since 8/01/07
Started 40 mg. Prednisone on 9/16/07 and tapering by 5mg per week  which started on 9/28/07:  40, 35, 30, 25, 20, 15, 10, 5, 5 every other day, 5 every three days, done!
 


Knitty_Cat
Regular Member


Date Joined Jun 2006
Total Posts : 105
   Posted 11/10/2007 10:10 PM (GMT -6)   
Thanks heaps Old Hat. Great article. Interesting that they said that (for left sided UC) taking your oral 5ASA and just doing 2 5ASA enemas a week is way better than just doing the oral 5ASA. I'm going to add 2 foam enemas per week and see what happens.
UC since 2001, diagnosed May 2005
Salofalk tablets (Asacol) 2 tablets 4 times daily (4gm total) for maintenance, Salofalk enemas and/or Colifoam for flares
Oat bran 60grams daily, Metamuscil and multivitamins


MitzMN
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Date Joined Feb 2007
Total Posts : 624
   Posted 11/11/2007 10:02 AM (GMT -6)   
Wow! Interesting article but very article. Are you medically trained, Old Hat? I felt like I was reading a bit of Greek. Maybe if I print it and read a hard copy, that will help.

Thanks!

Mitz
Sporadic proctitis since about 1985. Mother had J-pouch surgery 1983.
DX'd with clostridium difficile in 2000. Pred, two courses of Flagyl, then Vancomycin finally got rid of it. 2001 colonoscopy dx'd left-sided UC. . Treated with prednisone, Rowasa, Asacol. Asacol not working, switched to Imuran. Three small flares since in 2002, 2005, and 2007, brought under control with steroid and Rowasa enemas. Lap Chole performed October 26, 2007, after gall bladder attack in June, '07.
Daily meds: 100 mg Azathioprine and 225 mg Effexor XR (for chronic, longstanding depression), many vitamins and Primadophilus Reuteri


Old Hat
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   Posted 11/11/2007 10:26 AM (GMT -6)   
Hi, Mitz! No, I have just a basic science background from college credit distribution requirements. I agree that some of this text is heavy reading, especially due to biochemical references, so printing it out to facilitate comprehension is definitely a help. The author is one of the most IBD-knowledgeable gastros in the U.S., a practicing doctor, a medical school professor who also participates in continuing ed seminars for established doctors, a collaborator in molecular biology studies on IBD, + involved in clinical drug trials for ca. a couple decades; that's why the writing is dense for us in places. But I think the chart on 5-ASA differences & other features could be useful for members here ... I'd rather sort thru this level than stay with the super-optimistic pap that generally is written for patients-only! / Old Hat

MitzMN
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Total Posts : 624
   Posted 11/11/2007 1:07 PM (GMT -6)   
Oh, I agree! Give me the truth. I can look up the big words or attempt to read through them. Don't feed me pablum. That I don't need. I need the truth, the whole truth and NOTHING BUT THE TRUTH, thankyouverymuch.

Thanks, Old Hat.

Mitz
Sporadic proctitis since about 1985. Mother had J-pouch surgery 1983.
DX'd with clostridium difficile in 2000. Pred, two courses of Flagyl, then Vancomycin finally got rid of it. 2001 colonoscopy dx'd left-sided UC. . Treated with prednisone, Rowasa, Asacol. Asacol not working, switched to Imuran. Three small flares since in 2002, 2005, and 2007, brought under control with steroid and Rowasa enemas. Lap Chole performed October 26, 2007, after gall bladder attack in June, '07.
Daily meds: 100 mg Azathioprine and 225 mg Effexor XR (for chronic, longstanding depression), many vitamins and Primadophilus Reuteri


quincy
Elite Member


Date Joined May 2003
Total Posts : 30587
   Posted 11/11/2007 1:42 PM (GMT -6)   
Old Hat....Awesome info..thanks for posting the site! I prefer hard copies as well, so printed it, but haven't had time to read all of it yet. Makes sense so far....at my last appointment, my doc mentioned new focus/talk about subtypes and gearing treatment.
 
In the archives, the one titled "Patient Adherence in Inflammatory Bowel Disease" is equally compelling...worth a read for all UCers.

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 !!!

Post Edited (quincy) : 11/11/2007 1:32:26 PM (GMT-7)


Old Hat
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Date Joined Feb 2007
Total Posts : 5182
   Posted 11/11/2007 4:02 PM (GMT -6)   
You got it, Quincy! Subtypes & geared treatment are picking up steam. There's a Dutch gastro named Daan Hommes who espouses "top-down" approach to medicating certain IBD patients, who is lecturing in U.S. this fall. The conclusion of this Web article states that identifying patients who will benefit from early immunomodulator &/or biologic therapy will result in minimizing or avoiding steroid use; this fits right in with Hommes's recommendations. That has major implications for many members writing to this site RE their trials/troubles with Pred! / Old Hat

Beth75
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Date Joined Jul 2007
Total Posts : 2148
   Posted 11/11/2007 4:02 PM (GMT -6)   
Old Hat, this is great, thank you! I read it, I am going to reread it a few times to digest the info, but this will keep me thinking and is just what we all need. thank you.
Beth, 32
UC Diagnosed March 2000 (30 cenitmeters)
Azathioprine 150mg 1xday nightly;Remicade tests pending;Hydrocortisone enemas 1xday;Calcium and Vit D 500mg 3xday, Multi Vit, Folic Acid 400mg 2xday, Potassium 600mg 2xday, Probiotics.
Minimal Change Disease (Kidney Disorder) Diagnosed Sept 2007
Prednisone 60mg 1xday, Simvastatin 20mg 1xday, Diovan 80mg 2xday. Fosomax 70mg 1xweek. MCD may be from hypersensitivty to 5ASA drugs.


Old Hat
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Date Joined Feb 2007
Total Posts : 5182
   Posted 11/12/2007 9:02 AM (GMT -6)   
RE archive article Quincy cited on the same Website: research indicates that single men are the most non-compliant in staying on meds. / Old Hat

jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10407
   Posted 11/12/2007 10:56 AM (GMT -6)   
Thanks for posting this link! I read the article, then went to my GI for my 6-month followup today. He recommended tapering the Imuran and, thanks to your posting, I was able to discuss this intelligently with him.
Judy
 
Left-sided UC diagnosed 2001.  Taking Colazal and Imuran, Remicade infusions and moving into remission. Finally off steroids after four years! 
 
Now in remission for almost two years. Remicade has been my wonder drug.
 
"If you spend your time second-guessing your past decisions, you'll never have time to enjoy today."


Old Hat
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Date Joined Feb 2007
Total Posts : 5182
   Posted 11/12/2007 11:45 AM (GMT -6)   
Glad it helped you, Judilyn! It cleared up some Qs I had-- re oral 5-ASAs. There is a lot of misinformation circulating about our meds. I recall reading in a thread probably a few months back that one member's gastro had told her Colazal does not get "all the way" to the end of the colon so she needed to use rectal meds as well. According to this article, Asacol is the oral 5-ASA LESS LIKELY to "get all the way" because it starts dissolving in the terminal ileum! / Old Hat

Sara14
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Date Joined Mar 2007
Total Posts : 4189
   Posted 11/16/2007 7:33 PM (GMT -6)   
Just started reading. Looks like a very informative article. Thanks. =)

That's a cool Web site, too. Can I send their "Patients Guide to Probiotics" to my GI's nurse? When I was telling her what supplements I take, she had no idea what a probiotic was. I had to explain it to her.


23 years old
Diagnosed with UC March 2007
Current inflamation in the rectum
Asacol 4 tablets 3x/day
Rowasa (generic) - as needed for flares
Nature's Way Primadophilus Reuteri 1/day; Chewable multivitamin; Metamucil; Viactiv (Calcium and Vit. D) for Osteopenia; flaxseed

Post Edited (Sara14) : 11/16/2007 6:38:21 PM (GMT-7)


Old Hat
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Date Joined Feb 2007
Total Posts : 5182
   Posted 11/24/2007 6:09 PM (GMT -6)   
bump-- for those with med Qs.

Old Hat
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Date Joined Feb 2007
Total Posts : 5182
   Posted 11/30/2007 9:35 AM (GMT -6)   
For Annie76-- this explains 5-ASA choices & reasons for changing to harder meds. / Old Hat

Old Hat
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Date Joined Feb 2007
Total Posts : 5182
   Posted 12/12/2007 9:49 AM (GMT -6)   
Recommend 1st section to PLEASE and others with Qs about 5-ASA meds. / Old Hat

Old Hat
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Date Joined Feb 2007
Total Posts : 5182
   Posted 12/15/2007 5:05 PM (GMT -6)   
5ASA chart is in part 1 on ulcerative colitis. / Old Hat

Wiped Out
Regular Member


Date Joined Jun 2007
Total Posts : 71
   Posted 12/15/2007 10:21 PM (GMT -6)   

Old Hat,

Fantastic website.  Thanks.


 
Left-sided UC Diagnosed 2004
Iron Deficiency Anemia Diagnosed 2007
Indeterminate Dysplasia Biopsy Result 2006   
Colazal  -  3X3 daily 
Entocort - 3 daily
Nexium
Folic Acid 
Ferrous Sulfate - 325 mg X3 daily
Vitamin C - 500 mg 
Canasa - As Needed
 
 
 
 


Old Hat
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Date Joined Feb 2007
Total Posts : 5182
   Posted 12/27/2007 10:40 AM (GMT -6)   

dakotagirl
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Date Joined Apr 2006
Total Posts : 3402
   Posted 12/27/2007 8:21 PM (GMT -6)   
Thanks for bumping this up! I missed it the first time around. I've saved it and hope to read it through soon.
Pan-colitis and GERD diagnosed May 2003
 
Asacol 12 per day,  Azathioprine 75mg, Rowasa and Canasa as needed
Aciphex, Effexor XR, BCP, Rhinocort nasal spray
Forvia and a Probiotic
 
Osteopenia (hip and spine) from prednisone use.  Started Azathioprine because I was steroid dependent.
 
Co-Mod for the UC forum
Keep HealingWell running smoothly:  www.healingwell.com/donate


Old Hat
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Date Joined Feb 2007
Total Posts : 5182
   Posted 1/5/2008 11:16 AM (GMT -6)   
bump-- for Eurelyus & others wanting to know where in GI tract the various oral 5ASA meds break down, see chart in Part 1 of article.

jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10407
   Posted 1/5/2008 11:44 AM (GMT -6)   
I think the engineered biologics are the future of treatment for those of us who don't respond well enough to the 5-ASA's. Hopefully they will return steroids to their rightful position - the drug of last resort when all else has failed.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Intolerant to Asacol and rectal mesalamine preparations.
On Prednisone then Entocort 2001-2006 with only short periods off. 
Current meds are Colazal, Azathioprine Remicade, Nature's Way Primadophilus Reuteri.
In remission since April, 2006. Remicade has been my wonder drug.
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30587
   Posted 1/5/2008 2:37 PM (GMT -6)   
Judy...old and easy habits die hard....the docs and unfortunately the patients have high expectations of having flares dealt with asap. I personally think it sets patients up for more failure in future treatments than the 5ASA meds.

There is still a HUGE lot of docs that refuse/don't prescribe rectal meds for UCers....figure that one out??? If a patient has to beg for rectal meds, there's something wrong with that doc's way of thinking..especially now-a-days!

quincy
*Heather*Status: mini flare Dec 28... increased enemas to nightly
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....bromelain 1 - 2x daily
~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 !!!


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5182
   Posted 1/18/2008 11:32 AM (GMT -6)   
bump-- for BTC & others with Qs about 5-ASA differences. See Part 1.

Old Hat
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Date Joined Feb 2007
Total Posts : 5182
   Posted 2/8/2008 6:42 PM (GMT -6)   
Print Part 1 & give to your gastro if you need more help with meds to achieve remission. / Old Hat
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