I'd recommend trying Cortenemas for at least 3 weeks. However, it does take a longer period of use for them to be effective if one has inflammation in the descending colon-- where the systemic chemistry has to kick in. In my experience, one can use them for 3 months w/o major side effects cropping up, except for increased appetite & some thinning of scalp hair. That being said, let me move on to the 5-ASAs. Pentasa is mainly for patients with right-sided inflammation because it starts acting in the terminal ileum. Dipentum can reduce inflammation, but prolongs D-- my gastro admitted that after Colazal came on the market. I myself have done better on Colazal than with any of the other older 5-ASAs, including Rowasa! Therefore, I would recommend that you try Colazal before giving up on 5-ASAs entirely. Ask your doctor what he thinks about
possibility of using Cortenemas alone for up to 4 weeks & then phasing in Colazal gradually. My feeling about
drug combos is that they make it harder to tell where side effects are coming from-- so better to do one type of drug at a time (initially) to determine which are ineffective or cause major adverse reactions. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily; seem to be back in remission) P.S. Your doctor may want to avoid prescribing steroids if you are middle-aged, due to potential for bone loss.