Sulphasalazine & Colazal work but cause diarrhea - advice?

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BenY
Regular Member


Date Joined Aug 2007
Total Posts : 60
   Posted 11/30/2007 6:58 AM (GMT -7)   

I've tried Sulphasalazine, Colazal, and Lialda and I think they work to reduce the inflammation, but they also cause bad diarrhea. Has this happened to anyone else? I've thought about taking an anti-diarrhea medicine at the same time, but I don't know if that's advisable. I am not crazy about the alternative to these drugs which appears to be 6-MP. My reaction to the above drugs seems to be very unusual.

 

Ben, 38


Ben, 38
 
Symptoms started 10/06, diagnosed 4/07.
Currently on 8.75mg Prednisone (w/calcium), trying Sulphasalazine.
 


Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 23549
   Posted 11/30/2007 7:57 AM (GMT -7)   
It could be that you are sensitive to the ingredients of 5-ASA's or even the sulfa. Unfortunately if you are sensitive to the ingredients, there are not much else out there in 5-ASA's besides Asacol. How long have you been on the Sulfasalazine? Also, do you limit your diet to a low residue diet? If not, this might help you slow down the D and maybe use a fiber supplement to help bulk up your stool. No, anti-diarrheals are not wise in Uc'ers but it can still be used sparingly. How many times a day are you going?
 @--->--SHERRY--<---@
~Left sided Uc -'92 - Colazal (9 daily), 6mp (50-100mgs), Prilosec, Biotin, Forvia, Pro-Bio, Colocort**Unable to tolerate Asacol, Rowasa or Canasa** 
~Allergies - Singulair, Astelin(got the script - just haven't tried it yet!)~
~Secondary Reynauds Syndrome - '04 - Norvasc~
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@--->--Moderator for Allergies/Asthma and Co-moderator for UC--<---@
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BenY
Regular Member


Date Joined Aug 2007
Total Posts : 60
   Posted 11/30/2007 10:45 AM (GMT -7)   
Thanks Sherry! Its not just Sulfa, because this has happened with the other 5-ASA drugs as well. I've just been on Sulfasalzine for a few days, but the diarrhea has predictable started up, to about 8 per day. No blood or muscus evident, but then I have been on prednisone, so I haven't seen that for a while.

If the Sulfasalzine is in fact reducing the inflammation, but just causing diarrhea, I guess I *could* live with it, a long as I drank plenty of water, replenished by eletrolytes and modified my diet. Might be better than taking a stronger drug, or living with an inflammed colon which also causes diarrhea plus has additional problems. I tried 6-MP, but I lost my appetite and felt somewhat nauseous a lot of the time.
Ben, 38
 
Symptoms started 10/06, diagnosed 4/07.
Currently on 8.75mg Prednisone (w/calcium), trying Sulphasalazine.
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 29842
   Posted 11/30/2007 10:57 AM (GMT -7)   
the "lots of water" could be contributing to it as well.

You could consider to add a fibre supplement to bulk up the stool.

Curious...what is your diet like?

5ASA can cause diarrhea, loose stool for some..definitely.

You're not on any rectal meds..maybe that can help lower rectal inflammation...and in-turn, lower the reaction of the colon above that.

Options are 5ASA or steroid enemas/suppositories.

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 !!!


katydid1994
Veteran Member


Date Joined Oct 2004
Total Posts : 504
   Posted 11/30/2007 8:14 PM (GMT -7)   
Hi,

I cannot take any drugs with mesalamine like Asacol and Colazal. It causes severe pain and watery diarrhea.

What my dr put me on was prednisone and then once I was off that Colcort, which is a hydrocortisone enema.
Diagnosed with Crohn's August 2006
Age 30
Asthma, Rosacea, Venous Insufficiency, Malabsorption and Excessive Bile production
Questran 1 package per day
Colocort Enema 2 per day
Metamucil
Advair 100, 2 per day
 
 


BenY
Regular Member


Date Joined Aug 2007
Total Posts : 60
   Posted 12/1/2007 7:24 AM (GMT -7)   
Well, I want to give this the best possible chance. I'll probably need more than fiber supplements to firm things up, but its worth a try, I have a container of FiberSure (inulin) I could try. I also have some cortisone enemas, but I think the problem isn't so much inflammation so much as my body not liking the medicine for some reason and trying to get rid of it. Eating "constipating foods" (rice, white bread, bananas) only goes so far.

No blood, mucus or pain right now, just the diarrhea. If anyone has any other ideas of how to calm it down, let me know!
Ben, 38
 
Symptoms started 10/06, diagnosed 4/07.
Currently on 8.75mg Prednisone (w/calcium), trying Sulphasalazine.
 


gaff
Regular Member


Date Joined Jul 2006
Total Posts : 442
   Posted 12/1/2007 7:56 AM (GMT -7)   
I take Colazal and Rowasa and both gave me incredible diarrhea when I started them, yet they stopped the bleeding. It took me a whole year to figure out that the meds. worked yet they were the cause of the diarrhea. I would try GRADUALLY lowering the dose of your meds. I have been able to lower my Colazal to 4 a day and 1/2 rowasa every other day. I have no symptoms and have been in remission for over a year. I feel normal and can leave the house a go to work with NO WORRIES!
gaff
left-sided UC since 11/05
 Rowasa, Colazal, Calcium, Centrum
Natren Healthy Trinity Probiotics


butterfly1
Regular Member


Date Joined Jun 2007
Total Posts : 112
   Posted 12/1/2007 3:16 PM (GMT -7)   
Ive been taking 3 colazal a day for almost two weeks and guess what? Im very discouraged right now because i keep having accidents in my pants, diarrhea and today i started bleeding. Ive been off work for a mnth and am supposed to go back to work on Monday. What am i gonna do now? Please help!

katydid1994
Veteran Member


Date Joined Oct 2004
Total Posts : 504
   Posted 12/1/2007 7:02 PM (GMT -7)   
Butterfly did you call you dr? Maybe they could try something else, like my dr tried Entercort after the colazal was a no go, it was less diarrhea on that.
Diagnosed with Crohn's August 2006
Age 30
Asthma, Rosacea, Venous Insufficiency, Malabsorption and Excessive Bile production
Questran 1 package per day
Colocort Enema 2 per day
Metamucil
Advair 100, 2 per day
 
 


butterfly1
Regular Member


Date Joined Jun 2007
Total Posts : 112
   Posted 12/1/2007 11:58 PM (GMT -7)   
Ill call Monday morning. I dont think im going to be able to go back to work yet. Thanks!

4Johanna
New Member


Date Joined Nov 2007
Total Posts : 10
   Posted 12/2/2007 2:54 PM (GMT -7)   
In my experience, Colozal and alcohol (even just one drink) should never be mixed. I always have big problems the next day if I have a drink with dinner and take Colozal before bed. I If I am doing OK with my UC, I will occasionally have a drink and skip my nighttime dosage.
Zach

Diagnosed with U/C in 1997
Remission 1998-2002
Constant struggle ever since
Currently taking:
Colazal 3-3x/day
Entocort 1/day
Canasa 1/day
Proctofoam 1/day


BenY
Regular Member


Date Joined Aug 2007
Total Posts : 60
   Posted 12/3/2007 3:29 AM (GMT -7)   
Butterfly,
How about trying Lomotil? Its an anti-diarrhea drug that stops the intentines from contracting for some period of time (4-6 hours). I've used it sometimes when I was going testing outdoors and knew there would not be a convenient bathroom. It doesn't heal anything, and you definitely want to let your body flush itself out at night, but it might allow you to work. Maybe long-timers have some additional warnings about it. Even a quarter of the tiny pill will stop things for a while.
Ben, 38
 
Symptoms started 10/06, diagnosed 4/07.
Currently on 8.75mg Prednisone (w/calcium), trying Sulphasalazine.
 


4Johanna
New Member


Date Joined Nov 2007
Total Posts : 10
   Posted 12/3/2007 5:08 PM (GMT -7)   
BenY,

Thanks for the Lomotil advice. There are times when I am working and know that I won't be anywhere near a bathroom. I could use the insurance from time to time.
Zach

Diagnosed with U/C in 1997
Remission 1998-2002
Constant struggle ever since
Currently taking:
Colazal 3-3x/day
Entocort 1/day
Canasa 1/day
Proctofoam 1/day

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