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Regular Member

Date Joined Nov 2007
Total Posts : 393
   Posted 12/15/2007 8:57 AM (GMT -6)   
my daughter came home from school yesterday and we had her appointment wit her new doc. dr. did a sigmoidoscopy (surprise, no warning) and saids she wanted her off the asacol as it did not look from the inside as if it was working well enough one month after. she put her on colazol, and i'm not sure what the difference is? can someone tell me their opinion of one over the other. she has to cut back on asacol and build up to 3 colazal 2x a day. we thought the asacol was beginning to work because she has much less blood and urgency? also added cotiform wants 3x a day? with canessa and somewhere in there is rowasa? i won't rememberall of the dosing until we get the packages from the pharmacict today, the dr was very fast telling us what she would be taking and din't write it down. although my daughter had her colonoscopy 1 month ago this dr took biopsies during sigmoidoscopy? anyone tell me what she's looking for . she jumped around the quesion when i asked.
Mom to 19 year old daughter diagnosed 11/07.

Veteran Member

Date Joined Dec 2005
Total Posts : 3238
   Posted 12/15/2007 9:00 AM (GMT -6)   
I'll let someone else explain the difference b/w Colazal and Asacol b/c I don't know specifics. They only thing I can time you go take a notebook and write down everything they say regarding dosage. It is your daughter's appt. and there is no reason for the doctor to rush you. I have a young child and when we go to the doctor if they don't write it down I ask them to repeat all instructions at least once. I never get it all the first time. If I have any questions I call the nurse back and ask them to explain it again. Your pharmacist can sometimes help as well.
Tabitha (Tab)

100mg Azathioprine, 2 Fibercon, Colazal-9 a day, Acidopholis Pearls, Nexium
Co-Moderator UC Forum

Regular Member

Date Joined Nov 2007
Total Posts : 393
   Posted 12/15/2007 9:24 AM (GMT -6)   
believe it or not i was writing it all down, but i ended up with a list and no specifics, it just came so fast and it was if one doesn't work use this .....but i mustg have been too keyed in to my daughters response to her sigmoidoscopy she was so firghtened that this could be done to awak person, i guess i blew it. the dr gave us her emal and we will write to her when we pick up all the drugs today.
Mom to 19 year old daughter diagnosed 11/07.

Regular Member

Date Joined Oct 2007
Total Posts : 61
   Posted 12/15/2007 9:27 AM (GMT -6)   
biopsies are just for looking very closely at what exactly is going on at the sight. To confirm diagnosis often times. Biopsies are a good thing, we want those, and sent to a good lab. If you find you can't get what you need from the doc, or are uncomfortable in any way, I encourage 2nd opinions, I had one & found out info the other doc didn't provide. I'd try working with current doc first, cause switching or starting over to get 2nd opinion can be a big pain at times, and is last resort, but try writing it down like Tab said is great, oh & the pharmacist knows me by face & name now...I use them all the time! that's what they are there for, and they can explain what a doc can't sometimes, why is beyond me!!! Bless you & yours...good luck!
Diagnosed with UP Sept. 2007-2nd opinion & 2nd colonoscopy confirmed UP, & UC old pain & new pain, it's spreading...Dec. 2007
misDiagnosed with Degenerative Arthritis, 2006
2 4 asacol 3x daily for UC/UP. 
Canasa suppositories, also 3x  daily,
3tsp. Donnatol every 6 hours, as needed
1 20mg tab aciphex daily
1-2 depacote 3x daily for bipolar disorder

Regular Member

Date Joined Oct 2007
Total Posts : 486
   Posted 12/15/2007 10:39 AM (GMT -6)   
Hm. I hope this doctor seemed like she had a good sense of how to deal with your daughter's case. It doesn't sound like a good experience but hopefully the outcome is a speedy way to getting your daughter's flare under control.

There have been previous posts about the differences between Asacol and Colazol. I can't find them right now, but if you do a search you'll find them. I think Old Hat posted a good link to a summary of different drug therapies. In brief -- Colazal is a similiar kind of medicine but it's released in a different part of the colon.

I think it might be a good sign that the dr didn't think the Asacol was doing enough. I mean, a lot of dr's are happy with any improvement but if your daughter is still flaring, perhaps this doctor is trying to find a medicine that will work even more.

about the flexi-sig exam. I've had a few without warning as well. If I suspect I might need one, I take a Xanax before the appointment. They truly suck but I still think that it might be better to have it without warning so you don't have to worry ahead of time. Still, for a 19 year old, that's a lot to handle.

I'd call the dr's office (or email the doctor) until you feel that you really understand the doctor's treatment, the tests, etc. It's a lot of info to take in at once and the doctor shouldn't be mysterious about it. If you don't hear from the dr office, you should check back to find out the results for the biopsies.
UC for the last ten years
Current Meds: 6MP
Past Meds: You name it; I've tried it.

Elite Member

Date Joined Mar 2003
Total Posts : 10407
   Posted 12/15/2007 10:44 AM (GMT -6)   
I'm not totally sure what the differences are between Colazal and Asacol. They're very similar and are released in the colon, but for some reason different people react to them differently. It may have to do with the other substances used to bind the medication, or where exactly they dissolve in the colon. I seem to recall my doctor explaining that Asacol acts primarily in the sigmoid and rectum, whereas Colazal acts throughout the colon, but I may be mistaken about that. I'm on Colazal because Asacol increases my D. Others are on Colazal because Asacol didn't work well enough for them.

Our meds tend to be a trial-and-error process, finding out what combination works for each person. Do take a note pad along when you go to the doctor, and if you aren't sure what she's saying, ask. In my GI's office the appointment clerk always asks if you have any questions, and will call the nurse practitioner to talk to you if needed. If you find when you get home that you're confused, call the office and ask.

Remember, your daughter is watching and learning from you how to advocate for herself. She may tell you to butt out one of these days and take over for herself. Kind of like how we carry them when they're small until our arms hurt, then they learn to crawl and push us away. It's growth for them, but it still hurts.
Moderate to severe left-sided UC diagnosed 2001.
Current meds are Colazal, Azathioprine and Remicade. Completely off steroids for more than a year now! In remission since April, 2006. Remicade has been my wonder drug.
Now tapering Azathioprine, please pray for me.

Old Hat
Veteran Member

Date Joined Feb 2007
Total Posts : 5186
   Posted 12/15/2007 6:38 PM (GMT -6)   
Hi, PLEASE. I just bumped the article Julee70 mentioned-- so that you can find it easily on page 1 here. It has a chart explaining the different 5ASA meds: "New Online IBD article Summarizes Current Medical Treatment Options". (Part 1 discusses ulcerative colitis, part 2 Crohn's disease). Sorry to read that your daughter had a flex-sig procedure sprung on her by new gastro! I know from personal experience how unpleasant they can be. I also suspect that most UCers have this grand surprise pulled on them at least once in the course of medical treatment. It DOES show the doctor exactly what is happening to tissues in the sigmoid colon, rectum, & anal canal, though-- so that's why they do it. Biopsies are used to differentiate diagnoses, and this doctor likely did a new set to confirm the earlier one made by previous doctor. As for switching from Asacol to Colazal, it's likely based on what this new doctor saw in your daughter's exam + what improvement she's used to seeing in patients taking Asacol for a comparable length of time + her experience monitoring patients on Colazal. She's prescribing a more aggressive treatment-- recommending Cortifoam use 3 times daily-- this would be to speed healing in the rectum. It may have occurred to her that your daughter should try to optimize meds during the intersession break-- so that she can hopefully get out of this UC flare by the time her new semester of classes starts. That definitely makes sense to me!!!! Have a look at UC articles on Salix Pharmaceuticals Newsletter Website (Archive) and you'll get still more explanations on use of 5ASA & other UC meds, etc. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily for remission maintenance)

Veteran Member

Date Joined Apr 2006
Total Posts : 733
   Posted 12/15/2007 7:03 PM (GMT -6)   
I think it sounds like the doctor really wants to stay on top of things, that is good.
Diagnosed with Left-sided Ulcerative Colitis 1995 at 15
Tried: Prednisone, Rowasa & Hydrocortisone Enemas, Proctofoam, Sulfasalazine, Asacol, Probiotics, Fish Oil, Canasa, Enotcourt, Colazol, Proctocort, Anamantle...
Diagnosed with Ulcerative Proctitis with rectal fistula in 2004, put on Remicade
2007:Increased Remicade dosage-660mg every 6 weeks,diagnosed with Psoriatic Arthritis & Fibromyalgia
Current meds: Remicade 660mgs every 6 wks, Lomotil, Tramadol, Darvocet, Clorazepate, new meds I am about to start: Prograf, Cymbalta, Lyrica

Regular Member

Date Joined Nov 2007
Total Posts : 393
   Posted 12/16/2007 7:41 AM (GMT -6)   
thank you all for your answers. i did email the dr and i'm sure she'll respond. as for the note taking, i was writing, it just didn't make sence to me later there were too many things too fast. that said i am glad she looked in to see what was going on, we will just know for next time what the ossibilities can include.
Mom to 19 year old daughter diagnosed 11/07.

Old Hat
Veteran Member

Date Joined Feb 2007
Total Posts : 5186
   Posted 12/16/2007 3:11 PM (GMT -6)   
Flex-sig procedures are more likely during the 1st year in treatment, or when changing meds. Hopefully, your daughter's UC will come under control within the next couple of months-- so that she may be able to put off additional scoping for a good while. She should rest up for at least a day after the procedure, though, because the friction of scope passing over inflamed tissues can cause UC symptoms to exacerbate. Take the meds, eat as nutritionally balanced a diet as possible, and rest. Did the gastro say anything about vitamin/mineral supplements? There is a combo called Forvia that is formulated especially for adults with IBD. Among its components are vitamin D & folic acid, which are very beneficial. I hope you're both feeling more positive today! Keep us posted on how things are going as your time permits. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily; back in remission)
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