Friday, January 01, 2010 handmademel asks

Q: Does everyone find a medication that works one the 1st try?

Lialda didn't work- for my colitis.. now taking Asacol 3x daily- not working- won't dissolve. Anyone have any ideas? Are there tricks for taking these pills? I have been in 1 terrible flare after another and Imodium is the only thing giving me any relief! Any tips are much appreciated- Gluten free doesn't seem to help much either! struggling in the new year! thank you

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Answers (1)

Elizabeth Roberts, Health Guide

1/ 2/10 6:42pm

Hi Mel,

How long have you been taking the Asacol? If for only a few days or a few weeks you need to give it more time. The meds. for Colitis are not like taking an aspirin - meaning, you don't take them today and start feeling better today.

Lialda and Asacol are essentially the same drug - Mesalamine, just in two different doses. Mesalamine is an anti-inflammatory for the gut and for it to take effect you have to take it, as prescribed, for at least 3 weeks, some people longer. It took me a couple months before I really saw even a small decrease in my BMs. When I started I was at 20-30 liquid BMs/day, after a month on 9 Asacol/day I was seeing 2 or 3 fewer BMs per day.

It is not uncommon for you to see pills in your stool, or rather the casing from the pills. Drink a glass of water with each dose. And if you are actually finding whole, unbroken, pills in your stool - you may have to poke them with a popsicle stick to check - then you need to talk to your doctor about another option.

The tough part of all of this is patience. Even while taking the Asacol I lived on Imodium for nearly a year or so - never taking more than 4/day. Keep in contact with your doctor's nurse. If you see that your weight is declining be sure to call and let them know. But also realize that these medications take time to work. Like I said, they don't just work over night or in a week's time. It take a lot of time to build up the inflammation in our guts and it takes just as much time to decrease it.

You may want to read about how I got from really sick to living a decent life with IBD and IBS. I wrote a book about it called, Living with IBD & IBS: A Personal Journey of Success. It might be helpful to you - www.ibdandibs.com

Best of luck,

Elizabeth

handmademel

1/ 2/10 10:13pm

Thank you again Elizabeth. I have read your book- well I have 2 chapters to go! I found it to be very helpful & informative. I have been on Asacol for almost 3 months I think and the 3 x's a day about 1 week. I remember you telling me they don't work as fast as OTC drugs-I guess I just don't know what to eat or how to help myself.It seems so overwhelming. If you don't mind me asking what was your daily routine like? See I am usually OK mid-day till night- but then once I wake up I am in the bathroom all morning.. I'm trying to spread out my meds as much as I can. Perhaps I will have to ask about uping the dose yet again.

I can usually get by with 1/2 an Imodium a day, which I am thankful for. Thank you again for all of your help.

Elizabeth Roberts, Health Guide

1/ 4/10 7:06pm

Mel,

If you've only been taking 3 Asacol 3x/day (so, 9 pills/day) for 1 week try giving it a go for another 2 weeks and see if there's a change. From what I know, a typical dose for UCers in a flare is the 9 pills per day taken 3x/day. You can go up to 12/day, with your doctor's permission.

Or, if the Asacol just isn't working at all there are other alternatives like Colazal, Pentasa, Rowasa, Azulfadine, etc. You'd have to talk to your doctor about what might be a better alternative.

It's hard to give you a typical daily routine. If you're reading my book then you know there were days I could only eat white rice, toast, bananas, or grilled cheese sandwiches. I really cut out most fruit, except bananas for a couple years, and only ate asparagus, zucchini, and brocolli that were well cooked. I took to juicing veggies for a while, and still do, just to make sure I'm getting enought nutrients. I cut out all cow's milk products, beef, and now only eat organic meats and wild fish. I also take vitamins now, but couldn't take anything for the first 2 years after my Dx.

You're going to have to start trying different things and see what helps and what doesn't. Go through my old Sharposts on this site and look specifically at the one's about keeping a food journal and doing an elimination diet. These were the 2 most helpful things for me in the first couple of years I was learning to live with this.

It's hard, I know, and for that, I'm sorry. I wish I could give you that magical thing to do that would help you now. But, I can't. Hang in there, stick with it, and do be sure to keep up with your doctor and his or her nurse if things stay the same or get worse. There are other Rx options.

Best,

Elizabeth

handmademel

1/ 4/10 8:12pm

Thanks again for all your help. Yes, I remember wishing I could eat grilled cheese when I was reading that in your book! I am only taking Asacol 2 pills 3Xday. Maybe that is part of the problem. Again I appreciate all of your help and will continue to read your posts. There is still so much for me to learn and sometimes I start feeling sorry for myself and have to say "Snap out of it"! I've started eating a little gluten here & there which seems to not affect me either way. But I do think- I might try the ED very soon- just to be sure of what allergies I might have. Thanks again- you're an inspiration!

Elizabeth Roberts, Health Guide

1/ 5/10 12:18pm

You're welcome, Mel.

I recommend you talk to your doctor about possibly increasing your Asacol dose. My understanding is that 4-6 tabs is typically a maintenance dose used once a flare-up is under control. I've been taking 6 Asacol per day for more than 5 years now, down from 9/day. Nine to 12 tabs per day, as I understand it, is usually the dose given to get a flare under control. So, you may want to discuss this with him or her.

Best,

Elizabeth