Crohn's Disease Forum » Treatment » 5-ASA/Mesalamine » Going onto a 5-ASA treatment


 
08-26-2008, 05:20 PM   #1
GoJohnnyGo
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Going onto a 5-ASA treatment

Back from my new doctor (GP) today. I really like this guy. Third visit now and developing a bit of a rapport with him. Not sure if he has a lot of Crohn's patients, but that's okay because he seems to be the overly-cautious type (so at least he'll be thorough). Because I've gone through severe stages of the disease before (albeit a long time ago), he knows I'm up on chronicling my symptoms. He's left it up to me as to when I want to start on 5-ASA (don't know which one he'll prescribe me yet). I'll wait a few days to see how my infection clears up and go from there.

At the same time, I'm going to start a food diary (thanks to reading about it here) and work backwards in a process-by-elimination manner. He thought that was a good idea.

I don't really feel a lot better, but I'm now getting somewhere!
08-26-2008, 08:12 PM   #2
teeny5
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That's great that you found a dr. you like.
08-28-2008, 08:56 AM   #3
Agent X20
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Yes... I'm glad it's working out, your situation was getting a bit desperate when you started posting!
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08-29-2008, 10:12 PM   #4
Colt
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The choice of which med you get will depend on where your disease is. Different ones are active in different parts of the digestive tract.
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08-29-2008, 10:35 PM   #5
GoJohnnyGo
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Colt said:
The choice of which med you get will depend on where your disease is. Different ones are active in different parts of the digestive tract.
Yeah, I think so. I think this new guy is listening to what I say. I feel a bit of distress up and down to the sides moreso than centralized in the groin area. Maybe that's the lower bowel (going by anatomy)? The pain also moves around to the back (to the point it was difficult today for me to bend down on the toilet and half the stuff splattered all over while I was trying to bend down to sit).

I do know that further blockages tend to recur near previous resections (in my case the jejunum and terminal ileum), but this feels like a different area.

I had a good day yesterday, but today was hell. Being the long weekend, my first opportunity to see him again is Tuesday morning 10:00 sharp. Really don't like the idea of going back on drugs after so long, but present circumstances dictate it. Eating right isn't working (very frustrating) and a vitamin and supplement regimen a month in hasn't produced enough of a difference (although in my opinion something worth continuing with).
08-29-2008, 10:42 PM   #6
Isla
 
Asacol: Treats the terminal ileum, and the upper 75% of the large intestine
Pentasa: Treats the large intestine only (usually only the lower 75%)
08-29-2008, 10:48 PM   #7
GoJohnnyGo
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Yeah, I'm trying to research this. The last Crohn's-related drug regimen I had was post-surgery and it was Flagyl and Sulfa-something. Not really up on the new stuff.
09-02-2008, 08:31 PM   #8
GoJohnnyGo
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Well, Asacol it is. One 400mg tablet three times a day to start with and see how it goes. He also suggested prednisone, but I'm willing to wait a bit on that.
09-02-2008, 09:11 PM   #9
Isla
 
That seems an odd dosage unless you mean 2 400mg tablets, 3 times a day? For a total of 2.4 grams a day. That is the normal "remission" dose. It is what I am on and is working very well for me.
09-02-2008, 09:15 PM   #10
teeny5
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That's the same dose I have Isla...plus I take Rowasa now too at night.
09-02-2008, 09:18 PM   #11
GoJohnnyGo
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A total of three pills a day. That's what the bottle says.

Not really familiar with what normal dosages are. I'm supposed to see him in two weeks.
09-02-2008, 09:23 PM   #12
Isla
 
Ya that isn't a normal dose at all, I have done a lot of research on Asacol and I am not sure at that low of a dose that it will even help you. Though it could very well work for you. But it isn't the usual prescribing practice as tests have shown the best dosage is 2.4g a day, there is a step higher (more Asacol) which helps get a flare into the remission state in which you can drop back down to 2.4g a day. You can go to Asacol's website and find a plethora of information. Maybe you should look into it and print any pertinent information to bring with you on your next visit.
09-02-2008, 09:25 PM   #13
ladyB
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Did you ever hae any problems with side effects when you started another med.?
Maybe your doc is slowly getting your body used to the meds.
09-02-2008, 09:37 PM   #14
GoJohnnyGo
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ladyB said:
Did you ever hae any problems with side effects when you started another med.?
Maybe your doc is slowly getting your body used to the meds.
Nope. I've never been on any sort of crohn's medication before -- outside of Flagyll post-surgery 18 years ago. I have no known allergies nor adverse reactions to any medications.

Gee now I'm quite perplexed.

I did tell him that I am in considerable pain -- 8/10 on a personal threshold.
09-02-2008, 09:40 PM   #15
teeny5
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What did he say about your pain?

My GI just said "you'll have good days and bad days" Really irritates me!
09-02-2008, 09:41 PM   #16
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I would call and question him on why the low dose...or find a new doc
09-02-2008, 09:42 PM   #17
ladyB
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teeny5 said:
What did he say about your pain?

My GI just said "you'll have good days and bad days" Really irritates me!
Well let's just see how well the doc would handle one of our 'bad' daays...
Then see what action he would take
09-02-2008, 09:47 PM   #18
Isla
 
Well he said he has an appt. in 2 weeks. Lower doses are indicated if there is a possibility of impaired renal function. Though the 1.6 g dose a day is to have UC put into remission, not CD. Everywhere I have read 2.4 g / day is indicated for those with CD not UC.
09-02-2008, 10:02 PM   #19
GoJohnnyGo
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Definitely not renal concerns. I was tested for that. I am at a loss right now. Could the druggist got the prescription wrong?
09-02-2008, 10:08 PM   #20
Isla
 
It has happened to me before. So I would say it is a possibility but not a likelihood though. I would just wait the 2 weeks and ask your doctor then.
09-02-2008, 10:21 PM   #21
GoJohnnyGo
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To be quite honest, given a choice, I'd rather be under-medicated than over-medicated. Not that I don't trust the medical profession, but we are a society of pill-poppers and sometimes I wonder why.

Thanks for bringing it up though, I'll definitely ask him.
09-03-2008, 02:25 AM   #22
Agent X20
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I've been on one 400mgs tablet three times a day... and it worked well for years... until my latest problems 18 months ago. The Doc is quite emphatic about the dosage, so no mistakes there. If I have a "bad patch" I just double the dosage for a while and it usually clears up. And no mention of any renal problems... ever!
If it works I wouldn't worry about it... if it doesn't work, you need to see the doc again!
09-03-2008, 03:00 AM   #23
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I maxed my Asacol dose out at four times that Agent, I've actually never heard of a dose that low, I was started out at double your dose (3 times a day still, just the pills were multiplied)...I've been off it for 9 months almost though, it was thought to be too uneventful for the severity.

Try Lialda if you can look into it, it's essentially a one a day Asacol dosage, more or less...
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09-03-2008, 09:28 AM   #24
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I take pentasa 4 times a day, at 4 pills each time. Quite the pain.
09-03-2008, 09:35 AM   #25
GoJohnnyGo
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Agent X20 said:
I've been on one 400mgs tablet three times a day... and it worked well for years... until my latest problems 18 months ago. The Doc is quite emphatic about the dosage, so no mistakes there. If I have a "bad patch" I just double the dosage for a while and it usually clears up. And no mention of any renal problems... ever!
If it works I wouldn't worry about it... if it doesn't work, you need to see the doc again!
Well, that puts my mind at ease a bit.

Here I went to bed thinking maybe the doctor was taking my symptoms lightly. Now that I think about it, he's taking a cautious approach because those are the vibes I'm giving off (turning down the prednisone for instance). Dosages can always be upped, and obviously I know better than to expect an instant alleviation of symptoms.
09-03-2008, 01:15 PM   #26
Agent X20
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My doc seems quite cautious. Maybe I give off that "I don't like taking tablets" vibe. On the other hand, he's made it quite clear to get back in touch asap if things start getting worse!
09-03-2008, 01:17 PM   #27
teeny5
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Mine seems the same way...though I am really peeved right now because I have been worse and he hasn't returned my calls yet! I think it is better to have one that is cautious than one that is just giving you a ton of meds you don't need.
09-03-2008, 05:05 PM   #28
Isla
 
Remember Asacol can take 6 or more weeks to start taking effect. So if you want to stick on this low dose, I suggest you try it for 2-3 months before thinking you need a higher dose.
09-05-2008, 10:27 AM   #29
GoJohnnyGo
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Does the pain get worse before it gets better?

Because that's what's happening and it's wearin' me out.
09-05-2008, 07:23 PM   #30
teeny5
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That's what I thought...went to Urgent Care yesterday and they changed my meds. Now I am like a whole new person. I think the Asacol just wasn't working...despite my GI insisting it was.
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