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Sulfasalazine to Balsalazide

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Ulcerative Colitis
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Posted 2/14/2013 9:18 AM (GMT -5)
I did a search and read every article I could find on the subject. I found quite a bit that helped, but there is still one question lingering. Has anyone taken enteric coated sulfasazine for years then told to go cold turkey and put on balsalazide?

Here's the story: I've taken sulfasalazine for about 4yrs. I had no cramps and somewhat loose stool while on the sulfasalazine. This last summer was great, but as fall came near and thus the holidays, it meant more contact with irritating family members and along came a small flare. My GI put my on Prednisone to stop the flare and it worked at first but by the time I was down to one pill a day I was bleeding a lot more. I started to have pain in what he told me was the ilium. He scheduled me for a CT for January 28th along with blood and stool tests. I am negative for C-diff and still waiting on the other tests. He also put me on balsalazide. For 4 days everything was fine, but now 10 days later on balsalazide and I'm back in a full on flare. I have severe cramping, blood, mucous, unable to eat, unable to make it to the toilet, the whole enchilada.

I was just wondering if I should stick with this and hope it kicks in or call the doctor? I have no side effects from the drugs. My urine is crystal clear(was muddy gold on the sulfasalazine)and my stool is a "normal" color....as normal as bloody diarrhea can be anyways. Is this drug even working?? My guts feel like I'm inside a microwave.
Posted 2/14/2013 10:21 AM (GMT -5)
IMO, you should call your Dr. and ask for mesalamine enemas.

My GI put me on the same amount of balsalazide but said that it would not reach the whole colon (left side).
To reach the left side, you need enemas.

As quincy says, "treat from both ends".

Then consider diet restrictions like eliminating lactose, gluten and (maybe) sugar to see if you benefit. Also eliminate anything that you think might be an irritant like fried foods, high fiber, etc.
Posted 2/14/2013 11:34 AM (GMT -5)
I take both sulfasalazine and balsalazide. I agree with the idea of using rectal meds.

I find it confusing that you are having pain in the ileum (lower right) when your disease up until now has been limited to the left colon and rectum. What were the results of the CT?
Posted 2/14/2013 12:40 PM (GMT -5)
I still have 1000mg Canasa that I can use & I did last night. I've become lactose intolerant since about '07 when UC hit me the worst. I can't think of the last time I had a single dairy product since Christmas really. I do try to avoid a lot of different foods as a precaution anyways. I don't think it's food that's causing the pain, but I'm being careful there.

You know I haven't heard back from the doctor's office yet. When I try to call I can't get thru. The only number I can get to is scheduling. I'm going to try and get through by their website. They changed their phone system recently and it's a mess over there.

Yeah he said my colon is only effected on the left side and including the first bend. Where my pain was and when he palpated that area he felt something and thought the ilium was swollen, but he had this look about him like he thought it might be something else so that's what the CT was about. I just wish I could get the results.

So is the medication trying to work you think?
Posted 2/14/2013 12:48 PM (GMT -5)
Ahh so their nurse line says to wait 10-15 days after pathology tests before results. It hasn't been that long since my stool tests.

As for the CT, I don't know how long it takes. I'm worried that it was a disaster. My first tech instructing me on what to leave on and what to take off for the test said to keep the tshirts(which she saw) so I did. I was so nervous and such a mess that I gave no thought to it. It had glitter all over it..... If that has metal in it then the whole thing was a waste of time and a lot of money and I will have one very angry GI and I will be one very angry patient.
Posted 2/14/2013 1:08 PM (GMT -5)
That would totally stink if the imaging was screwed up by the t-shirt glitter. That's a lot of radiation exposure for potentially nothing! It seems like the radiologist should have been able to provide results at this point - 1/28 was more than 2 weeks ago. If you have time can you actually go to the DR's office and personally ask for the results? How awful that they cannot get their phone system in order.

If it was your ileum then I would think budesonide would be an appropriate course to get this under control. And then a long talk with your GI about right-sided disease.
Posted 2/14/2013 2:14 PM (GMT -5)
I left a message & if I don't hear anything from them by next Wednesday then I'm driving out there. I need to know what if anything is causing my flare.

You don't suppose the barium stuff I had to drink, the scan itself, or the dye they used could cause a flare could you? I felt great for 4 days after the scan. Wonderful actually then everything got worse day by day.
Posted 2/14/2013 2:28 PM (GMT -5)
My personal experience was that the contrast for the CT gave me diarrhea for a week. It wasn't a flare, though - I felt fine, just had diarrhea. And it started the day after I drank the contrast.
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