SOOOOOO! Here I am, a year+ past LC diagnosis, a year+ of GF/DF/mostly SF. Weaned off of Entocort last month after a year+ on it. GI doc wants me to do balsalazide and see how that goes. I'm not optimistic, as a brief trial with it last fall sent me right back to Entocort.
So, what do we think about balsalazide/Colazal? My GI doc, who has been very good so far, seems to think that if I don't do well on the generic, she'd like to try Colazal. I can't figure out whether I'm having problems with balsalazide or reacting to some food.
I'm having a bit of an up/down week. Ate strawberries this AM on my GF Rice Chex with almond milk, and two hours later, significant burning belly discomfort (which is highly unusual for me) and yellow, watery D, which followed semi-formed BMs (sort of periodically normal for me) just a little earlier in the AM. I have not had problems with berries previously. Typically, that reaction indicates dairy, but I haven't had any in many weeks.
I continue to have problems, even after a year, figuring out how quickly the food I eat hits my gut and reacts, which is one of the reasons I abandoned the food diary that was making me completely insane.
Balsalazide and other questions
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Hi Suze. When I was first dx, my GI put me on Balsalazide and it did absolutely nothing for me. I may have even gotten worse. Hard to say since it was at the beginning.
How much Entocort were you taking before you got off of it? Did you wean VERY SLOWLY? If not, that could be part of the problem. If you were only taking one and feeling pretty good, maybe you need to stay on that small dose. I know that there are some people on this forum who have come to the conclusion that they have to either stay on a low dose of Entocort and/or immodium . period. Everyone is different. I don't know where I will end up because i am only on my fourth month with this thing, but I hope you get it figured out.
Leah
How much Entocort were you taking before you got off of it? Did you wean VERY SLOWLY? If not, that could be part of the problem. If you were only taking one and feeling pretty good, maybe you need to stay on that small dose. I know that there are some people on this forum who have come to the conclusion that they have to either stay on a low dose of Entocort and/or immodium . period. Everyone is different. I don't know where I will end up because i am only on my fourth month with this thing, but I hope you get it figured out.
Leah
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Deanna in CO
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Suze,
I can't really speak to what's going on specifically with you. However, my nutritionist/naturopath gave me a simple way to determine your "transit time" (how long it takes for something you eat to get through your system). Kernel corn does not absorb into your system unless you chew it well, which means it provides an excellent indicator of how quickly your food is moving through your system. All you have to do is swallow a small spoonful of kernels (swallow them like pills), and then watch to see when it shows up in the toilet. I did that early on and learned that my transit time is pretty much exactly 24 hours. I've been thinking recently that I need to re-check that just to be sure, but that is very easily done.
This will NOT tell you how your body is being affected by mast cell issues. If you are reacting to high-histamine foods, those reactions happen quickly, within perhaps 10 minutes to maybe an hour or two after you eat them. I apparently don't have mast cell issues - at least they didn't show up when the lab re-stained my biopsies. There are others on this board who can tell you about those and how they would affect you. But at least the corn will give you some indication of how quickly the food is moving, so you can have an idea what you're reacting to.
Just an idea that has worked for me.
Deanna
I can't really speak to what's going on specifically with you. However, my nutritionist/naturopath gave me a simple way to determine your "transit time" (how long it takes for something you eat to get through your system). Kernel corn does not absorb into your system unless you chew it well, which means it provides an excellent indicator of how quickly your food is moving through your system. All you have to do is swallow a small spoonful of kernels (swallow them like pills), and then watch to see when it shows up in the toilet. I did that early on and learned that my transit time is pretty much exactly 24 hours. I've been thinking recently that I need to re-check that just to be sure, but that is very easily done.
This will NOT tell you how your body is being affected by mast cell issues. If you are reacting to high-histamine foods, those reactions happen quickly, within perhaps 10 minutes to maybe an hour or two after you eat them. I apparently don't have mast cell issues - at least they didn't show up when the lab re-stained my biopsies. There are others on this board who can tell you about those and how they would affect you. But at least the corn will give you some indication of how quickly the food is moving, so you can have an idea what you're reacting to.
Just an idea that has worked for me.
Deanna
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wonderwoman
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Suze, When I was first dx with CC in Jan 2010 I was put on Balsalizide and it helped. Then in May 2010 I began having D even though still I was still on the RX. By July I was so very bad I went on Entocort with great success immediately. I slowly weaned myself off over a period of almost a year. Was off for almost two months last summer when I had a flair again. I tried Balsalizide again for about two weeks last summer because I had some here and it did nothing. Back on Entocort. Was off Entocort again when D returned this spring. Tried Balsalizide again for two weeks this last month and it did nothing. I am back on Entocort again since last Friday. I am presently taking two a day and have had normal BM's the last three days. If this continues I will alternate between two RX one day, and one the next day before dropping down to one a day. I may be one of those unfortunate ones who will need to stay on a low dose of Entocort forever.
When I was on Balsalizide I believe I was the only one on this board that was taking Balsalizide. Whatever you and your doctor decide to do, I hope it helps. Everyone is different.
When I was on Balsalizide I believe I was the only one on this board that was taking Balsalizide. Whatever you and your doctor decide to do, I hope it helps. Everyone is different.
Thanks for the responses, which are helpful.
@Leah, I had weaned the Entocort down to one every 4 days before stopping. When I had a flare last fall, it was, I learned, partially due to stopping the Entocort too quickly.
@ Deanna, great tip about the corn. I will try that.
@Wonderwoman, if this goes on beyond the weekend, I may discuss some of your med suggestions with my doc.
Doesn't balsalazide contain some of the ingredients of aspirin? And aren't we supposed to avoid aspirin? So why prescribe balsalazide?
What I don't like about the balsalazide is the burning sensation in the mid-belly. Yesterday, after the strawberries, it lasted most of an hour, and I ended up taking a Pepcid. I have the burning again as I write this, and did not eat berries. Maybe it's coffee? But a cup or two usually doesn't bother me. This morning, gurgling, watery D, not good, as I have family staying with me the next couple of days.
@Leah, I had weaned the Entocort down to one every 4 days before stopping. When I had a flare last fall, it was, I learned, partially due to stopping the Entocort too quickly.
@ Deanna, great tip about the corn. I will try that.
@Wonderwoman, if this goes on beyond the weekend, I may discuss some of your med suggestions with my doc.
Doesn't balsalazide contain some of the ingredients of aspirin? And aren't we supposed to avoid aspirin? So why prescribe balsalazide?
What I don't like about the balsalazide is the burning sensation in the mid-belly. Yesterday, after the strawberries, it lasted most of an hour, and I ended up taking a Pepcid. I have the burning again as I write this, and did not eat berries. Maybe it's coffee? But a cup or two usually doesn't bother me. This morning, gurgling, watery D, not good, as I have family staying with me the next couple of days.
Suze
Suze,
Balsalazide does not actually contain mesalamine (which is closely realated to aspirin). Instead, it contains balsalazide disodium, which is a prodrug. Prodrugs are typically inactive until they're activated by intestinal bacteria, in this case, colonic bacteria. While balsalazide is not totally immune to causing adverse reactions by someone who is sensitive to NSAIDs (which is a common problem with most mesalamine-based drugs), it does seem to cause problems for fewer patients, as you can see by the research article at the following link. This research was based on subjects who had UC (rather than MC), but the results should apply to patients who have MC as well.
Tex
Balsalazide does not actually contain mesalamine (which is closely realated to aspirin). Instead, it contains balsalazide disodium, which is a prodrug. Prodrugs are typically inactive until they're activated by intestinal bacteria, in this case, colonic bacteria. While balsalazide is not totally immune to causing adverse reactions by someone who is sensitive to NSAIDs (which is a common problem with most mesalamine-based drugs), it does seem to cause problems for fewer patients, as you can see by the research article at the following link. This research was based on subjects who had UC (rather than MC), but the results should apply to patients who have MC as well.
http://www.ncbi.nlm.nih.gov/pubmed/9428213RESULTS: More patients treated with balsalazide achieved symptomatic remission after 2 (64% [balsalazide] vs. 43% [mesalamine]), 4 (70% vs. 51%), 8 (78% vs. 45%), and 12 weeks (88% vs. 57%) and complete remission (none/mild symptoms, sigmoidoscopy grade 0/1, no rectal steroid use within 4 days) after 4 (38% vs. 12%), 8 (54% vs. 22%), and 12 weeks (62% vs. 37%). Patients taking balsalazide experienced more asymptomatic days (4 weeks, 24% vs. 14%) and achieved the first asymptomatic day more rapidly (median, 10 vs. 25 days). Fewer patients in the balsalazide group reported adverse events (48% vs. 71%); four serious adverse events occurred in the mesalamine group.
CONCLUSIONS: Balsalazide is more effective and better tolerated than mesalamine as treatment for acute UC.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Lesley,
I'm sure that she's referring to corn on the cob in the roasting ear stage, or similar soft, canned corn. The pericarp (the skin) of corn is very glutenous, and most of it has to be removed when making masa for tortillas, or the finished product would be too gummy. Only enough of it is retained to allow the masa to stick together (without being gummy). The only practical way to remove the pericarp is by steeping the corn for most of a day in a hot water bath that contains lime (calcium oxide), which is a very caustic (alkaline) solution.
We can't digest the pericarp of corn because our digestive system is designed to operate at the other end of the pH scale. IOW, our stomach is very acid (a pH of approximately 2 to 3), and our intestines operate at a near neutral level (a pH of around 7.0, more or less). Lime water has a pH up in the 12 to 13 range.
And yes, foods have differing transit times. Foods that are easier to digest tend to exit in less time than foods that are more difficult to digest. As a general rule, though, meals tend to sort of stick together and transit times generally refer to some sort of average time for typical meals.
Tex
I'm sure that she's referring to corn on the cob in the roasting ear stage, or similar soft, canned corn. The pericarp (the skin) of corn is very glutenous, and most of it has to be removed when making masa for tortillas, or the finished product would be too gummy. Only enough of it is retained to allow the masa to stick together (without being gummy). The only practical way to remove the pericarp is by steeping the corn for most of a day in a hot water bath that contains lime (calcium oxide), which is a very caustic (alkaline) solution.
We can't digest the pericarp of corn because our digestive system is designed to operate at the other end of the pH scale. IOW, our stomach is very acid (a pH of approximately 2 to 3), and our intestines operate at a near neutral level (a pH of around 7.0, more or less). Lime water has a pH up in the 12 to 13 range.
And yes, foods have differing transit times. Foods that are easier to digest tend to exit in less time than foods that are more difficult to digest. As a general rule, though, meals tend to sort of stick together and transit times generally refer to some sort of average time for typical meals.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
I can personally confirm that sweetcorn is an excellent indicator of how quickly food becomes poop! I quite often have sweetcorn in sandwiches for lunch and quite often see those lovely little kernels again by mid afternoon. Ditto peas which I often eat in my special home made rice of an evening and they are there staring up at me by the next morning!
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Deanna in CO
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Lesley,
Sorry it took me a while to get back to this - it's been a busy couple of days as my best friend's son (15 years old and my daughter's best friend) had major surgery this morning.
But Tex is exactly right - and knows much more about the "why" than I did or than my nutritionist told me. Canned, frozen, or straight off the cob corn is what she was talking about, swallowed whole, with a meal so it sort of stays together.
Thanks, Tex, for chiming in with the explanation and the support here. :-)
Deanna
Sorry it took me a while to get back to this - it's been a busy couple of days as my best friend's son (15 years old and my daughter's best friend) had major surgery this morning.
But Tex is exactly right - and knows much more about the "why" than I did or than my nutritionist told me. Canned, frozen, or straight off the cob corn is what she was talking about, swallowed whole, with a meal so it sort of stays together.
Thanks, Tex, for chiming in with the explanation and the support here. :-)
Deanna
Thanks all. I haven't had corn since enterolab declared it off limits.
Since I have (unfortunately) put on the weight I lost when I had WD I think, although things are by no means Norman, I must be digesting a lot more. At least, when I have C (a lot of the time) I guess the food stays inside longer, though not necessarily in the areas where it is absorbed.
I should try the corn test to see what is being absorbed and how quickly.
Since I have (unfortunately) put on the weight I lost when I had WD I think, although things are by no means Norman, I must be digesting a lot more. At least, when I have C (a lot of the time) I guess the food stays inside longer, though not necessarily in the areas where it is absorbed.
I should try the corn test to see what is being absorbed and how quickly.