I am back here reading the posts as I went off Entocort a week ago after cutting back very slowly.
I was taking 8 Pepto Bismol without relief when I had a terrible flair on our vacation and cruise almost two years ago. That was when the GI told me to take Imodium instead. That didn't work so he put me on Entocort August 2010. I went off March 2011. June 2011 back on until April 20. While cutting back on the Entocort this time I occasionally needed to supplement with 1/2 Imodium because I didn't want to increase the Entocort. BM's were normal or soft. This past week I have been having terrible stomach aches after eating and today EXPLOSIVE D.
I have almost a three month supply of Balsalazide here. I was taking them when I was first diagnosed in Jan 2010. I was down to one a day and they helped until the cruise that summer. Several days ago I could see the BM's getting softer and softer so I started taking the full dose of six Balsalazide a day to see if that would help. Like I said before, my GI wants me OFF OF ENTOCORT because of side effects. Who doesn't want to be off of Entocort! I hate taking a RX.
My questions are, should I try Pepto Bismol or stay with Imodium? I just read long term use of Imodium can cause Pancreatitis. Does Dr Fine still say 8 Pepto Bismol for two weeks? Should I continue with the Balsalazide?
Starting tomorrow, I will go back to writing down everything I eat.
Pepto Bismol or Imodium??
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
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wonderwoman
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Hmmmmm. Those are some tough questions. If you really want to avoid Entocort, I suppose I would try the balsalazide for a few weeks to see if it will allow you to gain control. Do you remember how long it took to get results the first time?
Dr. Fine no longer recommends the Pepto treatment - he recommends diet alone, these days. However, that doesn't mean that you can't use it, if you feel that it will help. It has more therapeutic value than Imodium, (Imodium only slows down motility). Many members find Imodium to be helpful for postponing urgency, though.
Unfortunately, mesalamine has also been shown to carry an increased risk of pancreatitis, (especially with long-term use), so that would almost surely apply to balsalazide, as well. The reason for that is because even though the active ingredient in balasalazide is not mesalamine, when it reaches the colon, bacterial enzymes digest the compound to release mesalamine, and it's the mesalamine that actually treats the inflammation. Pancreatitis is a very uncommon side effect of either mesalamine or loperamide, (Imodium), though, so it's unlikely that you would have that problem with either one. You might get better control with one of the other mesalamine-based medications, because most of them are released in the ileum, and MC is usually most active in the right side colon and the ileum. Balsalazide may not be available at all in the ileum, and it may have only limited availability in the right-side colon, since theoretically it shouldn't become active until it has already journeyed partway through the colon.
Decisions such as these are never easy to make.
Tex
Dr. Fine no longer recommends the Pepto treatment - he recommends diet alone, these days. However, that doesn't mean that you can't use it, if you feel that it will help. It has more therapeutic value than Imodium, (Imodium only slows down motility). Many members find Imodium to be helpful for postponing urgency, though.
Unfortunately, mesalamine has also been shown to carry an increased risk of pancreatitis, (especially with long-term use), so that would almost surely apply to balsalazide, as well. The reason for that is because even though the active ingredient in balasalazide is not mesalamine, when it reaches the colon, bacterial enzymes digest the compound to release mesalamine, and it's the mesalamine that actually treats the inflammation. Pancreatitis is a very uncommon side effect of either mesalamine or loperamide, (Imodium), though, so it's unlikely that you would have that problem with either one. You might get better control with one of the other mesalamine-based medications, because most of them are released in the ileum, and MC is usually most active in the right side colon and the ileum. Balsalazide may not be available at all in the ileum, and it may have only limited availability in the right-side colon, since theoretically it shouldn't become active until it has already journeyed partway through the colon.
Decisions such as these are never easy to make.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.
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wonderwoman
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Tex, I got immediate results with balsalazide when I was first diagnosed. I will continue to take it since I have so many left and see what happens. I had just had it refilled three days before he prescribed Entocort in 2010. I also have a large supply of Entocort which I will use if I need to but would really like to try without. That way I will have a better understanding as to what I am reacting to. That is why I questioned the Imodium or Pepto Bismol.
I had MRT testing done in January, however, the dietician I chose in this area (there were two and this one was closer, but still 50 miles away) really was not counseling patients but took me on for a little more than her cost of the testing. Her husband is a nurse so he drew the blood. Another savings. I worked the program with her for three weeks and then broke off a tooth and spent 4 hours in the dentist chair while he tried getting the root out. I had a very sore mouth for weeks. Because of this I didn't follow the program the way I was supposed to. I had every intention of going back on it but never did. Part of the problem was I was on 1 and 2 Entocort a day so how could I tell if I was reacting or not. I am only eating the foods that tested in the low green area. Today I ate strawberries. They are the lowest green food in the fruit section. In fact there wasn't even a green line showing on the chart. They went right through me. I had large chunks of strawberries in the toilet. She suggested I eliminate night shades because solanine was a low yellow under chemicals. Haven't had potatoes or peppers (higher green) or eggplant (very low green). Tomatoes are a lower green, however, I planted four tomato plants in pots and have eaten a few. Hard not to when they are on the cupboard. That might be part of the problem. I have given the majority of them away. I am ready to pull out the plants as they are at the end now. I was eating almonds prior to being tested. However, pistachio and cashews were the lowest of the green and almonds were a higher green. Mid week I quit eating the cashews thinking that might be it. Tyramine was a very low yellow so she had me eliminate spinach even though spinach was the lowest green of the vegetables. And I love spinach. I could post the results here but don't know how to do that.
Today I sent for another test container from Enterolab and am doing the A+C plus the Fat Malabsorption test. The first time I was 32 for Anti-gliadin IGA, 11 for Anti-tissue transglutaminase IGA, negative for casein, 14 for soy, and fat was normal. I had reintroduced a little dairy but haven't had dairy in about a month. I know ice cream is a problem for sure. It will be great to see the results for corn, rice and oats as well as the meats.
I am going to start writing down what I eat so I can refer back to it. It's crazy, but I have a diary of my medications and BM's since day one.
I had MRT testing done in January, however, the dietician I chose in this area (there were two and this one was closer, but still 50 miles away) really was not counseling patients but took me on for a little more than her cost of the testing. Her husband is a nurse so he drew the blood. Another savings. I worked the program with her for three weeks and then broke off a tooth and spent 4 hours in the dentist chair while he tried getting the root out. I had a very sore mouth for weeks. Because of this I didn't follow the program the way I was supposed to. I had every intention of going back on it but never did. Part of the problem was I was on 1 and 2 Entocort a day so how could I tell if I was reacting or not. I am only eating the foods that tested in the low green area. Today I ate strawberries. They are the lowest green food in the fruit section. In fact there wasn't even a green line showing on the chart. They went right through me. I had large chunks of strawberries in the toilet. She suggested I eliminate night shades because solanine was a low yellow under chemicals. Haven't had potatoes or peppers (higher green) or eggplant (very low green). Tomatoes are a lower green, however, I planted four tomato plants in pots and have eaten a few. Hard not to when they are on the cupboard. That might be part of the problem. I have given the majority of them away. I am ready to pull out the plants as they are at the end now. I was eating almonds prior to being tested. However, pistachio and cashews were the lowest of the green and almonds were a higher green. Mid week I quit eating the cashews thinking that might be it. Tyramine was a very low yellow so she had me eliminate spinach even though spinach was the lowest green of the vegetables. And I love spinach. I could post the results here but don't know how to do that.
Today I sent for another test container from Enterolab and am doing the A+C plus the Fat Malabsorption test. The first time I was 32 for Anti-gliadin IGA, 11 for Anti-tissue transglutaminase IGA, negative for casein, 14 for soy, and fat was normal. I had reintroduced a little dairy but haven't had dairy in about a month. I know ice cream is a problem for sure. It will be great to see the results for corn, rice and oats as well as the meats.
I am going to start writing down what I eat so I can refer back to it. It's crazy, but I have a diary of my medications and BM's since day one.
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wonderwoman
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- Joined: Wed Feb 17, 2010 8:59 pm
- Location: Sun City, AZ
Gloria, I do follow your progress and know how you struggle. A while ago I said had I known how hard it is to get remission the second and third time going off Entocort, I would never have gone off. And then I go off again. Mainly because the darn stupid GI wanted me off. I won't go to him again. Will get my meds on line.
I like your idea of Imodium with Entocort. How much Entocort are you on each day.
I like your idea of Imodium with Entocort. How much Entocort are you on each day.
Charlotte,
I am taking two pills for two days and three pills for the third day. I've been trying to go to two pills every day, but so far haven't been able to. I take 1/2 Imodium every morning. I'm considering taking another 1/2 Imodium the evening of the second day to see if it makes a difference. The regimen I'm on brings mostly 1, sometimes 2 Normans a day with no gurgling and no urgency.
I'll be buying my budesonide from India now that I'm on Medicare. What plan do you have and how much do you have to pay for Entocort?
Gloria
I am taking two pills for two days and three pills for the third day. I've been trying to go to two pills every day, but so far haven't been able to. I take 1/2 Imodium every morning. I'm considering taking another 1/2 Imodium the evening of the second day to see if it makes a difference. The regimen I'm on brings mostly 1, sometimes 2 Normans a day with no gurgling and no urgency.
I'll be buying my budesonide from India now that I'm on Medicare. What plan do you have and how much do you have to pay for Entocort?
Gloria
You never know what you can do until you have to do it.
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wonderwoman
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- Joined: Wed Feb 17, 2010 8:59 pm
- Location: Sun City, AZ
I have Cigna and I have to see their doctors.
I pay $5. a month for 90 Budesonide (I just looked at my bottle and I made a mistake when I said in prior posts that I take the brand name Entocort). When I saw the GI in December I didn't tell him that I had some generic left from Canada that I was using. They are all used now. I told him I needed a new Rx. He wrote it out for 5 months. I have two refills left before December which I intend to fill just to have them here. I have to be careful that I don't reach the Medicare "donut hole" and have to pay full price. That is what happened in 2010 so I ordered from Canada. I can't understand why he prescribed a 5 months supply when he told me he wanted me to take 3 for one month, two the second month and then stop completely. The container says to take three a day in the morning. I was taking three and was constipated. Even two made me very hard most of the time so I dropped to one for several months and then reduced to every other day. Towards the end I was supplementing with 1/2 an Imodium.
I started Pepto Bismol last night and had 4 doses today and ate a very "legal" diet today. I am writing down everything I eat. Thought the Pepto was helping but had explosive D at 10:30 tonight. I am continuing to try the Balsalazide that I used when first diagnosed which worked then but so far it's not. Was on 6 last week and today I started 9, the normal dose.
I am going to repeat the Enterolab test. I have it ordered. I am suspecting I may have a problem with FAT as tonight I had a small steak. I have noticed on prior times that I am loose when I eat something with a lot of fat in it.
I will just continue to hang in there like the rest here.
I pay $5. a month for 90 Budesonide (I just looked at my bottle and I made a mistake when I said in prior posts that I take the brand name Entocort). When I saw the GI in December I didn't tell him that I had some generic left from Canada that I was using. They are all used now. I told him I needed a new Rx. He wrote it out for 5 months. I have two refills left before December which I intend to fill just to have them here. I have to be careful that I don't reach the Medicare "donut hole" and have to pay full price. That is what happened in 2010 so I ordered from Canada. I can't understand why he prescribed a 5 months supply when he told me he wanted me to take 3 for one month, two the second month and then stop completely. The container says to take three a day in the morning. I was taking three and was constipated. Even two made me very hard most of the time so I dropped to one for several months and then reduced to every other day. Towards the end I was supplementing with 1/2 an Imodium.
I started Pepto Bismol last night and had 4 doses today and ate a very "legal" diet today. I am writing down everything I eat. Thought the Pepto was helping but had explosive D at 10:30 tonight. I am continuing to try the Balsalazide that I used when first diagnosed which worked then but so far it's not. Was on 6 last week and today I started 9, the normal dose.
I am going to repeat the Enterolab test. I have it ordered. I am suspecting I may have a problem with FAT as tonight I had a small steak. I have noticed on prior times that I am loose when I eat something with a lot of fat in it.
I will just continue to hang in there like the rest here.
Re: Pepto Bismol or Imodium??
Hi Wonderwoman (LOVE the name!),wonderwoman wrote:I am back here reading the posts as I went off Entocort a week ago after cutting back very slowly.
I was taking 8 Pepto Bismol without relief when I had a terrible flair on our vacation and cruise almost two years ago. That was when the GI told me to take Imodium instead. That didn't work so he put me on Entocort August 2010. I went off March 2011. June 2011 back on until April 20. While cutting back on the Entocort this time I occasionally needed to supplement with 1/2 Imodium because I didn't want to increase the Entocort. BM's were normal or soft. This past week I have been having terrible stomach aches after eating and today EXPLOSIVE D.
I have almost a three month supply of Balsalazide here. I was taking them when I was first diagnosed in Jan 2010. I was down to one a day and they helped until the cruise that summer. Several days ago I could see the BM's getting softer and softer so I started taking the full dose of six Balsalazide a day to see if that would help. Like I said before, my GI wants me OFF OF ENTOCORT because of side effects. Who doesn't want to be off of Entocort! I hate taking a RX.
My questions are, should I try Pepto Bismol or stay with Imodium? I just read long term use of Imodium can cause Pancreatitis. Does Dr Fine still say 8 Pepto Bismol for two weeks? Should I continue with the Balsalazide?
Starting tomorrow, I will go back to writing down everything I eat.
I am a newbie to this diagnosis and board but my GI recommended that I use Immodium in conjunction with tapering down my Entocort. I did not need to use it as I went to the other extreme with the EC and became C. Unfortunately, I am back to dealing with similiar issues as you and have gone back to 9mg. EC after tapering off too quickly. I am now getting the explosive D with undigested foods several times a day. I am going to pick up some immodium to get through this and will check back with progress. I too hate to be on this stuff but hate even more to have to worry about accidents! Good luck to you.
Hi Charlotte. I don't think I've spoken to you before, but I'm always sorry to hear that someone is doing poorly. I was on three Entocort, went down to two, but had a flare two weeks ago ( I also think that fat is bad for me) . Had to go back up to three and am just coming out of this flare. I wanted to say that if you do go back on Entocort, you might want to space them out throughout the day. I take one with each meal and it seems to work really well. Maybe it wouldn't cause constipation this way. Just a thought.
Keep us posted. Hope you feel better soon.
Leah
Keep us posted. Hope you feel better soon.
Leah