Medication Questions

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Lisa_D
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Medication Questions

Post by Lisa_D »

Hi All,

I saw my GI doc a few days ago and left feeling a bit overwhelmed. I've been on Entocort for 6 months now along with a very restricted diet (thanks reading/stalking all the posts on this board).

My doc is concerned about the length of time I've been using Entocort and some of my general lack of progress. Overall, I'd say I've gotten about 50% better in the past 6 months. My GI also acknowledges that part of the problem is that I'm still on Zoloft. I've been taking a high dose of Zoloft for almost a decade and am coming off of it very slowly.

All of this to say, he presented the following plan:
--I'm still trying to come off the Zoloft (but it will take a few more months)
--I'm going to lower the Entocort and add Lilalda
--If the Lilalda doesn't work in 4 weeks, our next option will be to try methotrexate

My question is: Has anyone here tried Lilalda or Methotrexate? Methotrexate scares me a bit (based on the Googling I did, so I'm not sure I even want to open that can of worms). I did a search and didn't see much on either medication.

I know diet is always the best and first approach, but given how long it's going to take me to get off the Zoloft, my doc seems to think we need to add some other medication into the mix to speed up the healing process. I appreciate any help.

Thanks in advance!
Lisa
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tex
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Post by tex »

IMO your doc is confused — medications don't heal the gut . . . the diet changes and getting off zoloft will deal your gut. I agree with you on the methotrexate. Suggesting that you take something like methotrexate is inappropriate (again OMO). What does he expect? It's very unlikely that you can heal as long as you are taking the Zoloft. Switching from Entocort to Lialda is counterproductive, but at least it's relatively safe.

Your doc is typical of many gastroentrologists who mistakenly believe that if a case of MC isn't under control within a few months, they must be doing something wrong. Sometimes it tales longer than that.

Tex
:cowboy:

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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Post by brandy »

I totally agree with Tex (and I was an Entocort user.) It looks like you are improving. Why change what is working? So you are on Entocort an extra 3 or 4 months in the timetable of your life that is nothing.

I suspect when you are off of the Zoloft you will keep improving.

You should be commended for the progress you are making.

There is no magic bullet drug on the market that heals us. Diet and getting off of drugs that prevent remission...like the zoloft....is key.

Mayo Clinic is ok with long term use of budesonide for MC. Google Mayo Clinic, budesonide/Entocort, and their studies should pop up and you should be able to print the studies out if you need them for your doc.

It is not uncommon for folks to be on Entocort 9-10 months or more. (And they are not on Zoloft.)

Weirdly I've noticed on the forum that the European docs don't have a problem with longer term use of budesonide but the topic comes up with the American docs.
Lisa_D
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Post by Lisa_D »

Hi Brandy and Tex,

Thanks for the response and my apologies for the delay -- been in a bit of a fog as I juggle all of these medication changes and diet modifications!

I am slowly tapering off the Entocort and am now on 4.8 mg of Lialda. Thankfully, my MC is better than it's been in months, so I seem to be in the minority where mesalamine is working for me.

My doctor and I have continued to discuss the methotrexate over email. He's noted that it can be helpful in a very small dose in some cases. I don't think this is the approach I'll take at this time, but I have an apt with him next week, so we'll see what he says.

Thanks again,
Lisa
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