Asacol Issue

[DougUte]

:voodoo:

I have been on Asacol for a little while now. Not sure how well it is working. I have been seeing pills in my fatty,liquidy stools. :stinks: How in world is it suppose to help a crohny when the med is not getting absorbed in my gut?

 

[bushydougie]

I believe that what you see is the shell of the tablet not in fact the medication.
I have very rarely seen this in my own bms
I'm sure others will be able to answer this question in more detail...

 

[bobtheman]

the coating will be found in the stool, its disgusting but if you want you can check if the capsule has a crack in it poke it with something you can toss out. if it does, the medication has been released. i get this all the time. even though they do crack for me, im not sure how well mesalamine really works though, for me at least

 

[hainman]

hey,its happened to me a few times before to and when i asked my gi nurse she said its very unlikely that they are whole tablets and like someone else said its just the shell that your passing through.ive sometimes seen more and sometimes less of the capsule shell in the bm.jsut depends how quickly or slowly your bm are

 

[DustyKat]

Hi Doug,

If I remember correctly you had surgery very similar to Roo, is that right?

If so most of the bowel removed was ileum?

I was under the impression that Asacol, although it can be used for mild to moderate Crohns, is not the drug of choice of when you have ileal Crohns. I only say this because Roo's GI didn't prescribe it for that reason and the GI Matt saw also said it wasn't suitable in his case because of the ileal involvement.

Any chance of having the Humira looked at again by the insurance company?

Dusty.

 

[Lee]

When I first started taking Asacol the same thing happened to me. I called the GI and his secretary told me that's normal for Asacol. The coating of the pill just doesn't digest well. The coating should appear to be slightly cracked. I have Crohn's Colitis and Asacol works well for me. At least I think it does--I have another colonoscopy in June so we'll see

 

[Jennifer]

I was under the impression that Asacol, although it can be used for mild to moderate Crohns, is not the drug of choice of when you have ileal Crohns. I only say this because Roo's GI didn't prescribe it for that reason and the GI Matt saw also said it wasn't suitable in his case because of the ileal involvement.

I have Crohn's in my ileum and my doctor prescribed Asacol and it worked for me for many years. I was at one of the best hospitals in the country (Lucile Packard Childrens Hospital in Stanford Ca.) and I've never found a better GI (Ricardo Castillo) ever since. Asacol is a time release tablet and does release in the ileum and colon.

 

[DougUte]

Any chance of having the Humira looked at again by the insurance company?

Dusty.

Hi Dusty.

Yes I had the same surgery as Roo.

We are still fighting the battle with the insurance company on the Humira. That is why I am taking this Asacol med. To jump through the insurance company's hoops I have to be on 2 therapies and fail them before they will approve Humira. I have failed on sulfasalzine, and now is the other one, Asacol. I just started Asacol last week, but my Doc and I are calling the insurance company every single day, trying to get the approval on Humira. If that comes through I will drop Asacol like a rock and start on Humira.

I hate Insurance Companies!

 

[DustyKat]

Hey Doug,

Oh boy, that really sucks!

It's interesting you mentioned the Sulfasalazine because I have read in articles that it is more effective at maintaining remission in Ileal Crohns than Asacol is. I guess that's why the doc started with that.

Did they ever discuss immunosuppressants with you as a way of maintaining remission? Or is this a way to fast track you through the hoops to Humira?

I hope your doc has success with the insurance company, good luck!!!

Take care mate,
Dusty

 

[Jennifer]

It's interesting you mentioned the Sulfasalazine because I have read in articles that it is more effective at maintaining remission in Ileal Crohns than Asacol is.

The only thing I found to be true about Sulfasalazine is that it makes people sick. Most doctors don't even prescribe it anymore because of that yet the insurance companies still pay for it and push for it because its cheaper.

 

[DougUte]

Dusty Yes, that is why we started with Sulfasalazine. But he is pushing hard for the humira. This battle with the insurance company really sucks. I have had 3 different docs tell me that Humira is the med I need to be on.

CrabbyRelish - That was my experience with sulfasalazine. A few days after I started taking it I started feeling more tired, and had more runs to the bathroom. I thought it was just another round of this darned disease. When I went off sulfasalzine, I felt better again. It was not a large difference, but .... interesting.

 

[hainman]

hi doug.ive been on asacol for 4yrs now and my gi nurse and the specialist and surgeon have all agreed that i should take these everyday.im on humira aswell but i dont think that the asacol is something that puts you into remission,think thats what the likes of aza,6mp,humira remicade are for,i could be wrong though.....

 

[Jennifer]

@ Hainman- I used Asacol and 6MP as maintenance drugs after my surgery. Currently I'm only taking 6MP for maintenance. I think steroids are the only ones that aren't meant for maintenance but more hard core immune suppressors aren't needed either unless your flare is really bad but not for maintenance.

 

[DougUte]

You guys are going to love this one. After weeks of my doc calling them every day and me calling them 2-3 times a week, the insurance company now tells me they have no record of any contact from my doctor since they denied the Humira in February.

My Doctor's office has been waiting for a new decision from the insurance company. The insurance company is not responding because they have not "been contacted" by my doctor. AAAGGGHHHH!!!!!!!!!!!!

 

[Jennifer]

I think most of us have had that problem or at least something similar. Insurance companies will do ANYTHING to not have to pay even if that means pretending they're absolutely retarded. After all these years though, I'm not so sure that they're pretending.

 

[Miss Underestimated]

You need to file a complaint with your state's insurance regulator. The Insurance company will do anything to get a complaint of this type withdrawn. They do not want an investigation. Do it in writing, send a copy to the company.

 

[tiloah]

I think most of us have had that problem or at least something similar. Insurance companies will do ANYTHING to not have to pay even if that means pretending they're absolutely retarded. After all these years though, I'm not so sure that they're pretending.

I laughed. :ylol:

 

[My Butt Hurts]

You guys are going to love this one. After weeks of my doc calling them every day and me calling them 2-3 times a week, the insurance company now tells me they have no record of any contact from my doctor since they denied the Humira in February.

My Doctor's office has been waiting for a new decision from the insurance company. The insurance company is not responding because they have not "been contacted" by my doctor. AAAGGGHHHH!!!!!!!!!!!!

My insurance company approved Humira, but when it started failing, they would not authorize a double dose until I tried Remicade. Did you get a reason from them on why they denied it?

The only thing I found to be true about Sulfasalazine is that it makes people sick.

I just want to say that this is not true in my case. Sulfasalazine was the first med I was ever put on and it kept me in remission for a good long time. I had no side effects from it at all, but I had to go off of it for breastfeeding.

edit - Oh, and to answer the original question - that is definitely the shell of the asacol. I actually picked that sucker out of the toilet to investigate it when it happened to me. :biggrin:

 

[DougUte]

My insurance company approved Humira, but when it started failing, they would not authorize a double dose until I tried Remicade. Did you get a reason from them on why they denied it?
.....
edit - Oh, and to answer the original question - that is definitely the shell of the asacol. I actually picked that sucker out of the toilet to investigate it when it happened to me. :biggrin:

They denied Humira because, according to them, I have not had 2 of their "accepted" treatments fail before they will approve a biologic. I have to take 2 of the other meds for a 2 month trial each.

I have had Ciprofloxacin, Flagyl, Welchol (which is a cholesterol drug, but as a major side effect fights the "D"), Sulfasalzine, and some I don't remember the names of. Flagyl is on their list, and it failed. Sulfasalzine is on their list, it failed to. And now, I am on Asacol until I can get on Humira. The doc is giving me Asacol samples, and we will see what happens. Asacol is doing better than the Sulfasalzine and Flagyl did. Everything I've taken starts out working and then, in a few weeks, stops. In 6 weeks we will make sure Asacol doesn't work and try this again, unless of course Humira gets approved before then.

My doc suggested suing the insurance company for practicing medicine without a license.

 

[Miss Underestimated]

Ugh. Any news? The insurance companies have doctors on their payroll who come up with these protocols.

Listen, I was an agent for a long time - file the complaint. Really. It always works. Insurance companies are afraid of state investigators.

 

[Lee]

It's like our insurance companies have replaced our doctors. At my old family physicians office he had a picture of six of the 7 dwarfs from the movie Snow White. Where Doc (one of the 7 dwarfs) would have been standing it stated, "Doc was replaced by an HMO" LOL

 

[DougUte]

Ugh. Any news? The insurance companies have doctors on their payroll who come up with these protocols.

Listen, I was an agent for a long time - file the complaint. Really. It always works. Insurance companies are afraid of state investigators.

Thanks. My doc's office sent in another written appeal to the insurance company. I will follow up with this tomorrow.

I am so tired of this crap.

 

[teeny5]

I had the same thing happen when I was on Asacol. GI told me it was just the pill casings and not to worry.

Sulfasalazine never made me sick, but my GI had me change since we were planning to have kids so that if I had any reactions to Colazol we would catch it early rather than in the middle of pregnancy.

As for the whole medical beaurocracy it is a shame that they make you jump through hoops. I know from working for a very large company sometimes it is that the different departments simply do not talk to eachother. Other times it is just that there are so many safeguards put in place due to past lawsuits and stuff. My advice is to be persistent and don't rely on them for the answers. If they say they will get back to you get a time frame and then call them back. Sooner or later you are bound to reach the right person who can help you. Lots of times the people answering the phones are only hired to do that and follow a script...they really have no idea what you are talking about. Frustrating I know.

Good luck!

 

[DougUte]

On top of the insurance battle, I now have another thing to deal with. During my G.I. appointment this mornining my doctor announced he is retiring at the end of the month. He will refer me to a new doc, but.... damn. I find a doc who really understands and in a few months he retires.

 

[Lee]

That stinks I'm sorry your doctor is retiring. At least he is referring you to another doctor--not all doctors do this. Hopefully he will refer you to someone whose like minded to him You always have hope.

 

[keepsmiling21]

I have been on Asacol for almost 2 years. 3 pills 3x a day. I do see whole pills (NOT just the capsule) in my stool occasionally and my doctor said not to worry about it. If I am seeing 3+ pills a day then that would be cause for concern...