What's next after Asacol

[nikimazur]

To make a long story short, was on Pentasa, Bentyl and Entocort which all poorly controlled my Crohn's. Went to new Dr, who thought I only had IBS was then treated with Elavil and Lotronex (which obviously didn't work), and quickly ran to an IBD specialist, who reconfirmed my Crohn's diagnosis, and then prescribed Asacol HD. SO far after three week, minor relief, but continual diarrhea. Besides prednisone, which I refuse to take, and well can't physically take (horrible Cushing's, even with extremely low doses), what is the next logical course of treatment? My Crohn's is in my ileum/ascending colon, if that helps.

 

[2thFairy]

Imuran (azathioprine), most likely. After that, probably Humira or Remicade.

 

[Bld]

Pentasa and Asacol are both variations of Mesalamine. I found this online:

How does Pentasa differ from Asacol
Both Pentasa and Asacol are prescription forms of mesalamine. The difference between Asacol and Pentasa is in the outer chemical coating. Oral Pentasa has a unique formulation. The active ingredient is contained in coated microgranules, which enables a prolonged release of the active substance throughout the intestinal tract, from duodenum to the rectum. Therefore the Pentasa preparation is more useful for Crohn's patients who often have inflammation of the small intestine. The average small bowel transit time is approximately 3-4 hours in healthy volunteers.

Asacol is a delayed release enteric-coated tablets which generally releases the active ingredient only in the colon. While there are always clinical exceptions, Asacol is generally suitable for patients with colitis only (ulcerative colitis or Crohn's colitis), but not disease involving the small intestine.

For me the next step after Pentasa was Azothioprine, which I am still trying to get to grips with.