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Suggest treatment for ulcerative colitis

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Posted on Fri, 11 Apr 2014
Question: I am having ulcerative colitis since end 2006. I have been treated with Mesacol, Balaco continuously with mesacol and entofoam enema .I have been given steroid like Wysolone and Defcort occasionally whenever there was flare up. I had two courses of Defcort since Sept 2013 & Nov 2013 and since Nov 2013 I have been give Azoran 1.5 tablets once in a day.After my 2nd stint of Defcort was over I was relieved for two months . But my symptoms are again propping up since last 7 days though I am continuing with Azoran, & Balacol. Can you suggest me how to bring longer remission. I am always consulting MD,DM gastroenterologist .
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Answered by Dr. Rakesh Karanwal (4 hours later)
Brief Answer: Ask your doctor to consider options given below Detailed Answer: Hello Mr. XXXXXXX Thanks for posting your query on this forum. I can fully understand the agony that you are passing through. Your ulcerative colitis has apparently become steroid-dependent, necessitating introduction of Azoran, apart from continuing Balacol. Efficacy of Azoran can be seen as early as 3–4 weeks but can take up to 4–6 months. You have already been on Azoran for about 4 months. The effect should hopefully come in the next few weeks. Had I been your treating physician- given the relapse of symptoms- I would have re-introduced oral steroids in gradually increasing doses and stabilize on minimum effective dose to suppress the relapsing symptoms. Thereafter, the dose of steroids would have been tapered off VERY GRADUALLY, once the effect of Azoran comes up. Thus, your Gastroenterologist has the following options :- * consider increase in the dose of Azoran * Re-introduce steroids in low doses for a short period, till Azoran's effect is manifest, or * in the event of your condition's failure to respond to Azoran despite an adequate trial, consider anti-TNF therapy, which is quite expensive and also has potentially serious side effects in susceptible people. Consult your Gastroenterologist and apprise him of my opinion. I am certain that he will agree with me and actively consider the options mentioned above. Hope I have addressed your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards, Col (Dr.) Rakesh Karanwal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Rakesh Karanwal

Internal Medicine Specialist

Practicing since :1980

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Suggest treatment for ulcerative colitis

Brief Answer: Ask your doctor to consider options given below Detailed Answer: Hello Mr. XXXXXXX Thanks for posting your query on this forum. I can fully understand the agony that you are passing through. Your ulcerative colitis has apparently become steroid-dependent, necessitating introduction of Azoran, apart from continuing Balacol. Efficacy of Azoran can be seen as early as 3–4 weeks but can take up to 4–6 months. You have already been on Azoran for about 4 months. The effect should hopefully come in the next few weeks. Had I been your treating physician- given the relapse of symptoms- I would have re-introduced oral steroids in gradually increasing doses and stabilize on minimum effective dose to suppress the relapsing symptoms. Thereafter, the dose of steroids would have been tapered off VERY GRADUALLY, once the effect of Azoran comes up. Thus, your Gastroenterologist has the following options :- * consider increase in the dose of Azoran * Re-introduce steroids in low doses for a short period, till Azoran's effect is manifest, or * in the event of your condition's failure to respond to Azoran despite an adequate trial, consider anti-TNF therapy, which is quite expensive and also has potentially serious side effects in susceptible people. Consult your Gastroenterologist and apprise him of my opinion. I am certain that he will agree with me and actively consider the options mentioned above. Hope I have addressed your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards, Col (Dr.) Rakesh Karanwal