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Q. I feel Pentasa is not helping with symptoms of ulcerative colitis. What should I do?

Answered by
Dr. Mian Shah Yousaf
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Aug 11, 2020 and last reviewed on: May 11, 2021

Hi doctor,

I am 23 years old with a weight of 52 kilograms and a height of six feet. I was diagnosed with ulcerative colitis last year. I had an E.coli infection four years back by food poisoning. I have symptoms of rectal bleeding, nausea, and constipation. When I got acute colitis, I took Pentasa sachet 4 grams and Budesonide capsules. I do not have any symptoms for a few years and now, I have a flare-up. I am taking Pentasa sachet four grams, Entocort enema 2 mg/100 ml every night, and Salofalk rectal form 2 grams daily.

I am using these medications for eight weeks now. My blood amount is low but my bleeding is continuous even when I quit my medicine for a day. My doctor will not advise me to take Entocort capsules due to bone suppression. My gastroenterologist suggests me to take Hyrimox. But its side effects are really long. I have inflammation only on the left side of the colon and rectum. I did a colonoscopy and it was shown in colonoscopy. What to do? I think that Pentasa sachet is not working for ulcerative colitis. But it works more for Crohn's disease. Can you suggest any foods with anti-inflammatory activity?

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#

Hi,

Welcome to icliniq.com.

You are having left-sided colitis. Before taking Humaira or any other biosimilars, I would like to optimize your medications. Regarding foods, there are no specific foods that can help you. I suggest you take an oral trial of Prednisolone as enema does not help completely for left-sided colitis.


Probable diagnosis:

You can have ulcerative colitis.

Treatment plan:

You can take Pentasa 1 gram four times daily, tablet Prednisolone 30 mg daily in two divided doses for two weeks, and then slowly taper it. Use Entocort enema. Instead of Pentasa, you can take tablet Asacol HD 800 mg three times daily.

Thank you doctor,

I cannot use Prednisolone due to the side effect of bone suppression. Do you have any other medical advice?

#

Hi,

Welcome back to icliniq.com.

I gave an opinion to have a trial. If you are not comfortable with a trial of Prednisolone, then I suggest you take Asacol HD 800 mg thrice daily instead of Pentasa. It is also Mesalamine presenting with different salt preparation and it works well for ulcerative colitis.


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