Hi all,

I was wondering if any of your doctors have ever prescribed oral pentasa as treatment for cuffitis. I am already taking canasa suppositories, as well as protosert(topical steriod suppository). I also take sulfasalazine for my Ankylosing Spondylitis. I just had my ileostomy closure performed on March 28th and I have already had cuffitis and pouchitis. The pouchitis is under control, but the cuffitis lingers. I am just so bummed that here we go again.....on all the medications I was on when I had UC. I am also scheduled to start Humira in three weeks....

Thanks everyone.

I don't see the point. You are already using topical and oral 5-ASA drugs (Canasa and sulfasalazine). It seems like overkill to add a third, particularly since Pentasa releases throughout the intestines and sulfasalazine releases in the terminal ileum and colon.

I will tell you one thing, I find that my cuffitis stays under better control when I am on Humira. When I was off it for three weeks, my cuffitis flared within two weeks.

I'd put your money on the Humira. For me it is a one-two punch, hitting both the arthritis AND the IBD at the same time. I hope you are as pleased by it as I am.

Jan

Jan, thanks for your response. My GI mentioned that Pentasa is absorbed better because it breaks down upon contact with the moisture in the intestine inside of the bacteria found in the intestine....or something along those lines. She said I could continue the Sulfasalazine for my AS, but that not that much of the drug is absorbed...about only 1/3 through the small intestine. Since we don't have colons alot of the drug, the 5ASA, is never activited. The bacteria in the colon activites the mesalamine derivitive of the drug. I may stop the Sulfasalazine...we will see.

Thanks again

Granted, the sulfasalazine's effect on the arthritis, is systemic, but it is topical for the cuffitis. It also may not be very useful for AS, unless you also have peripheral arthritis. So, you really don't need or want it to absorb for treatment of the cuffitis. Pentasa is prescribed for those with small bowel Crohn's disease and UC because it is released throughout the ileum and colon. So if you have pouchitis, it might be more useful than the Canasa suppositories. Pentasa is not prescribed or useful for arthritis, so it is not interchangeable with sulfasalazine in that respect.

The 5-ASA is activated in the sulfasalazine when the mesalamine is released by the breaking of the chemical bond by bacterial action in the terminal ileum and colon. For us, that would just be the terminal ileum/pouch, where we have the bacteria. But, I guess it certainly would not hurt to try the Pentasa.

http://www.spondylitis.org/about/ibd_med.aspx

Jan

This message has been edited. Last edited by: Jan Dollar,