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I'm allergic to sulfa, about to start Canasa for mild inflammation of the cuff and I have few very small ulcers in the same area. Pouch looks great based on my scope yesterday. Sounds like I shouldn't be concerned about the canasa then based on my sulfa allergy history. Is there a reason Canasa is first line treatment and not steroid suppositories? How common and treatable is cuffitis?

J

Canasa (mesalamine) has a better side effect profile than steroids, so it’s generally a better first choice, especially if it may be needed for an extended period. Cuffitis doesn’t afflict most people with J-pouches, but it’s not rare. Some people get great results from treatment, and others not so much. Like UC cuffitis can come and go or persist, and the treatment needs to be matched to the condition as it behaves.

Scott F

Thanks Scott. I'll see how things go with the Canasa. So expensive though! Originally was going to be $623 for 30 day supply since I've been lucky enough not to hit my deductible yet. Got it down to $377 with the Canasa coupon card from the manufacturer. In general I've had better results for my flares overall with topical steroids. Is it true than Anucort is much less pricey? I may want to switch. Both seem safe for long term use so if Anucort works and it's way less money I figure why not. I guess the biggest down side is thinning of the tissue over time correct? And maybe a higher change of dependence?  

J

The biggest downside of any drug is always much worse than the likely result. I don’t like the side-effect profile of steroids, and tissue thinning is a bigger deal than you might expect. If it were my body I’d price mesalamine enemas (probably cheaper than Canasa) before settling on Anucort.

As far as deductibles go, if you are sure to meet your deductible by the end of the year then there’s no financial benefit to delaying it, or agonizing over it, since it will be spent. In my case my deductible is exactly the same as my annual out-of-pocket max, so I just try to ignore how the expense is incurred - it makes no difference.

Scott F

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