Proctitis and Mesalazine(Pentasa)

[Qwerty93]

Hi,

I’ve been diagnosed via colonoscopy as having UC, well proctitis, and only ever had one flare which was mucus.. which led to the colonoscopy.

however since the colonoscopy I’ve not had any symptoms but my calprotectin has been raised still 250/350.

So the consultant wanted to start me on Mesalazine suppository’s…. I took my first one yesterday…. But now all my symptoms have come back(?)…. Mucus and a bit crampy.

could this be a side effect or have they re-triggered something within me? As I have been symptom free for over a year. But obv had high calprotectin.

thoughts? I’m do nervous and worried about it all?

As far as I'm aware you only take pentasa during a flare? So unless you have symptoms you shouldn't need them. Disclaimer: had proctitis for 5 years, intermittent flare ups but not a doctor 🤷🏻‍♀️

this is what I assumed… as not everyone will know calprotectin levels, they will just go by symptoms…. And I literally had zero symptoms, just during the year review he was adamant we use it.

He said to take the suppositories for a month? One a day… I’m just hoping if it doesn’t get my calprotectin down… it won’t suddenly cause me to get full symptoms again?

I use Salofalk suppositories which are interchangeable with Pentasa, according to the pharmacy, as both 1g Mesalazine. They contain the same medication, just that Salofalk is in fat and Pentasa is a pressed powder tablet. I prefer Salofalk.

I'm prescribed for UC maintenance, and can increase for flares, as I find I respond better to them than pills. I use 1 to 3 per week usually, but increase to 1 (or 2) daily if flaring. I've been in remission for about 5 years.

An interesting. By remission do you mean a calprotectin under 50, and no symptoms?

They seem to think that because mine came about during pregnancy in 2021 that it’s the likely cause!

Can I ask how your flares present?

I was diagnosed before they started testing for calprotectin, and have never had it tested. CRP was the inflammation marker tested at the time. Not seen a GP in over 5 years, probably 6 or 7 years since GI Consultant, as I moved during pandemic and haven't needed an appointment or had a referral in new area.

I have no UC symptoms. I poo once every 2 or 3 days usually, no diarrhoea. My last flare was early in the pandemic lockdown, with urgency and diarrhoea approx 6 times daily. Thankfully a daily Salofalk suppository, with a few days of twice daily got me back in remission.

I was diagnosed (a couple of months after a baby) with Pancolitis (entire colon ulcerated) about 15 years ago. Passing huge amounts of blood and diarrhoea 25 times daily.

I've been on steroids, including intravenous in hospital. I couldn't get off them, so moved on to Azathioprine, but developed an intolerance. I then spent years on Mercaptopurine immunosuppressant chemotherapy, before weaning off that and have relied on Salofalk since.

yeah, just slight green mucus that slips out of bum very easy. Which is mild compared to most.

Wow, well on the basis of that… I really shouldn’t be trying anything as I felt fine in myself…. Just the admin side showed that I was inflamed, ie. Calprotectin.

I’ll try these for a month as ordered and then hopefully ask to be off them.