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FAQ: If hospital admission is not required for a flare of colitis what changes to oral treatment will be effective?

Increasing the dose of 5-ASA medication (Pentasa or Asacol) is only of modest benefit.
This change alone is not usually be enough to resolve a relapse.
However any benefit of higher doses is achieved with only minimal risk of side-effects.
The usual maintenance dose can be increased from 4 to 6 tablets daily (for both Pentasa and Asacol). 8 tablets per day occasionally used.
If Salazaopyrin is the current treatment this can be increased from 4 to 6 tablets daily.
Even this dose increase will often result in headaches or gastrointestinal side-effects.
Most people can not tolerate 8 tabs per day because of some side-effects.

Most relapses will require a course of oral Prednisone.
The starting dose should be 40mg daily. Lower doses (10-20mg daily) are often not enough to induce remission. The dose should be decreased only when improvement is seen. This may take 2-3 weeks. Once symptoms have resolved there should then be a gradual reduction in dose. Total duration will usually be 4 - 8 weeks but depends on severity of relapse.


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