Apriso

[MBombardier]

Hey Tex, when I joined the board, you told me this about Apriso:

Yes, Apriso is the newest 5-ASA medication to be approved by the FDA. I would guess that the reason why it has not been very effective for you is because it was specifically designed for treating UC. UC only affects the terminal colon, (the lower end), and it spreads upward from there, but rarely affects the entire colon, and never affects the small intestine. Consequently, Apriso uses a special delivery mechanism that insures that it does not become activated before it reaches the colon. No other drug for treating GI issues that I'm aware of, has such a restrictive delivery method. Most are activated at least by the time they reach the ileum, (the lower third of the small intestine).

Do you remember where you found this information? I suspect that my GI will not be very happy that I never filled his prescription for Apriso, so I wanted to be able to show him proof from the medical literature that it is not likely to do me any good since all the biopsies through my whole colon showed CC.

Thanks!

[tex]

Marliss,

I wish I could find it too, but unfortunately, I didn't bookmark it, and apparently it was incorrect, anyway, because everything I find now, shows that Apriso should be active for the entire small intestine and colon, (such as the reference below).

A major goal of UC therapy is to prevent relapse which may decrease the risk of disease progression. Apriso accomplishes this goal through the combination of an enteric pH-dependent coating which provides for a delayed release starting at a pH of 6.0 and a polymer matrix core, which provides for extended release. This patented delivery technology is designed to distribute the active ingredient beginning in the small bowel and continuing throughout the colon. Previous generation pH-dependent 5-ASA treatment options provide for release of the active ingredient starting at a pH of 7.0. According to published data, many people never reach a pH of 7.0 in their small or large intestine.

http://www.drugs.com/newdrugs/apriso-gr ... -1171.html

Hmmmmmm. I don't believe you're taking a PPI for GERD, (as I recall), but do you take any antacids? That would be an excuse, since antacids are contraindicated for any drugs which use a pH-dependent activation mechanism. Presumably, an apple cider vinegar treatment program would also be a pH-altering process, but he may not feel that such treatments are appropriate, (since they fall under the jurisdiction of the other medical camp - natural treatments. Other than that, your only hope is to claim that following your last visit, you improved so much that you didn't see the need for the drug.

Tex

[MBombardier]

Thanks, Tex. That is what I will tell him, that the gluten-free and lactose-free diet has caused the D to cease. I am printing out information for him since he indicated at our last appointment that he's a former researcher ready to learn about things that work for his patients, and he didn't know about the frequent gene correlation between MC and celiac. I am going to ask him to prescribe the gene testing as that way my insurance may pay for it, and discuss non-celiac gluten sensitivity.

I was just reading a transcript of a talk by Dr. Fine, and he had an excellent example of the benefits of treating a disease before there is damage. He said that a doctor would not tell a patient who came to him with high blood pressure and chest pain that a biopsy of the heart showed no damage and therefore his symptoms didn't need treatment until the biopsy showed damage.

Speaking of heartburn, I have had a bad cough the last couple of weeks that really exacerbated it. The ACV didn't seem to do anything but give me ulcer symptoms. I have had ulcers in the past, but always test negative to h. pylori. I must be immune to it because my husband has had it and been treated for it twice. Thankfully, as the cough has decreased so has the heartburn. I was quite concerned as I don't want to be tossing back antacid tablets like M&Ms, and the ACV just seemed to make it worse.

I will probably post a list of what I am taking to the GI on Tuesday when I get done mining the board.

[tex]

Now that's a great example from Dr. Fine. I hadn't seen that before.

I hope the cough has pretty much run it's course, and will soon be completely gone.

Thanks,
Tex

[hoosier1]

So what's the difference between Apriso and Asacol HD? Is it that Apriso releases medication even lower in the colon that Asacol HD?

[tex]

Rich,

I don't know at what pH Asacol HD activates, but regular Asacol activates at 7.0, which suggests that it may not activate until it reaches the terminal ileum and beyond. It is claimed that the pH in the intestines of many/most UC patients may never reach 7.0. Anyway, that means that Apriso is probably more useful for then, than regular Asacol, since it begins to activate at a pH of 6.0.

Tex

[hoosier1]

Tex,

I would guess there is no simple test to determine the PH in one's own intestinal track (in various locations)? I have seen those pH strips that people have used to test their saliva. I'm not sure what they are trying to determine even by doing that.

Rich

[tcorbett]

This is all very interesting - I have been on Apriso since November, for my MC. Not sure if it's working just yet. I still have some foods to ferret out of my diet! Oh the joys. But, on those days when I am good diet wise, I do notice that my D is not as watery, not watery at all, just loose. My GI explained that the Apriso would coat the lining of my colon (not sure of the technical word she may have used) and help to reduce the inflammation which was causing my colon to not absorb the excess water, thus causing the waterY D! Does this make sense?

Good Luck - glad you are feeling better with diet and all. Waiting for that day!!!

Theresa