Need help with enemas for my UC

I've got UC in Sigmoid colon. Had a colonoscopy on June 21 st this summer that showed my UP progression to UC with 25cm of ulceration. Had been on Canasa 1000 for about ten years and Doctor said the rectum showed absolutely no inflammation which indicated it was working for me. So he put me on Lialda oral 2 pills per day in morning with the Canasa supp at night. This was after finishing a few rounds of prednisone to stop bleeding. Adding the Lialda seemed to be working but lately I was having bouts of diarrhea and very loose stool about 6 or so times during day. Mostly mornings. I took Pepto Bismol to calm my stomach which helped. Saw my gastroenterologist in September who said to increase Lialda to 4 per day. I tried that for awhile but was feeling sick to stomach so went back to 2 per day. Saw another gastroenterologist two weeks ago who explained based on the results of my last scope that he felt the Rowasa enema would hit the place in the colon that the Lialda and Canasa were not reaching. I tried the Rowasa enema and was able to keep the first one in for 4 hours and the second one for about 8 hours. But I'm afraid to use it at bedtime feeling it would wake me up to go during night and I'm so tired from interrupted sleep anyway. So, I was wondering if there are any foam enemas that might work like the Rowasa liquid ones as I really don't like laying on the bathroom floor for 45 minutes waiting to get up and move around. I had used the Cortifoam a few months ago for awhile before the Dr put me on Lialda. Do you think the Cortifoam might be a good alternative to the liquid Rowasa? Any other suggestions? Thanks for any thoughts on this.

You can take a rowasa enema directly in bed and then fall asleep on your left side. You can take rowasa enema in the bathroom, immediately walk to bed, lay on your left side and then fall asleep on your left side.

What country are you in? Mesalamine foams do exist in some countries but i don't believe they are available within the usa. Foams often only cover the rectum (with a few exceptions), therefore not the best if you also have sigmoid colon involvement.

Thank you both for your replies. I will try it in bed to see how that goes. I have no bleeding at this point, so I believe there is healing going on as I had horrible bleeding for from January this year through August.
Its the urges to go now and the D that I still have. Although some days are good. As I tell my husband, I never know how I'm going to feel from one day to the next so it's so hard to plan anything.

I also just bought some new Probiotics today. The Ultimate Flora 30 billion strains. Hoping this helps too. Many of you are so young and I can't imagine having to deal with this at your age and trying to go to work. I'm almost 70 years old now and retired, with some flexibility in part time jobs. This hit me when I was 60. Just in time to enjoy my "golden years"!!

There's been a number of threads where people have ordered mesalamine-based oral drugs with a delayed-release coating: asacol, asacol hd, pentasa, or mezavant XL ( manufactured by Shire, as lialda is) from Canada for a lot less money. You can search the forum and I'm sure some recommended pharmacies and ordering procedures are mentioned. It's 100 percent out of pocket as your insurance doesn't pay for internationally ordered medications.

Within the usa, you can get prescriptions for these generic-equivalents to asacol: Balsalazide Disodium, Olsalazine, or Sulfasalazine. They're older UC medications without a delayed-release coating but are a lot more affordable. Rather, they have a more complex molecule that is broken down by gut bacteria into mesalamine and a byproduct. A different delivery mechanism to get mesalamine to the large intestine. Something to ask your gasteroenterologist about and your pharmacist to see if they'd work as well, and at what cost.

Good luck, the medication costs are crazy, many struggle with the cost.

Naturalcurl, on the Medicare Advantage I never heard of the catastrophic level you are speaking of. Right now my doctor's prescription is for 2 Lialda per day, but he last visit he told me to increase to 4 per day to see if it quiets down the continual diarrhea I've been getting. The second gastroenterologist prescribed the Rowasa too for 21 days to see if that helped. The 4 Lialda a dY would cost me $500 per month on my insurance. And the Canasa would be another $250 per month. I have been getting the Canasa from Canada for a couple years now and I can get 3 months supply for $259. In looking at Lialda from Canada 🇨🇦 it would besometimg like $350 for 120 pills which would be two months supple so it saves me some money. But I too wish something could be done about cost for people on Medicare.

Just took the Rowasa enema last night and was able to retain it from 8:15 pm tonow 2:40 am. Hoping it gets easier the longer I do it. Does anyone here know about how long you need to keep using the nightly enema before you see a difference? I just want to be able to have a regular formed poop 💩 again, if at al possible!!!

Congrats you did well with the enema as retaining it for 6 hours is near perfect. I'd expect the enema to make a difference within a few weeks, maybe sooner if you're lucky.

Nana:
Hope you are doing even better with the rowasa! I am a poster child for that medication and see an improvement in only a couple of days. But it's not the whole story; after it "wears off" in the afternoon or evening blood and mucus return. Adding Canasa doesn't help. At the risk of annoying our favorite moderator I will say that during the worst of a flare I like to be fairly empty before application, to give a better chance the liquid will get to its destination on the left.

We don't have a Medicare Advantage plan where I live so I don't know how drug coverage would work. In many of those plans there is a donut hole in which you pay more for your drugs. If you ever slipped into the donut hole you would know it by sticker shock at the pharmacy. But it sounds like your Canadian source works and the prices you quote are reasonable. Which pharmacy do you use?

You won't have to be on them nightly forever...but there is a tapering process.

You stay on them nightly until things are normal...then for another week. If all is good, switch to every second night for about a month.
If all is good, then every third night....etc. staying at twice a week is a good maintenance plan.

I've used enemas for almost 28 years....

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I was unable to taper off of nightly, so i did nightly for two years.