HealingWell
Search Close Search
☰

Flare help: Foam or enemas

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 7/2/2020 12:43 PM (GMT -5)
Hello,

I was diagnosed with proctitis in 2009 and have had relatively mild symptoms with some periods of remission over the past decade. I have been in a mild flare over the past several months that my Rowasa enema is not resolving. I know it’s a maintenance drug but it managed to get me out of a bad flare more than two years ago, on its own. Now, I feel like it isn’t working that well at all, as I have had continuous, with some breaks, mucus and blood. Some days I have good stool but mostly feel more constipated lately. No D and only go to the bathroom about 1x per day, on average. Had a virtual visit with my GI last month. She increased my refills to double up on the mesalamine enemas. I also mentioned hydrocort or a biologic, which she is willing to prescribe if this doesn’t work, but really didn’t have much else to say about it. I have tried doubling the enemas, only a few days, and no improvement. Was interested in others experiences with hydrocortisone enemas or foam. Which brand, how long and what side effects did you experience. More important, did it help get you out of a flare? I should add that I have a pretty clean diet, mostly SCD or Paleo. Not on any other meds. Started having side effects to Lialda. So, no pills since then. Any thoughts and experiences would be greatly appreciated.
Posted 7/2/2020 4:28 PM (GMT -5)
Hey, I can only speak from my own experience with enemas and this may not even be helpful. But for me, they really worked. I think the thing with enemas is that people give up to early. My GI even told me how a whole family had trouble just administering it (to their young son) and so they gave up. I think that's something GIs need to push harder--is that you have to practice enemas til your a pro and stick it out. This might not be related haha.

I was in a horrible flare (on Inflix and Aza too) and the next step was to increase the dose of Inflix but the doc outta nowhere said to try Rowasa. So I did, and it got me out of the woods in about two weeks of constant practice and willpower. I really did my best to stick with it and get it done right even when I felt hopeless. Maybe you need to be more persistent? I know you said you tried a few days then gave up. I'm telling you from experience, as someone who is well on his way on the immunomodulator/biologic road, try what you can with mesalamine or enemas before you step it up. Be vigilant, be hopeful.

Post Edited (DavidEA) : 7/5/2020 8:03:03 AM (GMT-6)

Posted 7/2/2020 5:32 PM (GMT -5)
Thank you for that. You are right. I probably need to give this more time. One enema per day had been working really well until this year. So, the fact that I haven’t experienced quick improvement similar to what you described using two per day just got me discouraged. This disease is a wrecking ball to one’s emotional health. Thanks again .
Posted 7/3/2020 10:07 PM (GMT -5)
If you do increase to 2 Rowasa applications daily w/o seeing improvement in 2-3 weeks, it could mean that your inflammation extended to the descending colon. In that case you would need to use an oral med, preferably Colazal, or a steroid drug to treat that. It's always best to try for control with mesalamine meds, though, especially if your symptoms stay on the mild side. / Old Hat (39 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 7/4/2020 10:41 AM (GMT 0)
When did you last have a scope? Or a calprotectin test? Hard to know what treatment course to take without knowing how much inflammation there is...
Posted 7/4/2020 12:28 PM (GMT -5)
My last scope was in 2018 and showed no change in the disease, it had not expanded beyond the lower end of my rectum. It was more inflamed, as I was in a bad flare at the time. My doc did ask for a stool sample to test for inflammation recently. Is that the test you mentioned? I am picking that up from the lab this week.

Post Edited (journeytoheal) : 7/4/2020 11:37:31 AM (GMT-6)

Posted 7/4/2020 12:33 PM (GMT -5)
Thank you Old Hat. I may mention that to my GI, depending on what happens over the next couple weeks. I have to say that I don’t have a really good GI. I feel like she doesn’t know much more than me sometimes. I usually mention drugs to her but receive no real guidance on what might be best given my current circumstance. Before starting Rowasa, she had suggested pred to get me into remission, which seems like an atomic bomb response given the severity of my condition. It was actually another doctor in her practice that suggested Rowasa, after an emergency call. I really need to find a better doctor.

Post Edited (journeytoheal) : 7/4/2020 11:36:48 AM (GMT-6)

Posted 7/4/2020 6:40 PM (GMT -5)
Proctitis can be pesky, but you're absolutely right that doc should NOT Rx Prednisone for mild symptoms. There are steroid enemas, foam, & suppositories to use next if the mesalamine enemas or suppositories (Canasa) don't work. Unfortunately, there is a helpful mesalamine foam made by Shire in Europe that has never been marketed in North America; forum members in the UK, Australia, & NZ reported favorably on it here over the past decade. You might have success using Rowasa nightly + Canasa in AM, which many proctitis sufferers have recommended on the forum in prior posts. / Old Hat (39 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 7/5/2020 10:27 AM (GMT -5)
I haven’t tried prednisone-based foams but have used uceris foam during the day and found it helpful with cramping and urgency and that it felt rather soothing to my gut. I wouldn’t say it got me out of a flare but it did help greatly with symptom relief.
✚ New Topic ✚ Reply