Rectal meds

I only ever used rectal meds as my treatment for Over nine years. Now that they no longer work what will I use for rectal medication. I’m on entyvio and currently using budenofalk enemas. Obviously I can’t use those forever. I will be trying butyrate enemas but they’re not cheap at $180 for 2 weeks. Would Pentasa enemas work again after being off them for over a year and a half?

The problem with using rectal meds only for UC is that of the old Step Up therapy treatment. This was an archaic way of dealing with UC particularly for moderate to severe cases where the patient got sicker and sicker before they were finally exposed to more aggressive therapies. Perhaps this escalation ties in with how your UC worsened TAA. Nowadays patients really need to be on a treat to target and top down approach where more aggressive therapies are given at the start to alter the natural course of the disease.

Rectal meds have some role to play but only a very limited way in the modern approach to severe disease. In fact mesalamine is now thought not to have any significant effect on CD.

I think what damo is saying is some doctors would go straight to entyvio rather than wasting time on 5ASAs that can prolong suffering in patients with more advanced inflammation.

For what it's worth.... rectal meds sometimes work for me when I have mild inflammation at the beginning of a flare. When I have had severe inflammation in my rectum they did nothing.

In your case.... they may or may not help.

Entyvio is one of the safest UC treatments.