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blood with enema liquid - urgent question from my forum friend

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Ulcerative Colitis
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Posted 11/9/2018 6:10 AM (GMT -5)
One Ukrainian girl I often talk with on the Polish uc forum has asked me to post this thread because she doesn't speak English. When she does salofalk enema, the next day she has stains on her sheet, as if enema liquid mixed with blood. She has been in a mild flare since about October - 2-3 bms and blood occassionally, now the flare seems to be under control but this enema liquid with blood is upsetting her. Anya has been diagnosed with left sided colitis and since she came to Poland two years ago, she has been taking asamax twice daily plus enemas whenever she felt something was going wrong. She thinks she doesn't have any hemmorhoid. Any advice would be appreciated, thanks on her behalf.
Posted 11/9/2018 7:32 AM (GMT -5)
Most likely, she is not putting enema correctly. Ask her to lie down on her left side with a right leg up (folded) and left leg flat and then squeeze bottle hard so that the liquid gushes inside and reaches to the point of action.

If it needs ask her to put the enema bottle in the fridge to cool it down but shake vigorously before administration. This is because if the enema is cold, she will 'feel' where the enema is reaching. This is how I figured out in my earlier days and adjusted my positions, administration technique so that the enema will reach where it supposed to work.

I suspect that some of her liquid stays in the rectum and as and when she passes wind in sleep that enema comes out. The blood could be scratched rectum wall or if she has proctitis as well or something else, can't say for sure. Also, ask her to lube the enema tube with KY Jelly like lubricant or mineral oil.
Posted 11/9/2018 9:51 AM (GMT -5)
If the enema liquid isn't given sufficient time to absorb then a rogue nocturnal fart can stain the sheets (it's air plus liquid). Important to lay on your left side for at least 20-minutes before falling asleep. It can take longer with bad inflammation for the enema to mostly absorb, so falling asleep on your left-side laying against a body-pillow or a few spare pillows to keep you in place helps.

I get in trouble for this, on occasion. My dear wife, in her typical dramatic/baroque posturing says "John what is this (with an expression of horror)!?!?!" with a finger toward a purple stain (from my enema) on the sheets on my side. I'll dutifully change the bed sheets and start the laundry with the soiled ones in it. I'll wake up sometimes with a wet spot on my butt cheek of my pjs from wet enema farts too, nothing like changing into different bottoms at 2am while half asleep lol.
Posted 11/9/2018 12:26 PM (GMT -5)
Delta, iPoop - thanks for the replies, I've just translated everything and sent to her. Anya says that she's quite an experienced enema user so she's administering it properly, but she has never had such experiences before even when she was flaring. The strange thing is that there seem to be no more blood in her bms nor she's having any urgency or pain so why this blood flowing out with the enema. iPoop - you say "purple stain" from the enema, do you also mean blood? As far as I remember my salofalk enema experiences, the liquid is white, I don't think that they have changed the components? She's worrying that this is a sign of some serious inflammation and she is far away from home.
Posted 11/9/2018 12:49 PM (GMT -5)
The liquid goes in white, but when exposed to oxygen stains purplish-black on fabric (say a drip of enema fluid left to dry on the flooring, or toilet seat, or a wet fart composed of enema fluid that dries on pjs or dries on bed sheets).

Unabsorbed enema liquid can dilute/spread blood out, making a few drops of blood look like a lot more trouble than it actually is.

If she's worried about getting worse/flaring, then see about getting a stool test for C Diff, and a Fecal Calprotectin stool test. A CRP blood test can be substituted for FCP, if desired.

Does she have any history of hemorrhoids? As those could explain the blood as well.
Posted 11/9/2018 1:30 PM (GMT -5)
It will change colour if she uses bleach in washwater.

How is it in the toilet? On tp?

It's leaking from her butt or from the bottle during administration.

How often is she doing enemas? And does she have hemmies?

q
Posted 11/9/2018 5:39 PM (GMT -5)
Quincy iPoop thanks so much for your replies, this should calm her down because she's been so worried and she refuses to go to the doctor, I'm not sure whether she's got an insurance in Poland. She says she doesn't have hemmies and the fluid with blood seems to be leaking from her butt, not form the bottle. Besides these stains on the sheet, she doesn't have any alarming symptoms, no blood in the toilet or tp, no urgency, stools more or less formed. It's been several times that she's had those stains during this flare which started in October. Before, as she says, she used to do enemas nightly quite often and it had never been like that.
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