trying to get rectum into remission

I had my colon removed just over a year ago, having no problems with my stoma at the moment, it's working great. The surgeon left my rectum though. He didn't want to do pelvic surgery on me at the time, because of the potential fertility issues - I only have one ovary, had the other removed when I was 19. So he didn't want to further reduce my chances of conceiving. Also I was extremely sick going into the surgery, and probably to give me time to think about reversal down the line.
My rectum has been giving me awful trouble for the last couple of months. When it started getting bad, I started using Asacolon suppositories - just one a day. They actually helped for about two weeks, then symptoms started again. I upped the dose to two a day, but there's no improvement.
I saw my consultant today, he's given me steroid suppositories to use twice a day. If after 4 days there's a great improvement, I've to continue on them for two weeks, then start using Pentasa suppositories instead of one of the doses and wean onto that as a maintenance. If there's a slight improvement, then I've to add steroid foam into it after 4 days to see if that works. And if that doesn't work, then I've to go back to him & bring my surgeon into our conversations. He's basically giving me two weeks to get this into remission.
I'm really disheartened by the whole thing, I feel almost like I did back when the whole colon was inflamed. The difference this time is the pain & cramps are localised to my pelvis. And obviously I'm not malnourished as I can eat fine with my stoma.
I'm thinking as well, I've been on all of these medications before, and nothing ever worked for me - why would they now? Maybe I'm being pessimistic thinking like that... And I'm delaying the inevitable, it's going to have to come out at some stage. But it's a huge decision to have another major surgery. I'm doing my PhD and have basically been sick for the whole thing, and it's taking me so much longer than it should have. I just want to finish it! But obviously my health has to come first. It's just such a horrible decision to make... My consultant said today that if I can't get this into remission then my surgery a year ago was pretty much for nothing - and I would agree with him. I'm even afraid of accidents again, as the urgency gets so bad!
I guess I'm just looking for some advice from you guys - anyone been in a similar position? Did using steroids locally work? (I know everyone is different though!) What would you do in my situation? I'm just feeling a bit lost...

How come you haven't had j-pouch surgery? Did you not want a j-pouch or is that a possibility for the future? Being reconnected to your rectum - even if you got it into remission - would most likely be a disaster.

Can't women freeze their eggs nowadays? I don't know anything about it, but I'd look into it as a possibility. Personally if I was in your shoes I would want surgery sooner rather than later. On the other hand, 2 weeks isn't very long - at least your consultant is acting fast, which is more than most of them do. "Here's a prescription for 1g mesalazine suppositories. Make an appointment to see me in six months' time."

I'd get that rectum out ASAP too. Sue is right, re. disease being active in that area. As far as fertility goes- I truly don't know the stats on it, but I don't recall an end ileo being much of a hindrance re. fertility. Removing your rectum doesn't seem like that would affect it much either. There are quite a few women who have end ileos & successful pregnancies. This is with your current fertility chances, with the one ovary. It would seem that ongoing chronic disease/inflammation would be more of a hindrance re. potential pregnancies. You've done so well, mentally & Physically, with the end ileo- seems like a no-brainer to get the rest of it out. Good luck! Talk with your surgeon re. fertility issues, if that's what's preventing you from pursuing it.

I'm in your boat to a degree as well SB. Had mine out right at 2 years ago and left rectum to consider JPouch. Happy with my stoma and I have young kids don't want to deal with surgery.

Anyway I had to wean off prednisone after my surgery and as soon as I got off it went nuts. I started having urgency again and ended up 8-10 running trips to the bathroom to pass blood and mucous. I went down the same path you are with limited success. My doc ended up putting me on some kind of protein enema, don't remember what it was now, but I didn't see any results with it and it burned like hades. Finally after a month or so I just said screw it and quit everything. No suppositories no enemas nothing. After about 3 days it eased up and I got into a groove and now I generally pass some stuff in the mornings when I get up, and then once more before bed with only minimal urgency.

It's not perfect, but it's still much better than when I had a colon so I'm just dealing with it. I do have to go in every 1-2 years they say for a scope, but if that keeps me from having another surgery whike my kids are young... So if you go throug all the doctor recommended items and are headed for surgery I'd recommend giving it all up for a few days to see if it will ease up, sometimes doing nothing is something.

Hope it lines out for you. Cheers