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Steroid enema right into an ileostomy

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Posted 10/18/2015 1:39 AM (GMT 0)
Boy, this has been a fun week. Got my first blockage, like, serious blockage and wound up in the ER. NG tube, sucked it out, and in the hospital for 4 days. So I have a stricture just behind the stoma that's only 5mm wide. I refused the IV/oral steroids they wanted to give me (it took me 2 years to get off steroids and that was only 3 months ago). So they gave me steroid enemas, the kind one uses rectally, and are having me insert them directly into the stoma. Has anyone done this before? I'm having a lot of trouble finding anything on the Internet about this. I was really looking for tips on how to do these things. I'm lying on my back and putting it in but it's a huge bottle and the liquid keeps spurting back out of the stoma. Any ideas? Any experience? Thank you for any help you can provide.
Posted 10/21/2015 11:47 PM (GMT 0)
I've only used the enema in the rectum. It wasn't pleasant and it really didn't work. I was told that the Corrifoam is more effective because it stays in place longer. It was much easier to insert. So maybe ask for the foam instead of the enema?
Posted 10/22/2015 11:19 AM (GMT 0)
I can't imagine an enema via your stoma would be very effective. The peristaltic waves (the way your stoma moves) is meant to push things out of your stoma not take things in - any liquid you put into your stoma is just going to be forced right back out again. Speak to your surgeon or stoma nurse and see if they can suggest an alternative medication for you.
Posted 10/22/2015 1:57 PM (GMT 0)
Thanks for the responses. The foam was suggested and then rejected since the stricture is 6cm behind the stoma and they didn't think the foam would reach that far. But yes, everything just gets pushed out because that's what peristalsis is supposed to do! I'm playing ball for a month or so until my next scope but I have little expectation that this will help.
Posted 10/22/2015 2:17 PM (GMT 0)
Like others have said, I can't see how you can possibly hope to retain a liquid enema. It's hard enough for people with UC who have voluntary control over their sphincter muscles, let alone for those who have literally no voluntary control. You would have to plug up the stoma somehow, and that doesn't seem too safe to me.

What about Entocort? It was designed to release in the terminal ileum/right-sided colon, so it should reach where the stricture is, provided you've still got all your small bowel left. Entocort is topical, so it won't have the same systemic effects that pred does (unless you stay on it for 6 months+) and should be much easier to get off.

As an aside, I'm so sorry you're still struggling with this, even after getting an ileostomy. I'm scared of the same thing happening to me if I go back to having an ileostomy. (But I'm in misery now, so...)
Posted 10/23/2015 2:29 PM (GMT 0)
Thanks, NCOT. Sorry you're still having troubles. I actually met with my surgeon yesterday and the biopsies and final scope report came back showing no evidence of Crohn's recurrence. So why the stricture? Don't know, but I don't think the steroid enema would do much if the stricture's not from inflammation.

Now they want me going in for a barium x-ray where they shoot the barium right through the stoma! Um, won't that have the same problem as the steroid enema? I expect to be mopping up a lot of barium off my stomach. They want to see if this is an anatomical issue, a kink in the intestine, or even whether the stricture is still there. So, good news, but I'm still puzzled over all these doctors' (up to 3 now) insistence that liquids get squirted into my stoma.
Posted 10/23/2015 10:50 PM (GMT 0)
Just found out today my anaemia's back and my GI's recommending I have an iron transfusion. Everything is going down the pan in more ways than one.

It's good news that you don't have Crohn's, though it's hard to see how you got a stricture otherwise. As for the barium x-ray, it seems a weird choice of test :/ I'd ask about an MRI scan. That was what I had when my GI wanted to find out if my stricture (located in the terminal ileum - I didn't have an ostomy at the time, but that shouldn't matter) was fibrotic or inflammatory - the scan suggested it was mostly inflammatory. Tbh, I could have told them that from the steroids. But yeah, steroids won't work on a fibrotic stricture that's made up of scar tissue.
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