Post Colonoscopy diagnosis

I had the "deal" done about a week ago. The new GI doc considers my colitis mild and wants to add Rowasa enema to my current meds (1,000mg colozal and 750mg canasa). He says this should work for me and get me in remission.

Thanks! I'm kind of nervous about the whole enema thing. I've never done one of those before. I have to pick it up today. Is this a daily thing or do they usually have a timeframe for enema treatments?

ok, cool. That gives me some idea of what I'm in for.

That's great news! I consider my colitis to be mild even though I was Dxd as moderate. I've read the description of mild, moderate etc online and I feel as though I fit into the mild category even though it can be stubborn at times.

I was having trouble going into remission, so my GI had me do the enemas every night for 2 months. He said even if it seems better, keep doing it every night for the full 2 months. Sure enough it worked. I had quite a few months of no symptoms at all.

He told me not to do anything less than every second or third night. Unfortunetley, I think I got a little cocky and started going for 4 and 5 nights without doing anything and I've been fighting a flare for a couple of months now.

I'm now back to every night and will continue for at least 2 months. Once you get used to the enemas, it's like brushing your teeth...just part of the routine of life. I just do a buns up kneeling position on the bathroom floor, then go lie down on my left side on the couch for at least 1/2 hour.

When the enemas work, they work really well.

Once last thing...when I used to taper I used to taper by going every second night, then third night etc. My GI suggested I taper by going from seven nights to six nights in a row, skip one night...5 nights in a row skip 2 nights. When you get to that stage, you start doing every second night...third night etc. HTH :)

fruitgirl said...
You should use the enemas until your symptoms are gone, gone, gone. All of them. Completely gone. :)
Then, you can start tapering.

I stayed on nightly enemas until I hadn't had symptoms for 2-3 weeks. Then I went to every other night for a few more weeks (can't remember exactly how many) then to twice weekly. I intend to stay at twice weekly (unless I think I'm starting a flare, when I'll jump back up to nightly) for forever. There are studies that show people who use them twice weekly stay in remission for longer than those who don't.

Would you happen to know what studies these are as I need access to them

Thanks

I'm also creating a separate thread to list the article citations and abstracts for bbc to make sure she (sorry if you're a he!) sees them, but will also post them here.  I didn't have a lot of time to search, but here are two I found:

Effect of weekend 5-aminosalicylic acid (mesalazine) enema as maintenance therapy for ulcerative colitis: results from a randomized controlled study.
Yokoyama H, et al.
Inflamm Bowel Dis. 2007 Sep;13(9):1115-20.

BACKGROUND: 5-aminosalicylic acid (5-ASA) is known to be effective in the treatment of active ulcerative colitis (UC). The aim of the current study was to investigate the effect of 5-ASA enemas, as a maintenance therapy for UC, when administered twice weekly as a weekend treatment regimen, compared to daily oral 5-ASA alone. We hypothesized that the weekend enema therapy would be better tolerated by patients who worked or attended school. METHODS: Between January 2004 and August 2005, patients with UC, in whom remission of the condition had just been induced, were randomly assigned to either: the weekend 5-ASA enema group (n=11), who received 1 g 5-ASA enemas twice a week on Saturday and Sunday plus oral 5-ASA 3 g/day for 7 days, or to the daily oral 5-ASA use only group (n=13), who received only oral 5-ASA 3 g/day for 7 days. The primary endpoint of the study was defined as the incidence of relapse. The study was stopped after 24 patients had been enrolled because an interim analysis showed a significant benefit of the weekend 5-ASA enema group. RESULTS: In the weekend enema group, 2 patients (18.2%) had relapses compared with 10 (76.9%) in the oral 5-ASA only group. The multivariate hazard ratio of relapse associated with weekend 5-ASA enema, relative to the oral alone group, was 0.19 (95% confidence interval, 0.04-0.94). CONCLUSIONS: This study demonstrated the beneficial effects of adding weekend 1 g 5-ASA enema to daily 3 g oral 5-ASA as maintenance therapy for UC.

 

Long-term intermittent treatment with low-dose 5-aminosalicylic enemas is efficacious for remission maintenance in ulcerative colitis.

Piodi LP, Ulivieri FM, Cermesoni L, Cesana BM.

Scand J Gastroenterol. 2004 Feb;39(2):154-7.

BACKGROUND: The standard remission maintenance treatment for ulcerative colitis (UC) is 5-amino-salicylic acid (5-ASA), given orally and topically and in different doses, with various frequencies and duration of administration. Both the efficacy of long-term intermittent therapy with low-dose 5-ASA enemas in preventing UC relapses and its economic implications were evaluated. METHODS: In accordance with a prospective case control study, 42 adult UC outpatients (29 M and 13 F) were treated with 5-ASA tablets (1.6 g/day) and 5-ASA enemas (2 g/50 mL) twice weekly, and 42 concurrent UC outpatients, matched for sex, age, extension and duration of disease, received only the oral therapy; the median treatment period was 6 years. RESULTS: There was a significant reduction in the number (42%: P = 0.034) and incidence of relapses (43%: P = 0.022) in the patients receiving combined oral + topical 5-ASA, who also had a significantly higher cumulative probability of not experiencing a first relapse (P = 0.001). There were no dropouts or side effects. Local therapy increased drug costs, but decreased the costs of relapses by 48% and completely precluded hospitalization costs. CONCLUSIONS: The scheduled oral + topical 5-ASA treatment, at the lowest cumulative topical dosage tested over the longest known observation period, is efficacious in improving clinical outcome and decreasing overall costs in UC patients.

 

 

 

Good you have no problems doing the enemas...hope you notice much improvement soon.

Regarding the Colazal..I'd be concerned that you're stopping the med, but can you possibly ask the doc for Asacol or other to deal with inflammation above the rectum...You're best to be on both oral/rectal....

Keep us posted as to how you're doing.

q

Hi...ah, ok...got it now.

You shouldn't need the Canasa with the enemas at this point. How is it going using the Rowasa?

q

Yup, the Rowasa can cause whitish stuff in your poo...don't worry about it!
Glad to hear the Rowasa seems to be working!