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urgency issues with Rowasa enemas?

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Ulcerative Colitis
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Posted 3/16/2010 8:27 PM (GMT 0)
I've been using the Rowasa enemas for several weeks now, but just recently I've been trying to use every night because of excessive mucous. I think I'm almost out of a flare (colonoscopy shows a small amount of active inflammation left in the lower colon).

The past couple of days I've been having urgency issues -- like the ones I used to have in the past when I've taken oral Asacol. They are usually just once a day, but always at a horrible time. Like when I'm in my car. Stuck in traffic! Absolutely awful -- and the reason I don't take mesalamine anymore. I realize the enemas are mesalamine, but I didn't expect it to cause urgency like this.

Wondering if this is just a fluke--maybe I just ate some bad food? -- or if anyone else has this similar problem with the enemas.

I was hoping to not have any side effects, because I fell like they really were helping!
Posted 3/16/2010 10:33 PM (GMT 0)
I also have urgency issues when taking mesalamine (which is why I now take my Lialda at night), but I haven't had any issues with Rowasa as long as I use it at bedtime.

I missed a dose one night so decided to use an enema in the morning and figured I'd lay on the couch for a while before leaving to run errands.  After about 20 minutes I had to bolt to the restroom.  I used the restroom 3 or 4 times before finally feeling well enough to head to the grocery store.  I got on the road and had to find a gas station within a few minutes to use the restroom yet again. 

In any case, you're not alone in the urgency dept - however if I use the enema at night I have no effects the next day.  Is that what's happening to you?

Posted 3/16/2010 10:46 PM (GMT 0)
If I use them in the morning, the Rowasa needs to be expelled - with urgency! - if I have any inflammation in there. If I'm really on the tail end (so to speak) of the flare, no issue.

I figure the urgency-to-expel is because the Rowasa is a heavier liquid than the cortenema, and I assume it's a heavier liquid because the way it works is basically topical, not by absorption like the Cort.
Posted 3/16/2010 10:58 PM (GMT 0)
     I have been having a problem holding the cort enema in.  I am so inflamed that it just bubbled right on out.  The night before last was the first time it actually stayed in, but only for a few minutes.  My doctor said that was ok as long as it can form a coating up there.  I am slowly improving.  Still have mucus and blood but the stool is better formed and the urgency is lessening.
Posted 3/17/2010 3:24 AM (GMT 0)
I have been using them at night only, and still getting the urgency issue. I'm wondering if its just that I am sensitive to mesalamine, no matter what form its in. I had problems with Pentasa, Azulfidine, Dipentum, Asacol... all of them!
I'm going to stick with these and see if it continues to be a problem. Maybe once I get closer to full remission I can taper down to just a couple a week.
Posted 3/17/2010 3:25 AM (GMT 0)
lv2Bhealthy;

I have not heard much about Lialda. Is that another type of enema? How is it working for you?
Posted 3/17/2010 5:02 AM (GMT 0)
1 Lialda = 3 Asacol.  For me they've finally worked in combination with the enemas, but it took some time for my body adjust.  Lialda makes me feel very nauseous, anxious, and (I think) increases the onset of urgency.  Taking them at night has been better.  If you're sensitive to mesalamine they likely will not agree with you, but in case you're curious there's a good tutorial video at: http://www.lialda.com/how-lialda-works.aspx
Posted 3/17/2010 2:23 PM (GMT 0)
I dont get how the enemas can cause urgency? I mean, I know you can get the feeling of wanting to expel the meds right away when you put it in but to say that it causes the symptom of urgency is hard to believe...if mesalamine is working in any other form I cant see why the enemas wouldnt help with ALL symptoms as well..
I guess our butts are all very different here LOL!
Posted 3/17/2010 3:06 PM (GMT 0)
I know, you wouldn't think I would have urgency from using an enema the night before. And its not just in the morning, sometimes the urgency happens the next day, late in the day or even the evening. I'm just wondering if since I'm sensitive to Mesalamine, maybe I cannot even tolerate it in enema form either. Surely its getting absorbed somewhat by the colon.
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